Dr. Claire McCarthy is a primary care physician and the Medical Communications Editor at Boston Children’s Hospital. Along with her blogs here on Thriving, you can find her at the Huffington Post and Boston.com. Follow her on Twitter @drClaire.
The 14-year-old, in for a routine check-up, handed me the questionnaire we give all adolescents to fill out. It covers general topics like diet and exercise habits, but it also asks questions about things like sexual activity and drugs and alcohol. I’d been the girl’s pediatrician since she was a toddler, but it was the first time I’d firmly kicked her mother out to finish the visit alone with the girl.
As I took the questionnaire from her, I explained that everything she told me would be confidential. I wouldn’t share any information with her mother unless it was necessary for her safety—and even then, I wouldn’t do it without talking to her first.
“Really?” she said. “Okay, then give it back to me. I lied on it.”
It’s not really surprising that this would happen. In fact, a study published last week in the journal Pediatrics found that confidentiality is incredibly important to adolescents when it comes to health care. If they think their health information might be shared with parents or with other staff, well, they are far more likely to not give that information at all. Teens also don’t like being judged, the study found. They will keep information from health care providers because they don’t want them to think less of them. (Also read a USNews & World Report article on this topic.)
“That same 14-year-old hugged the corrected questionnaire to her chest for a while before giving it to me. ‘You are going to think bad things about me!’”
That same 14-year-old hugged the corrected questionnaire to her chest for a while before giving it to me. “You are going to think bad things about me!” she said.
I told her that I wouldn’t. I said that I might worry about her, but that my job is to help her be healthy and safe, and I can’t do that job unless I know what she’s up to. And indeed I did end up worrying when I read the questionnaire. But her truthfulness gave me a chance to help her, a chance I wouldn’t have had if she thought I was going to tell her mother.
We all want privacy. It’s a normal thing for us as adults—and for adolescents, at the brink of adulthood, it’s normal too. But it can be really hard as a parent to let our child have that privacy. We think that being a good parent means knowing everything there is to know about our child. And we expect our child’s doctor to tell us everything; we expect them to be on our side.
But there are a couple of realities involved. First, kids don’t tell their parents everything. Look back at your own adolescence—did you tell your parents absolutely everything? (If the answer is yes because you never did anything risky, would the answer still be yes if you had?)
Second, as the study points out, if teens think that their doctor will rat on them, they won’t tell the doctor everything either—and may therefore miss the chance to get the advice, information, tests and treatment they need. Is that really what you want?
So…here’s what parents of teens need to do:
- Make sure your teen has good health information. Talk to them about sex, relationships, alcohol, tobacco and drugs. You can and should insert values where appropriate, but the most important thing is being sure they have the information they need to make good choices. Even if you think your kid would never, ever have sex or smoke, talk to them about it anyway. If you present information in a non-judgmental way, your kid may be willing to talk to you about what they are thinking or doing. Maybe not, but it’s worth trying.
- Make sure your teen has access to confidential health care. Give them the doctor’s number, or the number for a school health clinic or other health care site. Our pediatrician gave my older children her email address so they could contact her without letting me know.
- Don’t badger your doctor for information. I remember an incredibly awkward conversation with the mother of a different teen, another I’d followed since early childhood. The mother was very upset that the nurse who called looking for her daughter wouldn’t say why she was calling—and I wouldn’t either. You need to trust us, I told her.
That’s what’s so hard: trusting. Trusting your kid, and trusting others to take care of them. As long as you’re in the mix, you think, everything will work out better. But sometimes it doesn’t work that way. Sometimes being a good parent means letting go instead of holding tight. And just because your doctor doesn’t tell you something doesn’t mean they aren’t on your side.
They are on your side: they want your teen to be happy, healthy, and safe. Which is actually what your teen wants, too, even if they don’t act like it sometimes.
So take a deep breath, and leave your teen and the doctor alone.