Adolescent medicine

Adolescent medicine or hebiatrics is a medical subspecialty that focuses on care of patients who are in the adolescent period of development, generally ranging from the last years of elementary school until graduation from high school (some doctors in this subspecialty treat young adults attending college at area clinics, in the subfield of college health). Patients have generally entered puberty, which typically begins between the ages of 11 and 13 for boys.

In developed nations, the period of adolescence is extended both by an earlier start, as onset of puberty is beginning earlier, and a later end, requiring more years of education or training before economic independence from parents.

Issues with a high prevalence during adolescence are frequently addressed by providers. These include:

Adolescents who are gay, lesbian or bisexual tend to demonstrate more risky health behaviors and have worse health outcomes compared to heterosexual youth, including:

The rising dominance of chronic conditions over acute conditions, along with dramatic improvement in life expectancy, has made the management of such chronic conditions in adolescence of greater importance: Chronic conditions and adolescent development are mutually impactful.

Chronic conditions often cause delay in onset of puberty and temporary or permanent impediments to growth; conversely the growth and hormonal changes can destabilize treatment for the chronic condition. An increase in independence can lead to gaps in self-management, for example, in the decreased management of diabetes.

In addition, issues of medical ethics, particularly related to confidentiality and the right to consent for medical care, are pertinent to the practice of adolescent medicine.

Adolescent medicine providers are generally drawn from the specialties of pediatrics, internal medicine, med/peds or family medicine. The certifying boards for these different specialties have varying requirements for certification, though all require successful completion of a fellowship and a passing score on a certifying exam. The American Board of Pediatrics and the American Board of Internal Medicine require evidence of scholarly achievement by candidates for subspecialty certification, usually in the form of an original research study.

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