Recently, a 16-year-old girl came to me with what sounded at first like a routine urinary tract infection (UTI): frequent urination with a burning sensation and abdominal pain. But when a teenager is sexually active, these symptoms can also be caused by a serious sexually transmitted infection (STI) — often chlamydia or gonorrhea. And the tests and medications for UTIs and STIs are different.
After I requested that her mom have a seat in the waiting room, I asked my patient if she had ever had sex before. She said “yes”—but begged me not to tell her mom. I did a urine test, a gynecologic exam and looked at a slide under the microscope. She had an STI and got the treatment she needed. The lesson?
Teenagers need time alone with their doctors. It is important for all teenagers, not just those with problems like my patient, to have some private time with their doctors. I explain to teenagers and their parents that I will be talking about sexual health, substance abuse and emotions. I also explain the reasons why I would need to break confidentiality, like if a teenager tells me that he or she is suicidal.
Since the facts are that half of teens have had sex by the time they graduate high school, I use some of my alone time with them to make sure that they have medically accurate facts. Talking about sex, condoms and emergency contraception does not encourage a teenager to have sex, just as discussing sad feelings does not encourage an individual to attempt suicide. With my 16-year-old-patient who had an STI, we had a lot to talk about.
Teenagers deserve doctors who give them ample time and attention. Teens need to feel comfortable talking about the difficult tasks they must work on during their adolescence: Understanding their changing bodies, becoming independent, managing peer pressure, and developing their identities. I get exhausted even thinking about all they have to do!
Don’t get me wrong. A doctor is not a substitute for you when it comes to talking to your kids about “sex, drugs, and rock and roll.” But when you encourage your teenagers to talk openly with their doctors, you are showing your kids how much you love and respect them. I want my own children to have this relationship with their doctors, so much so that at my son’s 13-year-old check-up, I left the room even before the doctor had a chance to ask me to leave!
Teenagers and their parents need doctors they both like and trust. The doctor may be a pediatrician, family physician, internist, or adolescent medicine specialist (a doctor with specific training in taking care of young people between the ages of 11 and 21). The doctor should be able to do a gynecologic exam if needed, or know when and to whom to refer the patient. I know it sounds impossible to believe, but some doctors may not be “teen-friendly.” After the first visit, ask your child what he or she thinks about the doctor.
In a future blog post, I’ll share more information about what teens want in a doctor.
For now, tell us about your experience with your teen’s doctor.