What to Expect at Your Teenager’s Next Checkup!

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Victoria just turned 15. She and her mother head to the pediatrician’s office for her annual checkup. The visit starts with the doctor’s questions about Victoria’s recent cold symptoms, family trip to Florida, overall health, and school performance. The doctor then asks to speak to Victoria alone… Victoria’s mom is embarrassed and angry…Her daughter is a good kid; there isn’t anything her daughter can’t say in front of her. The pediatrician is polite but insists that Victoria’s visit should include some confidential time. The doctor explains…
“Confidential care for teenaged patients teaches them responsibility”.
Confidential care promotes age appropriate responsibility. Speaking alone with the doctor allows teenagers to actively participate in their healthcare as well as reinforces the idea that they are responsible for many of the behaviors that may affect their health. It recognizes their growing independence and allows them to build a relationship with their care provider and begins the gradual process of transitioning health care responsibility and knowledge from the parent to the young person.
“Confidential care promotes safety and healthy choices for teenagers”.
When assured of confidential care, teenagers may be more likely to bring up a topic or issue that could negatively impact their health. It also allows doctors to gather complete and candid health care information as young people find it easier to discuss sensitive or difficult health concerns in a confidential setting. Doctors also offer a safe, secure, and accurate source of information regarding the teenagers’ developing bodies and health needs.
“Confidential care is recognized as the standard of care for teenagers”.
Most medical professional organizations including American Academy of Pediatrics, the American Medical Association, and the World Health Organization recommend confidential care for adolescent patients. As stated in the Society for Adolescent Health and Medicine position statement in 2004, “Confidentiality protection is an essential component of health care for adolescents, because it is consistent with their development of maturity and autonomy and without it, some adolescents will forgo care”.
Victoria’s mom wonders if this means she will not be made aware of all of her daughter’s medical problems and treatments. The doctor clarifies…
“Confidential care is closely related, but not identical to, the ability of teenagers to consent.”
The age of 18 is recognized as the age of maturity for consent to most medical and surgical procedures in all US states, including Indiana. This applies to most general medical issues – for example, childhood vaccines. However, adolescents under the age of 18 can provide their own consent to specific types of medical care. These generally include: 1) testing and treatment for sexually transmitted infections;2) family planning services and birth control; 3) drug and alcohol abuse treatment; and 4) emergency services for sexual assault.
Victoria’s mom continues to wonder just what her daughter and the doctor will talk about behind closed doors. The pediatrician reassures her…
Once alone with the doctor, teens are given the opportunity to ask any questions they may have been embarrassed to ask in front of their family. The doctor also has the opportunity to ask more sensitive questions about dating and relationships, sexual experiences, exposure to drugs and alcohol, feelings of depression or anxiety, and the young person’s safety at home, at school, and in the car. If the doctor identifies health concerns during this confidential time, they stress the importance of involving the teen’s parents in further discussions and treatment plans. Doctors are then willing to facilitate conversations between the young person and their parents about difficult topics. At the end of each visit, the family, teenager, and doctor reconvene to discuss diagnosis, treatment, and follow up plans together.
Victoria’s mom felt excluded from the medical visit.
The pediatrician explained that she encourages young people and parents to have conversations about these sensitive issues. She suggests that Victoria’s mom simply listen to her daughter’s concerns as a way to begin the conversation. Teenagers feel valued when they know that their opinion matters to the adults in their life. The pediatrician reassured Victoria’s mother that, despite what it feels like at home, young people do care about what parents think, and are interested in the parents’ experiences with these difficult topics. Research shows that teens are more likely to trust information on sensitive topics like sexual health received from family than information received from peers or the internet.
Hmmm. Victoria’s mom wonders if visits to the doctor’s office will generate questions on topics that are difficult to answer. The doctor offers some tips: (adapted from Tips for Parents, the National Campaign to Prevent Teen Pregnancy @ www.thenationalcampaign.org/parents/ten_tips.aspx):
1. Be clear about your own attitudes and values. Despite what you think, you teen is interested. Teens are particularly interested in your own experiences with dating and relationships. Decide if and what you are willing to share.
2. Talk with your adolescent early and often about sex, and be specific. Many short conversations starting at 12-14 years of age are more effective than a “big talk” when the adolescent wants to start dating. See #9 below for hints on “how to.”
3. Listen to what your adolescent is saying. Their concerns may be different than yours.
4. Spend time around your adolescent – try and be at home when they are, volunteer at school events, allow them to have friends over when you are around. Time together not only allows you to supervise and monitor your adolescent, but it also lets them know that you are available to them, and that you are concerned.
5. Know your adolescent’s friends and their families.
6. Discourage early, frequent, and steady dating, and take a strong stand against your adolescent dating someone significantly older or younger than they are.
7. Help your teenagers to have options for the future that are more attractive than early pregnancy and parenthood. Let your kids know that you value education highly.
8. Know about what your children are watching, listening to and reading. Watch TV and movies with them. Read the books they are reading. Keep computers in common areas. Media can be a great way to start conversations. If a couple in a movie talks about sex, you can ask your teen what they think about it, or, for the older teen, how the couple should handle pregnancy and STD prevention. Then listen to what they are saying.
9. Above all, stay connected. These first nine tips for helping your children avoid teen pregnancy work best when they occur as part of a strong, close relationship with your adolescent that is built from an early age.