Family

Is it time for your teen to see the doctor alone?

Author: Canadian Living

Family

Is it time for your teen to see the doctor alone?

This story was originally titled "Going Solo" in the April 2009 issue. Subscribe to Canadian Living today and never miss an issue!

Sitting in our family doctor's waiting room one day, my son Wes, then about 13, calmly announced that he wanted to "go in there alone." This option hadn't occurred to me, but I didn't have much time to think: the nurse was calling his name. "Mmmm, OK," was all I could muster, and as Wes disappeared down the corridor, I watched with that curious mother-mix of pride, longing and anxiety.

When he returned, he hissed, "Let's go!" and scooted out to the car. Once inside he announced in a dramatic stage whisper, "He felt my balls!" His brother, 11, shuddered theatrically. For a brief flash I thought he'd been molested – then quickly grasped that he was referring to part of a checkup for an adolescent boy.

Wes, who had known the doctor for years and felt comfortable with him, was undisturbed and somewhat proud to have passed another milestone. But I didn't feel very proud. Certainly I'd made the right first step in helping him establish his own good health-care practices by taking him for regular checkups. But I felt I'd sent him into a new situation without any preparation at all, that I should have told him what to expect, what questions to ask, what rights he had.

Ready or not?

Kids are probably ready to go into the examining room alone around age 12 or 13, when puberty starts. That's also when they're beginning to make lifestyle choices and assume some responsibility for aspects of their own health such as diet and exercise, says Ginette Gilbert- Rasuli, a nurse practitioner (NP) in primary health care at University of Ottawa Health Services, who spent a year working part time with students in grades nine to 12 at a primary healthcare clinic in a school in Ottawa.

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If your teen wants to continue with her current health provider, that's ideal, since that doctor or NP will already know her and her history. But some teens will want to start fresh. Girls may want a female and boys a male; they may want privacy (free from parental queries) or a greater comfort level.

Emily Ibsen, 19, remembers going solo with her family doctor when she was 13. She and her younger sister, Laura, agree that this doctor made them uncomfortable. "She always made you take off your shirt – and she never explained why she was doing things," says Emily. By age 15, both girls had sought out a new health-care provider, Emily opting for a walk-in clinic suggested by friends, and Laura, with her mother's help, finding a doctor she describes as friendly and someone who "really talks to you."

Good communication is what adolescents value most, says Dr. Doug Klein, an assistant professor in the department of family medicine at the University of Alberta in Edmonton, who did his master's thesis on what teens think about seeing a family doctor for a checkup. Klein, who also has a family practice, says teens want their physician to be like a knowledgeable friend – someone who will explain things clearly, without being patronizing.

How you can help prepare your teen
• Arrange for the first appointment to be a "meet and talk," so your child can find out if she likes the doctor or NP before committing to an examination. She can expect the doctor to ask questions about her general health and habits, and areas of interest and concern. In turn, she should also ask questions, such as: what do you include in a checkup? How often do you do one? Do you keep everything confidential? Ideally you, too, should meet the doctor. If the fit is wrong, try someone else.

• Discuss the importance of being open. Kids might not understand why lifestyle questions (about topics such as diet, sexual activity, grades) are relevant to health care. Gilbert-Rasuli notes that teens often behave in ways that could jeopardize their health, and getting the best health care requires telling the whole truth.

• Let your teen know that health-care providers should maintain confidentiality unless they suspect danger (suicidal or homicidal thoughts, abuse, eating disorders, addiction) or a major illness. As a parent, you shouldn't try to violate that confidentiality.

• Discuss why a doctor gets physical, says Sue Cooper, a registered nurse with the Simcoe Muskoka District Health Unit in Ontario, who has worked with kids for many years. "As corny as it sounds, the 'laying on of hands' is essential to good health care."

• Offer to take your kids to the appointment; have their immunization records and other pertinent health information ready.

Page 2 of 3What teens can expect from a checkup
• A typical checkup includes checking blood pressure, heart rate, height and weight. The doctor will also examine the skin, eyes, ears, nose and mouth; listen to the heart and lungs; and feel glands, internal organs, joints and bones for lumps, sore spots or abnormalities.

• Boys can expect a genital exam, which will include having their testicles felt for swelling or lumps. Testicular cancer – though rare – can present at 15 years of age, and tends to affect younger males.

• Girls might require a pelvic exam, though it's no longer standard at age 16. Today doctors may wait until a girl is, or wants to be, sexually active, or feels there's a problem. If your daughter is scheduled for a pelvic exam, let her know what to expect, either by sharing your own experience (keep it positive) or by visiting a recommended website together for a complete description. (See "Want to Know More?" below.)

• Many doctors help young patients feel more comfortable by letting them keep as many clothes on as possible. Suggest that your teen wears easy-access clothing, such as a buttoned shirt or loose pants, to ease examinations. Wearing a camisole might give a girl more privacy.

• Encourage your child to ask questions. "Misinformation flourishes on the Internet and in the schoolyard," says Cooper. "Teens should know that it's important to hear from a pro rather than from friends on the street or in the locker room."

• Saying no is always an option. If your teen feels uncomfortable in any way – either with the doctor, or about any part of the examination – he can wait for another time, or another person.

Teens: This advice is for you
• Be honest and open. The doctor needs to know your history – and you're the historian. It's important to answer questions truthfully and share any concerns.

• Respect yourself. You have the right to get good health care, to ask questions and get answers, and to understand what's happening and why. You can say no.

• Make a list of things you want to know, and take it with you, so you remember what to ask.

• Be on time. If you need to cancel, give as much notice as possible (there might be a fee if you cancel without 24 hours notice).

• Be prepared to wait. Take a book or your iPod.

Want to know more?
Here are some helpful resources for teens:
Contact Kids Help Phone at 1-800- 668-6868 or visit and go to the kids' site.
Visit Kids Health – enter the teen site and search for "medical care."
Learn more at Family Health Online and click on Adolescent Health.

Read more
:
Teenage milestones
Your teenager: An owner's manual
Understanding growth spurts

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