Neinstein says he doesn't foresee adolescent health clinics popping up on every corner. But, he says, "one of the key roles for adolescent medicine is these special units, say at a Kaiser or at a university center, where we're going to teach pediatricians or internists or family practitioners so that they can ask questions and feel comfortable dealing with teens."
Another way to reach teens is through health clinics at schools. Childrens has operated a pioneering health clinic for two years at Los Angeles High School.
"I think it has been very successful in getting teens in who would not have had access to health care," Neinstein says.
Still, in an era of shrinking health-care dollars, a major question remains whether such programs are cost-effective. Klitsner says Kaiser is researching whether focusing now on teen-agers' health pays off later.
"Hopefully," says Klitsner, "we'll find out we're doing some good."
What the Doctors Think
One of the arguments for the development of adolescent health programs and clinics is that many physicians aren't particularly comfortable around teen patients.
Researchers asked a group of Southern California physicians likely to see adolescents whether they like working with teens. Specialty: Percent who like working with teens Pediatrics: 31.1% Internal medicine: 34.1% Obstetrics-gynecology: 50.6% Family practice: 61.2% Adolescent specialty: 100%
Source: Dr. Irving N. Klitsner, Kaiser Permanente Adolescent Health Center.