Adolescent Doctor Visits
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.
Who Should My Adolescent See for Healthcare?
Some families wonder who their adolescent should see for primary care. A pediatrician? Family doctor? Obstetrician/gynecologist? 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. Obstetricians and gynecologists are an appropriate choice for young women who are planning to become or are already sexually active. Internists are primarily doctors for adults and are a good choice for adolescents without a pre-existing pediatrician or family doctor. The personal and professional qualities of a doctor, and their skills in working with young people (and parents) are generally far more important than their title.
What Will Happen at an Adolescent Health Check?
Adolescents should visit their primary care physician at least every other year for a basic physical examination and preventive healthcare guidance. The American Academy of Pediatrics and some other organizations recommend annual visits. Such visits should be expected to include the following:
- Measurements of height, weight, and blood pressure
- Monitoring of general growth and pubertal development
- Discussion of school performance, peer relationships, and future plans
- Risk assessment and preventive guidance regarding mental health, injury, substance use, sexuality, contraception, sexually transmitted diseases, nutrition, exercise, and sports participation
- Screening tests for vision, hearing, and ]]>scoliosis]]>.
- Immunizations/boosters for ]]>tetanus]]>, acellular pertussis, ]]>influenza]]>, and for some adolescents, ]]>meningococcal disease]]>, and ]]>human papilloma virus]]>.
- 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
- Adolescent females who are becoming sexually active should be tested for sexually transmitted diseases.
Should I Stay in the Room During My Adolescent’s Healthcare Visit?
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 healthcare provider. 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. Still, it is important for teenagers to begin developing their own relationship and rapport with their healthcare provider, separate from the relationship that may exist between their parents and the healthcare provider.
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.
What Are the Laws Regarding Confidential Healthcare Treatment 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 healthcare providers—like some parents—do not feel comfortable maintaining the confidentiality of their adolescent patients. It is important to ascertain whether your adolescent’s healthcare provider feels certain that she can effectively and confidentially care for your adolescent.
Numerous studies have shown that, if the ultimate goal of both the parent and the healthcare provider 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 healthcare provider should be candid and truthful about the need to break confidentiality if the teenager discloses information that suggests he is in real danger.
If your healthcare provider cannot assure basic confidential healthcare for your adolescent, ask for information about an adolescent health clinic or other source of reliable, good, confidential healthcare.
How Can a Good Relationship With a Healthcare Provider Be Helpful to My Adolescent?
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 healthcare provider can be an important part of a healthy lifestyle, monitoring the health of the teenager’s growing and changing body and mind, providing a listening ear while the teenager navigates the stormy seas of adolescence, and encouraging the adolescent to make safe and healthy choices.
American Academy of Pediatrics
Planned Parenthood Federation of America
Society for Adolescent Medicine
Canadian Association of Family Physicians
Canadian Public Health
Adolescent medicine. Johns Hopkins: The Harriet Lane Handbook: A Manual for Pediatric House Officers. 16th ed. Mosby, Inc; 2002.
The Childhood and Adolescent Immunization Schedule website. Available at: http://www.cdc.gov/nip/acip.
Confidential healthcare for adolescents: a position paper of the Society for Adolescent Medicine. J Adolesc Health. 1997; 21:408-415.
Confidentiality in adolescent healthcare: policy statement. American Association of Pediatrics website. Available at: http://www.aap.org/policy/104.html. Accessed August 28, 2003.
Delivery of healthcare to adolescents. Behrman: Nelson Textbook of Pediatrics. 16th ed. WB Saunders Company; 2000.
Timing of primary and preventive healthcare visits for female adolescents. American College of Obstetrics and Gynecology through Medem website. Available at: http://www.medem.com/. Accessed August 28, 2003.
Your child’s physical: what to know before you go. Mayo Clinic website. Available at: http://www.mayoclinic.com/. Accessed August 28, 2003.
Sawaya GF. Cervical-cancer screening--new guidelines and the balance between benefits and harms. N Engl J Med. 2009 Dec 24;361(26):2503-5.
Last reviewed November 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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