A Team Approach to Address Adolescents’ Unique Needs

Lehigh Valley Reilly Children's Hospital provides integrated physical and mental health care specifically geared to individuals between ages 10 and 25.

Hatim Omar, MD, Chief, Adolescent Medicine, notes that early referrals are key to effective care. He describes a recent patient, a 15-year-old girl who was referred by her primary care physician for irregular menstrual periods. (Omar was trained as an OBGYN; he is also board-certified in pediatrics and adolescent medicine.)

“We realized that this patient’s irregular menstruation was actually a symptom of an eating disorder,” Omar says. Over the past year, the patient had lost 18 pounds, but this weight loss hadn’t been detected at her annual exam.

By the time she was referred, she also had developed decreased bone density, putting her at risk for osteoporosis.

“If we had seen this patient six months earlier, we could have worked with her on her body image concerns, helped her realize the consequences of her actions and possibly avoided long-term health issues,” he says.

In addition to Omar, the adolescent health team at Lehigh Valley Reilly Children’s Hospital includes Maria Aramburu de la Guardia, MD; a nurse practitioner; a physician assistant; two behavioral health counselors and a dietitian.

“Our specialists are trained to detect and address the developmental and mental health issues that are contributing to the physical issues,” Omar says. “We coordinate with the patient’s primary care physician to proactively treat these underlying conditions and manage patients until they are stable.”

• Menstrual disorders
• Other gynecologic issues
• Birth control
• Eating disorders
• Depression
• Anxiety
• Adjustment disorders
• Suicidal ideation
• Autism
• Developmental delays

Omar encourages all primary care clinicians to ask adolescents about their use of social media.

He has noted a troubling rise in teenagers participating in various stunts, including the “choking game,” in which participants intentionally cut off oxygen to induce a brief high.

“Ask your patients if they’ve considered doing any of these ‘challenges,’ and talk with parents about how closely they’ve been monitoring their children’s social media usage,” he says.

Omar notes that adolescence brings about dramatic physical and emotional changes, as well as conflicts between parents and children, which may be beyond the scope of a primary care physician to address in a typical annual visit.

“If anything doesn’t seem right, we encourage physicians to refer early,” he says. “We can work with you to address the issue in a comprehensive way and create a plan for moving forward.”