As specialists in Adolescent-Young Adult Medicine, we merge our broad-based medical expertise, of fields including allergy, dermatology, endocrinology, gastroenterology, gynecology, infectious disease, neurology, nutrition and sports medicine, with our knowledge and experience working with patients during the dramatic maturational stages of adolescence and young adulthood.
Specialized care addresses various serious and/or complex health needs of adolescents and young adults. Specialized care requires the additional training, expertise and experience of doctors trained and certified in adolescent-young adult medicine. Many of our patients initially come to our practice because they have a serious or complex health problem. Sometimes one of our established primary care patients develops a problem that requires, and can significantly benefit from, the specialized healthcare available at our office.
Anorexia nervosa, bulimia nervosa, binge eating disorder, and other difficulties with thoughts and behaviors related to body image and food are relatively common concerns among adolescents and young adults. Each young person with such a problem is unique, yet all patients benefit from healthcare related to physical, nutritional, emotional and social factors linked to their eating difficulties.
In our practice, we work very pro-actively with our patients who struggle with eating disorders. Most of our patients are treated solely by an “out-patient team” comprised of their medical doctor (one of us) and a psychotherapist (psychiatrist, psychologist or licensed social worker). Some patients also work with a registered dietitian (nutritionist) as part of the team.
Our role is to evaluate and treat any medical complications associated with the eating disorder and to engage our patient in “nutritional rehabilitation” to help him or her achieve and maintain a healthy weight, optimal metabolism and overall health and wellbeing. We serve as the “coordinator of care,” and when necessary, arrange for a patient to receive more intensive care in a day program or residential/in-patient setting.
For information on eating disorder treatment, please download our clinical handout on The Treatment of Eating Disorders: Information Guide for Our Patients and Families (PDF)
Adolescents and young adults who are overweight or obese may welcome guidance, strategies and support, yet do not always directly ask for such help. We recognize that for many young people nutritional concerns have been a lifelong struggle and they feel previous attempts to manage their weight have failed. We certainly hope that we can help!
As medical doctors, we diagnose and manage any medical or metabolic conditions that may be related to overweight or difficulty with weight loss, and on occasion, we prescribe medication. Our approach is individualized for each patient and family, addresses new strategies for dealing with particularly difficult times of the day or situations, includes attention to emotional triggers to overeating, emphasizes healthy and satisfying meals and snacks, and encourages activities which are both physical and fun.
The readiness to begin to work on nutritional concerns may be immediate for some, or develop more slowly for others, so we are always available to step in at the appropriate time. Our goal is to assist in achieving a healthy lifestyle and maximize the physical, emotional and social wellbeing of our each patient.
For "15 health tips for everyone," please download Feel Healthy, Be Healthy (PDF).
Adolescence and young adulthood are viewed as the “healthiest” times of life, when serious medical disorders are relatively uncommon; yet many young people do suffer from physical symptoms such as excessive fatigue, dizziness, headaches, or pain in the abdomen, chest, or back. Besides causing discomfort, such symptoms interfere with their sense of wellbeing, create anxiety and worry, and sometimes affect attendance at school, work or social activities.
As medical doctors, our role is to take a detailed history, do a complete physical examination and obtain the appropriate tests to fully evaluate our patient’s symptom. We also address the “three health basics” of nutrition, sleep and exercise, as well as any particular stressors that may exist at school, with peers or in the family that contribute to how a person feels. We then take an active role in the treatment of the symptom, which may involve consultation with a medical sub-specialist, nutritionist, or psychotherapist.
For "15 health tips for everyone," please download Feel Healthy, Be Healthy (PDF).
For our female patients, various questions and concerns often arise related to menstruation, vaginal hygiene and discharge, breast development or lumps, and urinary symptoms. Although we are not gynecologists, and do not perform gynecologic surgery, we are experts in the diagnosis and office management of the gynecologic disorders of adolescent girls, especially those that present in the pre-teen and early adolescent years. Among the most common concerns are those related to menstruation; periods which last too long, occur too frequently or infrequently, are too heavy or light in flow, or are very painful and/or associated with annoying pre-menstrual symptoms.
Adolescence is a time of rapid and dramatic growth and development that transforms the body from that of a child to that of an adult over a span of only a few years. Each adolescent grows and develops at his or her own time and pace. The range of normal is wide for the onset and progression of pubertal development, growth in height and weight, and for girls the onset of menstruation. The early or late developer may feel worried or unhappy about being a little bit different from most of his or her peers. For any adolescent, even those who develop at the “average” time, the transformation of their body is something they have to get used to. Puberty and growth are impacted by genetics, nutrition, amount of exercise, even stress. In some situations we may feel it is necessary to perform laboratory tests to learn more about why a teen’s growth and development are unusually precocious or delayed.
As part of providing preventive health care and anticipatory guidance to our patients, we regularly ask about their exposure to or use of cigarettes, alcoholic beverages and/or drugs (including un-prescribed prescription and “street” drugs). Our role is to counsel our patients regarding the risks of using these substances, and to address with each patient the concerns we and he/she may have regarding such use. For patients who smoke cigarettes, we hope to help them quit. With respect to alcohol use we consider the age, maturity and judgment of each patient. Illicit drug use is a very serious concern that may require referral for care with a psychotherapist or substance abuse specialist.
The daunting developmental tasks of adolescence and young adulthood are to achieve a high level of independence and autonomy, a social and sexual identity which allows for enjoyment and intimacy, and clarity regarding one’s place in society as a contributing adult within the context of a family and/or career. Therefore, the stages of adolescence and young adulthood are fast-paced, present high expectations for growth and change, and demand frequent adaptation to new situations.
Health problems may arise when an individual is having difficulty in some part of his or her “world,” such as stressors at home; disappointment in a relationship with a friend which is intense or romantic; or major challenges at school or at work. Not infrequently, difficulty in one part of this world impacts on another part, which then compounds the distress that a person feels and may present as a physical symptom, trouble with eating or sleeping, or mainly affect one’s mood and result in sadness, depression and/or anxiety.
At such times, we offer our patient an opportunity to meet with us for “counseling,” to begin to talk about and gain insight into their difficulty, problem-solve their particular situation, and hopefully reduce their stress level. If the problem is severe, persistent or complex, we refer our patient for additional evaluation and/or treatment with an appropriate mental health professional. In collaboration with a mental health colleague who knows our patient well, but is not a physician, we may prescribe medication for a mood disorder, attention problem (ADD or ADHD), or sleep difficulties.