Typically, a pediatric examination starts with the parent and child together while the doctor asks typical questions about medical history, any new issues, medications taken, eating behavior and how things are with family, friends, and school. This part of the visit is directed primarily to the parent, though the adolescent is always able to chime in as necessary.
Often a pediatrician will ask to spend some time alone with the child to give them an opportunity to share additional information when the parent is not listening.
As you child starts to get older and more mature, it’s important for them to start advocating for their own health care and to get comfortable interacting with their pediatrician. At age 18, as a legal adult a child can go to an appointment without a parent and, although not typical, can even deny a parent access to their records. The sooner a teenager gets comfortable asking and answering questions, the easier the transition.
Why is one-on-one time important?
The pediatrician has built a relationship with you and your budding adolescent, sometimes over the entire course of your adolescent’s lifetime. All patient-doctor relationships are built on mutual trust and respect. The goals of the pediatric health care relationship include guiding and protecting the health and well-being of your adolescent, but also preparing your adolescent for navigating an adult health care experience and confidently and independently joining the adult health care world and life in general.
It is a big step and parents typically have questions. We address some of them here:
“Is it that time already?”
The answer is…not really. The goal is to begin to forge a more adultlike relationship with your child before adolescence is in full swing. When you consider that one goal of parenthood is to prepare children to become adept and independent, teens need to begin to embrace and accept responsibility including their own health care. Beginning early allows the transition to happen gradually.
“I don’t think my child will like that.”
When parents say this, it is often a good sign that this is the very thing the child needs most. Children need to develop an ability to think independently, behave responsibly, relate to adults, and carry on a conversation with an adult.
“Why is this helpful?”
Adolescents are naturally more open about certain topics when parents are not listening because they might not want to disappoint or alarm their parents even if all they have are questions. Sometimes, an adolescent might have a very stressful and serious situation in his or her life that needs to be addressed and requires privacy and confidentiality. This guaranteed alone time with the pediatrician will allow and reassure the adolescent that there will always be an opportunity to discuss very pressing matters.
“Will you be sharing this private and important information with me?”
Not always. Although the actual law governing a minor’s rights to confidentiality can be vague and vary from state to state, pediatricians respect a child’s right to privacy and will protect it, except in the circumstance in which an adolescent discloses that he or she is being hurt or is looking to hurt himself, herself, or others. Legislation has expanded the rights of minors to make health care decisions for themselves.
However, a minor does not have unrestricted access to health care. The mature minor doctrine gives physicians some general guidelines for when they may provide medical treatment based on an adolescent’s consent. (States vary on whether this is adopted as doctrine, but courts recognize the principle.)
If an adolescent is in trouble, pediatricians will do the following:
- Assess the medical and emotional needs of the adolescent
- Make recommendations on how to include the parent
- Respect the wishes of the adolescent if the pediatrician feels there is cause to believe that the adolescent’s rights to health care supersede the parent’s right to know and the adolescent has sufficient maturity to support that decision
Pediatricians have been trained to recognize signs and symptoms of illness and disease, as well as signs of mental illness and dysfunction. They understand growth and development and the application of this to a child’s and teen’s health. They are advocates for children’s and teens’ well-being in every sense of the word. They are in a unique position to partner with your child concerning his or her health. This is the time in children’s development that forming a separate bond with their doctor can be of benefit to them. With your support, your child can be gently pushed to move in that direction.