One-on-One Time With the Pediatrician

By: Suanne Kowal-Connelly, MD, FAAP & Richard J. Chung, MD, FSAHM, FAAP

Aside from all the physical changes, adolescents are developing skills that help prepare them for adulthood. Part of this means participating more in their own health care. The adolescent well-child visits are tailored to support your family in this process.

What to expect at adolescent & teen checkups

Although pediatricians lend their own style to their examinations, many start the adolescent office visit with you and your child together.

The doctor asks the typical questions. The variety of topics discussed may include:

• the past year's medical history and any past and current problems
• any medicines or complementary alternative medications being used
• eating, sleeping and exercise habits
• how things are going with school, family and relationships with friends

This part of the visit is directed primarily to the parent, though the adolescent is always able to chime in as needed. Before the physical examination, the doctor will ask the parent to allow some time alone with the adolescent.

Why is one-on-one time important for adolescents?

Parents and adolescents need to understand the reasons behind this routine. The pediatrician builts a relationship with you and your budding adolescent—sometimes over the entire course of their lifetime, sometimes over a shorter period. No matter the amount of time, all patient-doctor relationships are built on mutual trust and respect.

The goals of pediatric care include guiding and protecting the health and well-being of your adolescent. But it also includes preparing them to more actively care for their own health. In this way, we bridge this gap together and pave the way for your adolescent to confidently join and navigate the adult health care world.

In many families, the biggest challenge for parents of adolescents is not how much more they can do for their kids, but how they can effectively do less. Parents should know that they can allow their adolescents to try, to fail to learn and to grow. We need to teach and prepare adolescents for the independence and responsibilities that lie ahead in both the health care arena and life in general.

Parents and pediatricians can partner in this effort to support kids on their path to adulthood. Still, it's a big step. Understandably, as a parent, you may have some questions. Here are some of the questions that parents often ask when told that the doctor needs to spend some of the time alone with their adolescent.

Is it that time already?

The answer is…not really. The goal, however, is to begin to forge a more adultlike relationship with your child before adolescence is in full swing.

With most families, the doctor-patient relationship has focused primarily on the parent and pediatrician. And certainly, through the early years, this was completely appropriate.

But when you consider that one goal of parenthood is to prepare children to grow independent, teens need to begin to embrace and accept responsibility for their own health care. One reason for starting this transition a little early is to foster that sense of confidence in taking charge of their own health.

Many kids need a lot of time to do this. Often when a doctor asks children direct questions with their parents in the room, such as what they ate for breakfast, when their last period was, and how they did in school this semester, they inevitably turn to their parent for answers!

As your child matures, the pediatrician aligns topics discussed in well visits with their developmental stage. By starting the process a little early, kids might have a better chance of being more self-reliant and comfortable when they really need to answer tougher questions.

If your child has a neurodevelopmental difference, this dynamic may be different. Talk with your child's pediatrician about the right approach to maximize their independence while ensuring safety and support.

I don't think my child will like that.

When parents say that they don't think that their child will be pleased about them having to leave the room, it is often a good sign that this is the very thing the child needs most. Kids need to learn to think independently, behave responsibly, relate to adults and carry on a conversation with them.

Pediatricians are trained to recognize signs and symptoms of illness and disease, as well as signs of mental health challenges. They understand growth and development and how this affects a child's and teen's health. They are advocates for children's and teens' well-being in every sense of the word.

Adolescence is a time in your child's development when forming a separate bond with their doctor can benefit them. With your support, your child can be gently pushed to move in that direction.

Why exactly do you need to do this?

The question of why doctors need to meet with adolescent patients alone likely stems from fear on the parent's part. The teen years are the gateway to adulthood, and with that comes teens' desire to test their new wings.

Adolescents are naturally more open about certain topics when parents are not listening. This is simply because they might not want to disappoint or alarm their parents, even if all they have are questions.

Sometimes, an adolescent may have a very stressful and serious situation in their life that they don't feel comfortable addressing without privacy and confidentiality. This guaranteed alone time with the pediatrician reassures them that there will always be a chance to discuss pressing concerns.

Will you be sharing this private and important information with me?

The laws governing the rights of a minor (a patient under age 18) to confidentiality can be vague and vary from state to state. Your pediatrician can explain how it works in your area.

However, pediatricians respect an adolescent's right to privacy and will protect it. The exception is when the teen discloses that they are being hurt or are looking to hurt themselves or others.

In general, pediatricians will:

• Assess the medical and emotional needs of the adolescent.

• Encourage them to share important health information with their parents and caregivers, and involve them as much as possible. Often, they will coach teens on how to communicate effectively with parents. They may also offer to be the health communication liaison between a parent and an adolescent.

• Respect the request of the adolescent for confidentiality if the pediatrician believes it is what's best for their health and well-being.

Remember

You have worked tirelessly as a parent to raise a child who respects your values. Pediatricians know that because, in many instances as parents ourselves, we have done the same.

In the end, though, our children develop their own understandings, perspectives, attitudes and priorities that guide their decisions. Your adolescent's physician will encourage them to share important physical and emotional health issues with you; however, there will be times that an adolescent will want something to remain private.

Pediatricians are partners in your child's health care, and you can count on them to assist with their health care concerns.

More information

• Stages of Adolescence
• What's Going On Inside the Teenage Brain?
  

• Teens & Telehealth Can Be a Smart Combination