Part of the maturing of the teen years is the development of new strengths and inner resources. Well-adjusted teens strive to achieve certain goals on the way to adulthood. They are trying to:
One of the outcomes of this development is a young adult prepared to assume responsibility for making wise health care decisions. At some stage, usually between the ages of 11 and 14, children decide that they want to be more independent on visits to the doctor. Parents are no longer welcome to sit in the room with a teen perched on an examining table, the parent talking with the family doctor or pediatrician while the teen nods in silence.
This type of exchange between doctor and parent does nothing to help develop the independence of a young person. Instead, the teenager needs to be involved and guided to make some informed health care choices. Teens who are able to ask their own personal questions gain confidence. They realize they are regarded as unique individuals worthy of respect from within and outside their families.
Most teens will choose to see a doctor rather than any other health care professional and about 90 per cent will visit a family doctor. Sit-ting in the waiting room of a pediatrician with lots of babies and elementary school children often make teens feel uncomfortable. It is, however, not always the best choice to move away from the pediatrician who has cared for the child with chronic illness (more on this later). The ideal family doctor for a teenager is one who has good rapport with the teen and knowledge of the family.
Some teens will begin to feel uncomfortable with the family’s regular doctor. It may be that a teenage girl will ask to see a female doctor and vice versa for a boy. While this may be an appropriate change, families should discuss the switch with their regular doctor. In this way, everyone can be involved in the solution. It may be that the teen will continue to see the same doctor who knows the family well or shared care will be arranged so that the regular doctor is still a resource for the family and teenager.
Teens may also want to switch doctors because of a fear of breakdown in confidentiality. The doctor can usually reassure teens about their safety and privacy.
If teens are worried that their discussions with their doctors will somehow get back to their parents, they should not be. Doctors regard confidentiality to be of immense importance.
There are, however, four areas in which teens and their parents must realize that the doctor cannot remain silent:
Some parents have problems when their teens go to doctors on their own. Understandably they may be nervous and concerned, particularly if they are concerned about the teen’s sexual activity or drug abuse. Doctors will usually encourage teens and parents to have good, open com-munication but will respect the teen’s privacy.
Teens usually want their physicians to be approachable and easy to talk to. At the same time, however, they do not expect the physician to be unprofessional. Teens often need time to ask questions and to consider the answers. The physician must remain non-judgmental but give accurate information when risks are being taken with safety in vehicles, drugs, alcohol and tobacco, and sexual activity.
Because of the nature of teenagers’ lives, teens often prefer to walk in to a doctor’s office with-out an appointment. This makes them more likely to use Walk-In clinics in malls, special teen clinics or clinics for sexually transmitted diseases. A teen using these sources may get useful health care, but not necessarily the best care. Seeing one doctor over several years, particularly when that doctor knows about the teen’s family, provides a valuable overall approach to care.
Teens should be encouraged to make an appointment with a doctor. They will get more out of their visits if they decide how much time they may require and then schedule an appointment when time will be available to address all the problems. It may be disheartening for a troubled teen who has not made an appointment to be rushed through an interview with a doctor. The chance to solve a problem at its outset may be lost.
Teenagers who attempt or commit suicide have often seen a doctor shortly before the event. Teenagers need time to talk and be heard.
Options for Choosing A Doctor
|Preteen||Pediatrician||Family doctor||Family doctor and pediatrican for special problems|
|Teen||Different pediatricians||Same pediatrician or same family doctor with shared care for some services||Different family doctor||Same family doctor (the ideal choice)|
|Older teen or adult||Family doctor||Different family doctor|
Some teens have chronic illnesses. Often these patients are best cared for by a combination of specialist and family doctors. Expert advice and monitoring are often needed for teens with chronic illnesses, some of which are:
Family doctors will often help select a specialist doctor to assist with this care. The family doctors and the specialists will often work in teams of nurses and other workers. They will continue to see these teens until their 20s because of the importance of continuing care and the potential for these conditions to be more difficult to manage in adolescence. In the late teens, the main responsibility for care is usually handed back to the family doctor. Hence, it is always desirable for a family in which chronic illness exists to have formed good links and communication with a family doctor who can help not only the teen but also the parents to cope with their health care needs.
Teenagers who make some of their own health care decisions become involved in their choices and in the outcomes. Through their choices, they learn a healthy level of independence. Participation in their own health care will help them develop confidence in their ability to make wise choices as they enter their adult lives.