By Lisa Rapaport
(Reuters Health) – Roughly half of U.S. teens and young adults don’t have private time with doctors during their checkups, and may be less comfortable asking questions about their health as a result, researchers say.
The study team examined nationally-representative survey data from 1,918 young people ages 13 to 26 and found that overall, just 55 percent of young women and 49 percent of young men had ever had private time during a medical exam.
Perhaps not surprisingly, the youngest teens in the study were least likely to have private time with a clinician: only about 22 percent of 13- and 14-year-old girls and 14 percent of boys this age ever had this opportunity. And just 43 percent of teens ages 15 to 18 had ever had private time with a clinician during a checkup.
Even among young adults, however, more than 30 percent of women and almost 40 percent of men had never had private time with a clinician.
“Private time and confidentiality are critical because when confidentiality is not assured, adolescents and young adults are less willing to discuss sensitive topics with providers or may skip care altogether,” said lead study author Stephanie Grilo of the Columbia University Mailman School of Public Health in New York City.
“Parents need to know that private time and confidentiality are important parts of keeping teens healthy and they should be asking for this as it will improve the health of their adolescent,” Grilo said by email.
Several leading physician groups representing pediatricians, family practitioners and specialists in adolescent health and reproductive medicine all recommend that teens and young adults get private time and discuss confidentiality with clinicians during routine checkups.
While there are limits to this – doctors wouldn’t keep it confidential if a teen discussed harming themselves or others, for example – it’s widely accepted in the medical community that young patients need to be able to speak freely with clinicians about sensitive topics like sex, drugs and drinking.
“Private time has been a recommended part of adolescent clinical care for quite some time, and is a cornerstone of the movement to support the transition from the pediatric system of care (which focuses on the parent as the key partner to the clinical provider) to the adult system of care (where the adolescent/young adult must assume that responsibility),” said Sarah Clark, co-director of the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan in Ann Arbor, in an email.
The study wasn’t designed to prove whether or how private time or confidentiality discussions during checkups might directly impact teen health.
However, teens and young adults who did have this opportunity reported more positive attitudes about their providers and thought these interactions should happen at a younger age.
For teens to make the most of private conversations during checkups, doctors and parents should start preparing children gradually as they approach adolescence, said Clark, who wasn’t involved in the study.
Starting around age 12, parents can promote teens’ independence by encouraging them to write down any health problems or questions in advance, and then by having them handle checking themselves in and completing any forms on their own when they get to the doctor, Clark advised.
During these transitional visits, parents can also wait to speak, giving children a chance to interact more with doctors, and parents can also volunteer to step out of the room to allow for private time.
“The early opportunities to gain skills and confidence, with a parent nearby for guidance, will pave the way for teens to navigate the health care system when they become adults,” Clark said.
SOURCE: https://bit.ly/2TdRBcD Journal of Adolescent Health, online January 9, 2019.