Adolescent Medicine focuses on care of patients who are in the adolescent period of development. Patients have usually entered puberty, typically begining between the ages of 9 to 11 for girls, and 11 to 13 for boys. As a primary care subspecialty, adolescent medicine incorporates aspects of psychiatry, endocrinology, sports medicine, nutrition and gynecology. Adolescent Medicine doctors are generally drawn from Pediatrics, Internal Medicine or Family Medicine. The certifying boards for these specialties have differing requirements for certification, however all require successful completion of a “fellowship’ and a passing score on a certifying exam.
Issues with a high prevalence during adolescence include:
- Birth control
- Sexually transmitted disease
- Menstrual disorders
- Eating disorders
- Unintended pregnancy
- Substance abuse
Most Adolescent Medicine doctors take a holistic approach to the patient, and attempt to obtain important information pertinent in several areas. They use the “HEADS assessment,” which is a screening acronym for adolescent patients. It includes:
- Education (or Employment)
Some doctors favor the addition of Strengths to the list, in an effort to avoid focusing on issues of risk or concern, and to reframe the patient interaction in a manner that highlights resilience. In addition to a detailed history, adolescents should have a comprehensive physical exam on a yearly basis. In addition, developmental progression should be considered with appropriate endocrinological work-up if needed, as well as screening lab tests, screening tests for sexually transmitted diseases for the sexually active, and pelvic exam (including a Pap’s smear) for sexually active females.