This time of year my office is filled with young adults seeking their pre-college physical.

Beyond simply checking off boxing on a mandatory form, I also like to make sure that my college-bound patients are feeling well both mentally and physically, and that they have adequate supplies of any medications they may be taking. Every student who is a patient of mine has my e-mail address, and they all know how to contact me.

Nevertheless, when they leave for college, my patients are facing a brave new world of medical care, beyond the reach of their parents or family doctor. Times are changing, and the health care offered at college is spottier than ever before and more unpredictable. Colleges are overwhelmed by the cost and liability of providing primary care.

Given this stark reality, I encourage my student/patients to pack a First-Aid kit, and to go to school with a complete medical history. I encourage parents to open up a dialogue with their child about potential alcohol, drug use, and depression, since these are by far the biggest health concerns.

Here is what college students face these days in terms of medical facilities:
• Most universities no longer have overnight beds for sick students. The cost is just too high. According to a 2009 survey by the American College Health Association, only 10 out of 170 schools studied have an infirmary. These schools include Brown University, Princeton, Yale, Harvard and Dartmouth. Cornell, Columbia, and the University of Pennsylvania (along with a majority of colleges) now redirect students in need of medical attention to outside facilities.

• Some hospitals near universities have hired nurses to tend to students who come in.

• Most campuses still maintain health clinics for students during the day, and have strategies for emergencies at night. Many have nurses and doctors on-call at night.

• Schools are places where germs are exchanged rapidly as students sit close together and socialize. Handwashing is important but is frequently ignored. Common problems seen in college health clinics include alcohol and drug intoxication, sore throats, colds, flu, rashes, injuries, STDs and depression.

Bottom line: The more preparation you do in advance of your child going away to college, the better. The more healthy communication you have with your child while they are away the better for their health. Remember, your child’s college is not in another solar system, though it may seem to be on another planet.

Dr. Marc Siegel is an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a member of the Fox News A Team and author of "The Inner Pulse; Unlocking the Secret Code of Sickness and Health."