Most generalists reluctant to provide primary care for young adults with chron...(of the Journal of General Internal Med...),Health

Advances in medical treatments have significantly extended the life expectancies for patients with chronic conditions such as CF and SCD, which had previously been fatal in early childhood, according to Okumura. Consequently, the prevalence of chronic illness among young adults has also significantly increased. Up to 30 percent of children today report having some sort of chronic condition, she said.

"The technology has been remarkable in keeping people alive. What we are so lacking in is how to keep taking care of them and give them the health services they need to have productive lives," Okumura added.

To effectively meet the needs of the growing adult population living with chronic conditions, experts now recommend that young adults begin transitioning from child-focused to adult-oriented primary health care when they are 14 years old. However, according to Okumura, the study findings indicate that generalists are not yet prepared to handle the wave of individuals with chronic conditions needing primary care, and this could have a negative impact on the patients' care overall.

"Generalists are the primary caretaker and safety-net for people with chronic disease. They are there to help any patient who walks through their door, and it's up to them to figure out which subspecialist to recommend and what other resources are necessary for their healthcare," Okumura said. "I consider them the foundation of health care, and when that falls apart the entire health system becomes fragmented and it becomes difficult to provide high quality care."

A total of 1288 physicians responded to the survey, which was issued by mail to equal numbers of general internists and general pediatricians between October 2005 and March 2006. Of those who responded, 537 were internists and 751 were pediatricians.

Each physician randomly received one of two survey versions one
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