With or without justification, many adolescents consider themselves to be adults, capable of choosing their own paths and making their own choices. However, when it comes to adolescent healthcare, parents should continue to be actively involved in the choice of providers and settings.
Finding the Right Doctor
Some families wonder who their adolescent should see for primary care. A pediatrician? Family doctor? Internist? The truth is, there is no single right answer.
Most pediatricians will continue to see children throughout their adolescence, and sometimes even through college. Family doctors see patients at all stages of life, from babyhood to old age. Internists are primarily doctors for adults and may be a good choice for older adolescents without a pre-existing pediatrician or family doctor.
Remember that the personal and professional qualities of a doctor, and their skills in working with both of you are far more important than their title.
The Adolescent Health Check
Adolescents should visit their primary care physician on a regular basis. The American Academy of Pediatrics and other organizations recommend annual visits. When you make the visit, you can expect:
- Measurements of height, weight, and blood pressure
- Monitoring of general growth and pubertal development
- Screening tests for vision and hearing if there are problems
- Any needed immunizations or boosters
- Evaluation relevant to chronic medical conditions (asthma, diabetes, high blood pressure, elevated cholesterol, acne, depression, among others) indicated by family history, past medical history, or findings on examination
As children get older and move into adulthood, the doctor visits will start to include:
- Discussions of school performance, peer relationships, and future plans
- Risk assessments and preventive guidance regarding mental health, injury, substance use, sexuality, contraception, sexually transmitted diseases, nutrition, exercise, and sports participation
- Immunization for human papillomavirus (HPV)
- Testing for sexually transmitted diseases in those who are sexually active
Private Time
Although young children need their parents in the room for reassurance and to provide good medical history information, adolescents need some private time alone with their doctor. Some parents feel concerned about this private time, imagining that this time is being used to divulge secrets of the teen’s sexuality or drug use. In the end, teenagers have to begin developing their own relationship and rapport with their doctor, separate from the relationship that may exist between their parents and the doctor. Empowering a child with health responsibility may also encourage them to adopt healthier behaviors.
Furthermore, while some parents do not like to imagine that their children have secret or private aspects to their lives, it is important that the teenager has some time to ask questions or discuss concerns that might be hard to talk about in front of a parent.
Confidential Healthcare Treatment Laws for Adolescents
Laws about an adolescent’s right to obtain healthcare without parental consent are set by individual states. Most adolescents receive this right, though only for certain medical concerns or conditions, between the ages of 12 and 15. They are then able to obtain healthcare without parental consent for sexually transmitted disease, pregnancy, substance abuse, and mental health.
Although state laws address the rights of adolescents to confidential healthcare, some doctors—like some parents—do not feel comfortable maintaining the confidentiality of their adolescent patients. It is important to ascertain whether your adolescent’s doctor feels certain that they can effectively and confidentially care for your adolescent.
Numerous studies have shown that, if the ultimate goal of both the parent and the doctor is the good health and safety of the adolescent patient, then assurance of confidentiality is crucial to the vast majority of adolescent patients. On the other hand, the doctor should be candid and truthful about the need to break confidentiality if the teenager discloses information that suggests danger.
If your doctor cannot assure basic confidential healthcare for your adolescent, ask for information about an adolescent health clinic or other source of reliable, good, confidential healthcare.
Adolescence is a crucial time for good healthcare. Because both the temptations and the obligations of the larger world are increasingly available to these young people, every adolescent can benefit from supportive adult relationships to help guide them through this exciting, but tumultuous period. A supportive doctor can be an important part of a healthy lifestyle. Providers monitor the health your teen's growing and changing body and mind, lend a listening ear while your teen navigates the stormy seas of adolescence, and encourage your teen to make safe and healthy choices.
RESOURCES
Healthy Children—American Academy of Pediatrics https://www.healthychildren.org
Society for Adolescent Health and Medicine http://www.adolescenthealth.org
CANADIAN RESOURCES
Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca
Public Health Agency of Canada http://www.phac-aspc.gc.ca
References
ACOG Committee Opinion no. 599: Committee on Adoscent Health Care: Adolescent confidentiality and electronic health records. Obstet Gynecol. 2014;123(5):1148-1150. Reaffirmed 2016. Available at: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Adolescent-Confidentiality-and-Electronic-Health-Records.
Adolescence 11 to 21 years. Bright Futures—American Academy of Pediatrics website. Available at: https://brightfutures.aap.org/materials-and-tools/tool-and-resource-kit/Pages/adolescence-tools.aspx. Accessed December 12, 2016.
Finding the right pediatrician for your teen. Healthy Children—American Academy of Pediatricians website. Available at: https://www.healthychildren.org/English/family-life/health-management/Pages/Finding-the-Right-Pediatrician-for-Your-Teen.aspx. Updated November 21, 2015. Accessed December 12, 2016.
Hardoff D. Legal and Ethical Issues in Adolescents' Health Care. Georgian med News. 2012;(210):18-23.
Recommendations for preventive pediatric healthcare. American Academy of Pediatrics. Available at: http://pediatrics.aappublications.org/content/suppl/2007/12/03/120.6.1376.DC1/Preventive%5FHealth%5FCare%5FChart.pdf. Accessed December 12, 2016.
Sawaya GF. Cervical-cancer screening—new guidelines and the balance between benefits and harms. N Engl J Med. 2009;361(26):2503-2505.
Tebb K, Hernandez, LK, Shafer MA, Eyre SL, Otero-Sabogal R. Understanding the attitudes of latino parents toward confidential health services for teens. J Adolesc Health. 2012;50(6):572-577.
Thrall JS1, McCloskey L, Ettner SL, Rothman E, Tighe JE, Emans SJ. Confidentiality and adolescents' use of providers for health information and for pelvic exams. Arch Pediatr Adolesc Med. 2000;154(9):885-892.