Most generalists reluctant to provide primary care for young adults with chron...( The majority of general internists a...),Health

The majority of general internists and pediatricians in the United States are not comfortable serving as primary care providers for young adults with complex chronic illnesses that originate during childhood, according to findings from a new national survey.

The survey, conducted by researchers at the University of California, San Francisco and the University of Michigan, examined a random sample of internists and pediatricians to assess their comfort levels in treating young adult patients with cystic fibrosis (CF) and sickle cell disease (SCD) two hereditary diseases that involve single gene mutations.

"My interest is in how to improve the quality of care for youth and young adults with childhood onset chronic diseases," said Megumi Okumura, MD, lead author of the paper who is an assistant professor in pediatrics at UCSF and treats patients at UCSF Children's Hospital. "These individuals are a unique bunch, because they are born with their diseases, and the health care services they receive as children are not necessarily matched in the adult health care setting."

Survey findings showed that only 15 percent of the general internists said they would be comfortable providing primary care to young adult CF patients, while 32 percent reported being comfortable providing care for those with SCD. Among the pediatricians surveyed, 38 percent said they would be comfortable serving as the primary care provider for CF patients, while 35 percent said the same for treating patients with SCD.

Both the internists and pediatricians reported that they would be more comfortable treating young adults with common diseases, such as asthma and hypertension, than treating patients with a history of CF and SCD.

Findings from the survey are currently available online at http://www.springerlink.com/content/rj738l32700m35k1/ and will be published in the October issue
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