Laurel Carignan was filling out some insurance paperwork in her pediatrician's office recently when she overheard a conversation between her 12-year-old daughter, who was chatting with a toddler in the waiting room, and a nurse who had just walked into the room.
"The nurse comes up to her and says, 'Are you the mom?'" recounted Carignan, whose daughter is as tall as an adult. "If you need evidence that we probably don't belong [at the pediatrician] anymore, there you go."
Luckily for Carignan and other parents, there's somewhere else to take kids who are in the phase between childhood and adulthood. A specialty known as adolescent medicine, or teen medicine, fills the gap for parents and young people who feel out of place in the brightly decorated waiting room of the pediatrician's office, but unready for the primary care physicians and specialists who see mostly adults.
Adolescent medicine is an official sub-specialty of pediatrics, with board certification. But it's relatively little-known, and has only about 500 board-certified practitioners around the country, said Margaret Blythe, an adolescent medicine specialist who is chairwoman of the adolescent committee for the American Academy of Pediatrics.
The specialty has its own association: the Illinois-based Society for Adolescent Health and Medicine, which aims at care for young people ages 10 to 25, and carries out education, research, clinical services and advocacy activities.
SAHM issues position papers on topics that affect adolescents such as sexually transmitted diseases, vaccinations, and nutrition that are of particular interest to doctors who care for young people.
Some regular pediatricians make a point of talking with teenage patients without parents or caregivers listening in, but those private chats between doctor and patient are an essential component of adolescent medicine.
"We always spend time alone with the teen," said Blythe, a professor of pediatrics at Indiana University School of Medicine in Indianapolis.
Parents are sometimes surprised to find themselves on the other side of the exam room door, but most accept the time has come for their child to talk to the physician alone, Blythe said.
A waiting room for an adolescent health specialist can make the patient feel more at home with pamphlets and brochures about health topics such as risky behavior, sexuality, and mental health.
One important difference is that adolescents are growing rapidly and reaching puberty, a time of enormous change.
Mental health is also another big topic in adolescent medicine; one in five young people has a mental health problem, such as depression, anxiety, or an eating disorder, that needs to be addressed, Blythe said.