Parents, give your teens a chance to talk to their pediatricians…alone…

by Claire McCarthy on November 30, 2010

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.

5 comments

  • Shawn Simmons

    Great advice!!

  • MothertoMany

    One more way parents have no rights at all any longer. Our children can do whatever they want and we don’t even have the right to know they are dealing with serious medical issues we could help them with.

  • Kay

    I’m not sure how allowing your child to speak in a room alone with a medical professional for 10 minutes is stripping parents of their “rights”. Being in a room to listen to every conversation your child has about personal issues is not a constitutional right.

    Teenagers deserve an opportunity to learn how to be honest with health care providers – in a few years, they will be adults getting their own healthcare. We need to teach our kids to be independant adults, not relying on parents for every minor detail. Letting them have opportunities to practice these skills – with involved parents and concerned pediatricians in partnership with the young adult – will help them develop those skills.

    Pediatricians and Pediatric NPs are trained in assessing risk factors in adolescents, and guiding adolescents towards healthier choices. If something medically concerning was at hand, or if your child’s safety was at risk – the pediatrician would talk to you.

    Our kids are without us at school all day, with their friends on the weekends, and we are not insisting on being in the room for every minute of these interactions. I trust the advice my pediatrician has for my child much more than I trust the advice she may get from her peer group.

  • MothertoMany

    “If something medically concerning was at hand, or if your child’s safety was at risk – the pediatrician would talk to you. ”

    That is not correct. That is the problem. If that were true it wouldn’t be an issue.

    I am a medical transcriptionist and transcribe many many pediatric reports a day. I was also a healthcare professional in more direct patient care prior to that. I have done many reports in which the child did have a medical issue and the parent was lied to about it. A recent one was a very young teenager with an STI. The mother suspected something like this was going on and was told very specifically her child did not have an STI. It was not a vague answer. It was a very direct “No, your child does not have..” I found that horrifying! If my child is engaging in high-risk behaviors that put his or her health at risk, that is a safety concern. I respect my children’s right to privacy but I also feel I have the right to know if my child is ill. If my child is sexually active and not taking care of his or her health and thus has become infected with an STI, I do not feel that I should be lied to about it. I don’t want to know so that I can reprimand my child or for the purpose of simply knowing every detail of their life. I want to know because obviously I have not done a good job in educating my child on this topic and need to talk even more. Forget sexually transmitted illnesses, my child could have an ankle sprain, request that per HIPAA the physician not tell me and guess what? The doctor wouldn’t tell me. I’m not talking about minor details. I’m talking about big issues that doctors keep from parents every day. I do feel that it is my right as a parent to know what is happening to my child when it comes to their health.

  • dcinma

    A minor child does not have the right to privacy from their parents. We are responsible for them morally and legally and for the medical profession to refuse to disclose information to the parent is wrong. By law it is assumed that a parent will act in the child’s best interest unless there is a finding otherwise. It is up to the parents to determine how to handle issues such as STDs or other things like that, not for the doctor to take the role of parent/guardian which is what he is doing when he refuses to disclose information to the parents.

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