Ready to help your teen gain health independence? Step 1: leave the exam room

Alone time between a teen patient and doctor can be beneficial to the child’s long-term health

Teen transition to adult healthcareAs parents, everything concerning our child’s health concerns us. We are the ones who take them to the doctor for that first shot, first fever and first broken limb. We naturally always want to be there, so it can be nerve-wracking to let our kids begin to take the lead at health visits, especially the first time we are asked to leave the exam room.

As our children grow up to be adolescents, it’s clear that they aren’t always comfortable talking about their bodies and health with us in the room. Despite this, we still may be hesitant to leave. Some parents may be concerned that their child is keeping secrets from them, or that the doctor may give their child guidance they don’t agree with. Other parents may just want to feel like they’re “in the loop.”

If you have trouble letting go of the reins at your teen’s health visits, you are not alone. Nearly 40 percent of parents say that they – not their teen – ask questions about the child’s health issues with the doctor, according to a recent report from the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan. Less than 10 percent say their teens can complete their own health history form.

However, as a family physician and mother, I can tell you there are many reasons why confidential care is important to your child’s health and well-being. Stepping back allows your children the opportunity to gain experience and confidence in managing their own health over the long term. Raising a teenager can be challenging; the doctor can be your partner in helping keep your child safe and healthy.

Some factors to consider:          

  1. Private time between a doctor and adolescent patient is an important step in teaching minors to take ownership and gain a sense of control of their own health. This time alone lets them practice describing symptoms and asking the doctor questions, which will help them gain confidence and comfort in the health care setting. Encouraging this independence bit by bit throughout their teen years can have a long-term impact that will benefit them when they move out and truly are on their own.
  2. There are just some things most adolescents simply are not comfortable discussing in front of a parent or guardian. Some health concerns and parts of an exam are sensitive or just plain embarrassing for a teen. Adolescents cite confidentiality as one of the key factors in how they seek and use healthcare. Not giving them the opportunity to discuss their health freely and confidentially once they reach a certain age can hurt them more than help them.
  3. Studies show that a lack of confidential care does not delay or dissuade adolescents from engaging in risky behavior such as substance abuse or sexual activity. In fact, adolescents who skip health care visits due to confidentiality concerns are more likely to engage in risky behaviors and report psychological stress. By allowing time alone with a physician you are enabling another trusted adult to help your child make healthy choices.
  4. As I have found in my own practice, alone time with patients is a key part of developing a rapport, building trust, and having a strong patient-physician relationship. This confidential time sets the foundation for them to be confident to share all health concerns in the future.I always encourage teenagers to talk to their parents about anything we discuss privately, and help them with strategies to approach difficult discussions with their parents. Confidential time with a teen is a great opportunity to encourage open and honest communication within families.
  5. Despite laws protecting teens’ rights to confidential care, there are times when minors share information that requires physicians notify parents. Any time a patient is in danger or at risk a physician must break confidentiality and inform the parent or guardian. In the state of Michigan specifically, physicians may choose to share information with parents about all care received by a minor patient if they believe it is in the patient’s best interest.
  6. There are many services minors cannot receive without their parent’s knowledge and consent. For most states, this includes medication for mental health services, any kind of vaccination (including HPV), emergency services and abortion services.

Ways to help your child become independent at health visits:

  • Before an appointment, encourage your teen to write down any health problems or questions they have.
  • Upon arriving at a doctor’s visit, ask your teen to check in at the registration desk and complete forms.
  • During the visit, wait to speak, giving your teen space to describe any problems or ask any questions.
  • Allow your teen private time with the doctor without you in the room.

Remember that confidential care is not intended to shut parents out of their kids’ lives or to be secretive. The ultimate goal is to partner with families and help teens take ownership of their health in order to keep them safe and healthy.

Take the next step

BlogRiley_MargaretDr. Margaret Alana Riley M.D. is a family medicine physician at the University of Michigan’s C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital. She completed her residency and fellowship at the University of Michigan Medical School. She serves as Medical Director of the Adolescent Health Initiative, Co-Medical Director for the U-M Regional Alliance for Healthy Schools, and President of the Michigan Society for Adolescent Health and Medicine. Dr. Riley sees patients at the Corner Health Center, Lincoln High School RAHS Clinic, and Domino’s Farms Family Medicine.

mott blog - logo thumbUniversity of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” and among the 10 best children’s hospitals in the nation by Parents Magazine. In December 2011, the hospital opened our new 12-story, state-of-the-art facility offering cutting-edge specialty services for newborns, children and women.