The American Medical System Fails Patients With ADHD: A Call to Action

Charles P. Vega, MD


April 09, 2014

In This Article

Attention, Medical Community

ADHD is common and debilitating, but it can be treated successfully in adults and children. Why is there so much disparity in the diagnosis and treatment of ADHD? A study from Great Britain clearly identified skeptical and negative physician attitudes as adding to the already tremendous burden of ADHD.[21] The proportion of pediatricians who might treat ADHD was 65% in one study, and adult primary care physicians are even less educated about and inclined to manage ADHD.[22,23]

This is not acceptable. As a medical community, we need to take ownership of the complete care of our patients and understand that ADHD may affect as many as 1 of every 20 patients that we see. That means that we need to identify ADHD in patients with symptoms and support their treatment on a continuous basis, particularly in the transition between adolescence and adulthood. But it is not just physicians. The infrastructure to support the care of millions of individuals with ADHD is far from adequate; we need to emphasize not only pharmacotherapy but parent training and psychotherapy to help patients and their families overcome ADHD and lead better lives.

Clinical Pearls

Estimates of ADHD prevalence vary, but it appears to affect more than 5% of children and a lesser percentage of adults in the United States.

ADHD is associated with high rates of comorbid mental illness and worse quality of life among children. ADHD also promotes worse school performance.

Approximately half of children and adolescents with ADHD have persistent disease into adulthood, when ADHD may interfere with family and work life.

The current study demonstrates large disparities in the treatment of ADHD based on geographic location in the United States, with the most profound differences encountered at the state and county level.

Treatment for ADHD can improve behavior and school performance among children, and employment and other important social outcomes among adults.

Physicians need to accept the evidence for the diagnosis and treatment of ADHD to reduce regional disparities and improve health outcomes for children and adults.


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