MAY 2009


Residency-based program eases transition for adolescents with chronic, complex illnesses

As many as 60 percent of patients with chronic or complex medical problems experience gaps in medical care, health insurance coverage or both during their transition from adolescence to adulthood. The UCLA Med-Peds Transition Care Program helps to prevent these patients from falling through the cracks by providing patient medical assessments and referrals to primary-care physicians and specialists who care for adult patients. The program also provides assistance in obtaining appropriate adult health insurance coverage, patient self-care education and connections to educational and vocational training resources in the community. The UCLA program is unique in that it is run by medical residents with faculty supervision.

“Information about insurance coverage or community-based services is really important in the lives of our patients, but they’re not particulars most of us have traditionally learned about in medical school or in residency rotations,” explains Debra Lotstein, M.D., M.P.H., the program’s medical director. “It’s a newer part of the curriculum to have residents really understand the healthcare system.”

From left to right: Debra Lotstein, M.D.,
Ron Lopez, Monica Mau, M.D.

During their four-year residency, each of the 16 medical residents trains under the supervision of three faculty members, who are board-certified in both internal medicine and pediatrics. They also work closely with a program coordinator and social workers from other pediatric services within UCLA Health System. The residents receive comprehensive training in treating a complex patient population, primarily aged 15 to 25 years, with either one major medical problem or with multiple chronic illnesses, which requires multidisciplinary services from many types of clinical and non-clinical providers and resources.

“While it can be challenging to address patient care issues often considered outside the scope of medical care,” notes Dr. Lotstein, “it is also rewarding to see patients appreciate our support and to see residents get excited to learn more about the different aspects of care.”