December 13, 2010
By Claire McCarthy, M.D.
Boston Children's Hospital
Parents react with a mixture of surprise and worry when I ask them to leave the exam room. "Your child is a teenager now," I tell them. "We need a little time alone."
The thing is, we really do need that time alone.
Teens don't want their parents to know everything. It's a simple fact of adolescence. They worry about getting in trouble, or think it's uncool for their parents to know certain things. They are just plain embarrassed to discuss certain subjects (or body parts) in front of their parents. So if the parent stays in the room, I get less information.
Pediatricians have known this for years. However, a recent study published in the journal Pediatrics shed more light on teens' need for health privacy. Researchers interviewed 54 adolescents between the ages of 11 and 19 and found that:
- Teens do not want their health information shared with their parents.
- Younger teens are uncomfortable with having their health information shared with other office staff.
- Teens won't discuss information if they think that the health care professional will judge them or "jump to conclusions."
- Teens don't like having lots of different health care professionals. They prefer to develop a relationship with one.
- Many teens prefer a female health care professional (especially girls who need gynecologic care).
It's important for parents and doctors to understand these needs and work with them. If teens don't tell the doctor what they are doing or feeling, the doctor can't do anything to help.
So here are my tips for how parents of teens can give them privacy when it comes to health matters:
- Talk to your teen about sex, relationships, alcohol, tobacco and drugs. Make clear your position and expectations around these topics where appropriate. But the most important thing is to give your child the information he or she needs to make good choices. Even if you think your child would never have sex or smoke, talk to your child about these anyway. If you present information in a non-judgmental way, your child may be willing to talk to you about what he or she is thinking or doing.
- Find out which health care professional your teen would prefer to see. Most likely, you will stay with your pediatrician, but if your child doesn't feel comfortable talking to the pediatrician, consider changing to someone your child will feel comfortable with. For example, your daughter may prefer seeing a female doctor rather than a male pediatrician.
- Give your teen the telephone number of the doctor's office. Let them know they can call without telling you. If your child can't get to the office on his or her own, look for a school health clinic or other health care facility your child can get to without you.
- Don't badger the doctor for information about your child. Confidentiality is confidentiality. Just because the doctor won't tell you what your child said doesn't mean that it's something alarming. The doctor needs to be able to assure your child that his or her information is private, and you need to be able to respect that. You need to trust the doctor to take care of your child.
Sometimes being a good parent means letting go. When it comes to health care for adolescents, letting go is important if you want to be sure that they get the advice, information and treatment they need. So take a deep breath, and when the doctor says it's time to leave the room, leave. I know it's difficult, but it's the right thing to do.
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Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.