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.
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.
Adolescents should visit their primary care physician on a regular basis. The American Academy of Pediatrics and some other organizations recommend annual visits. When you make the visit you can expect the usual steps you experience at your visits such as:
As children get older and move into adulthood, the doctor visits will start to include:
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.
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 she 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 he is in real 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.
American Academy of Pediatrics
Society for Adolescent Medicine
Canadian Family Physician
Canadian Public Health
Adolescence 11 to 21 years. Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents. Available at: http://brightfutures.aap.org/pdfs/Guidelines_PDF/18-Adolescence.pdf. Accessed December 6, 2012.
The Childhood and Adolescent Immunization Schedule website. Available at: http://www.cdc.gov/nip/acip.
Confidentiality in Adolescent Health Care. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/Departments/Adolescent%20Health%20Care/Teen%20Care%20Tool%20Kit/ACOGConfidentiality.pdf?dmc=1&ts=20121206T1617156730. Accessed December 6, 2012.
Finding the Right Pediatrician for Your Teen. American Academy of Pediatricians Healthy Children website. Available at: http://www.healthychildren.org/English/family-life/health-management/Pages/Finding-the-Right-Pediatrician-for-Your-Teen.aspx. Updated December 29, 2011. Accessed December 6, 2012.
Hardoff D. Legal and Ethical Issues in Adolescents' Health Care. Georgian med News. 2012;(210):18-23.
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.
Tebb K, Hernandez, LK, Shafer MA, et al. Understanding the Attitudes of Latino Parents Toward Confidential Health Services for Teens. J Adolesc Health. 2012;50(6):572-577.
Thrall JS, McCloskey, L, et al. Confidentiality and Adolescents' Use of Providers for Health Information and for Pelvic Exams. Arch Pediatr Adolesc Med. 2000;154(9):885-892.
Last reviewed December 2012 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.
Copyright © 2012 EBSCO Publishing All rights reserved.
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