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Your teenager's body and mind are going through major developmental and emotional changes. At the same time, your teen is faced with adult decisions about experimenting with smoking, alcohol, drugs, sex, and other lifestyle factors that can impair his or her development. These tumultuous years require expert guidance, and the right doctor can be your teen's biggest ally.
But finding the right doctor for your growing son or daughter can be a challenge because teen health issues are often overlooked in the healthcare system. "Teenagers are in a between age group," says Garry Sigman, director of adolescent and young adult medicine at Evanston Northwestern Health Care. "Hospitals and the healthcare system are not thinking about them. They think about children, and they think about adults. But they don't think about what's in between."
According to the American Academy of Pediatrics, a pediatrician is responsible for patients from birth to age 21. While teenagers technically fall into this group, their needs are not always met by pediatricians, says Sigman. "Some doctors are uncomfortable with sexuality and other issues. They went into the profession to deal with infants and toddlers," he says. On the other hand, a general practitioner or an internist may not focus on teens. Sigman says they tend to concentrate their practices on adult patients.
You and your teenage son or daughter will need to work together to find a doctor -- whether a pediatrician, internist, or general practitioner -- who can effectively address the physical, mental, developmental, and sexuality issues that your teen is facing.
Two of the most important things to look for in a doctor are his or her level of expertise, and how comfortable he or she can make your teen feel in the office.Expertise
First and foremost, the doctor has to know her stuff. Schedule an appointment with your teen's doctor and ask these questions: Does she have a particular interest in teens, or is she more interested in adults and younger children? Is she trained in teen-related issues like peer pressure, substance abuse, and teen sexuality? Is she comfortable dealing with gynecological issues? What other services does her office provide to teens? Is the doctor experienced with the unique mental health and depression issues that teens often face?Comfort
"Lifetime habits form during the teen years. Smoking, drugs, alcohol..." says Dr. Marc Siegal, internist and clinical associate professor of medicine at New York University Medical School. Peer pressure can be a strong influence on these lifelong habits, and it's common for teens to struggle with difficult issues like depression, unwanted pregnancy, obesity, eating disorders, and suicide. Yet these are some of the hardest things for you teen to talk about with you, the parent, for any number of reasons.
When your teen comes face to face with these difficult issues, an experienced doctor should be able to put his mind at ease so they can frankly discuss the physical and mental health implications of his choices. Making your teen feel like an individual, and not just like one of the dozens of patients he sees in a day, will be essential. The right doctor will also make your teen aware of his privacy rights, and he will likely ask you, the parent, to leave the room so the discussion can be open and honest. (If your teen is under 18, the doctor will give you a general report after the consultation.) Some doctors even encourage their teen patients to keep in touch after the visit. Dr. Sigman offers his e-mail address to patients after consultations, yet another opportunity for your teen to get information about sensitive topics he may not want to discuss in person.
Finally, look for a doctor who provides the right atmosphere for an adult discussion. A room full of teddy bears and cute animal posters may not inspire the mature honesty with which your teen needs to approach these doctor visits. A pediatrician who sets aside a room or office specifically for his older patients may be the right choice for your teen.
"Part of becoming an independent person is going to an adult doctor," says Dr. Siegal. Generally, teens transition to an adult doctor when they are headed to college and need to take their college physical. Before your teen leaves your home, here's how you can help get him on his way.Encourage Responsibility
Teens claim that they're old enough to do things on their own and they should have more freedom, but when it comes to taking care of their own bodies, they don't match their words with actions. Instead, they tend to rely on you to make doctor appointments, fill prescriptions, and file the insurance claims. But it's time for you to pass the torch to them. Dr. Sigman says, "Teens should be mature enough to call the doctor themselves. They shouldn't depend on Mom to do that anymore."
Start with the basics:
Even after you pass on these responsibilities, you'll want to verbally remind your kids until they have proven that they have it down.Medical History
"Quite often I ask a teenager if they had [a certain illness] before, and they say, 'I think I had it'," Dr. Sigman says. "Kids don't always think about these things." As the caretakers, you know your teen's medical history best. Before sending your teen to see a doctor on his own, sit down and go over your child's health history, including vaccination shots, immunization records, history of allergies, hospitalization records, and any surgeries or important medical events. It's a good idea for your teen to keep this information in a small pocket-sized notebook that she can carry with her on future doctor's visits. If your family has a history of certain illnesses, record that too, especially heart disease, high cholesterol, high blood pressure, diabetes, cancer, breast cancer, and other hereditary conditions. Finally, if your teen is switching doctors, she should request copies of her medical and dental records from her previous doctors so her health history is accurate.Letting Go
"There needs to be some sense for the teenager that the doctor is their doctor, and not the parent's doctor," says Dr. Sigman. It's important to realize that there are certain things your teen might be more comfortable talking about with his doctor than with you.
"Parents have to let go and say, 'This is my child, my young adult child. I have to back up a bit,'" says Dr. Sigman.You're Still the Parent
Even though it's important that your teen's doctor is involved in these changing times of your teen's life, understand that you're still the biggest influence on your teen. Keep talking to your teen about where you stand on important issues.
"Don't assume that your son or daughter knows how you feel about difficult topics, such as underage drinking, drug use, and 'hooking up' (e.g., sexual encounters)," says Dr. Lawrence Neinstein, a leading specialist in adolescent healthcare. "Believe it or not, your son or daughter wants to know where you stand."
Originally published on LHJ.com, January 2005.