The teen years are a time of changing relationships. One important relationship that changes is between the teenager and his or her doctor.
The focus switches from making sure the children are up to date with their immunizations and hitting all the development milestones to making sure the teenagers are safe and educated.
“During the teen years, the biggest hurdle is winning their trust,” said Dr. Mark Mroczko, a family practice physician with Town & Country Healthcare in Eureka.
When teens recognize they can trust you, they are more likely to open up about whether they are depressed, using alcohol or abusing drugs, have an eating disorder, or are engaging in unprotected sex, Central Illinois pediatricians and family practice doctors said.
All of that is important for their doctor to know. The doctor can present medical consequences and treatment options of certain behaviors without the emotions that may accompany a parental discussion.
Doctors do not want to get in the middle of the parent-teen relationship, doctors said. Parents and teens need to communicate on sensitive topics also, doctors said.
But for doctors, Job One is caring for their patients.
How that relationship takes shape depends on the dynamics between the teenager, and his or her parents and doctor.
Dr. Jason Cash, a family practice physician at Carle Clinic-Bloomington/Normal, and Mroczko believe that’s an advantage of family practice. Those physicians may see an entire family, so they know family health history and may understand the relationship between the teen and the rest of the family and factors that may influence illnesses or behaviors.
Dr. Kolleen Burnett, a pediatrician with OSF Medical Group in Pontiac, said her first talk with a child entering puberty will involve acne, mental health and what will happen to their body and the bodies of members of the opposite sex.
Next time, she may ask whether they have a boyfriend or girlfriend. If so, she will discuss sexual intercourse and the risks of sex such as sexually transmitted diseases (STDs) including HIV, and early pregnancy. If the child is sexually active, she will discuss how the couple may reduce their risk of an early pregnancy.
“As the children get older, I focus more on behaviors, such as are they wearing their bike helmets, are they wearing their seat belts and are they sexually active,” Cash said. “I also screen them for depression.”
As Cash sees teens, he may ask them about their interests, motivations, career goals, hopes and dreams.
“I think it shows that I have an interest in them,” he said. “Teenagers don’t open up to everyone. If they see that I am interested in them, they may bring something (a concern) up next time. If I ask them how their ACT went, they’ll be more likely to open up later.”
Having that rapport is important because teens will be pressured in certain areas. Cash tries to convince students to avoid risky behavior by showing how things that interest them would be hindered if the risky behavior continued.
Whether the parent stays or not, Trainor will ask the teenager the same questions about sex, drugs and relationship with their peers and family members.
If a teen is sexually active, Mroczko screens the teen for sexually transmitted diseases and talks about the risks of early pregnancy.
At what age those conversations begin depends on the maturity of the child, Burnett said.
Cash asks parents to leave the room before he asks his teen patients about sex, alcohol and other controversial subjects. Cash said it’s important for him to know what the teen is doing or considering and to answer questions and present options to reduce their risk of disease.
“Some teenagers won’t admit to exploring with certain things if their parents are in the room,” he said. “Occasionally, I’ll have a parent who says ‘No’ and I’ll say ‘OK’ but will ask the teen the same questions.”
When the teen is alone with Cash or Mroczko and admits to trying alcohol or having sex with another minor, the doctors will encourage the teen to discuss that with their parents.
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