What does the doctor talk to your teenager about?

Beth J. Harpaz, The Associated Press

NEW YORK -- If you're the parent of a tween or teen, chances are you've been asked to leave the room during your child's visit to the doctor so they can have a private chat. Now of course I believe that teenagers should have a trusting relationship with their doctors. But while I'm sitting there alone in the waiting room, watching the younger mommies bounce babies on their knees, I can't help but wonder what my kids are telling the doctor behind that closed door. See, I'm a nosy mom, and if something's going on with my children's health, I want to hear about it. I mean, if your kid was suicidal, or a heroin addict, and somehow you didn't know it, would the doctor tell you? Turns out the answer is yes. "If we are concerned that someone is in danger, we are compelled to share that information," said Dr. Joseph Hagan, who is part of the American Academy of Pediatrics' Bright Futures initiative to improve children's health. But Hagan emphasized that giving kids a chance to speak privately with doctors "is not about secrecy. It's about autonomy. A 16-year-old should begin to ask his own questions about his health." In fact, if your pediatrician doesn't ask you to leave the room during teen visits, maybe he or she should."The pediatrician should spend most of the office visit alone with the adolescent," according to Dr. David Tayloe, president of the American Academy of Pediatrics. "It's very important for teenagers to have confidential conversations with their pediatricians." Tayloe said "the emphasis on confidential appointments for adolescents has become more the norm over the last 10 years." Tayloe added that 75 per cent of teenagers are sexually active by their senior year of high school, and Hagan said he starts talking to kids about sexuality around age 12, to let them know that sexual feelings are normal and to answer questions. But he also tries to get patients and parents communicating. "If a girl is concerned about pregnancy, I might say, 'What do you think your parents would say if you talked to them about this? Shall we tell them together?"' Some of the other things that keep me up at night - oh, the usual nightmares about teen smoking, car accidents and too much pepperoni and soda - are also on doctors' lists for teenage checkups. According to Tayloe, at least two-thirds of teen traffic fatalities involve teens who are not wearing seat restraints. Thirty per cent of teens are overweight and need to be enrolled in fitness and nutrition programs. And the vast majority of adult smokers began smoking by age 18. Tayloe added that most teenagers have experimented with alcohol by the time they are high-school seniors. "Pediatricians need to level with teens about alcohol," he said, including the fact that underage drinking contributes to car accidents and unplanned pregnancies. He also said that 20 per cent of children have mental health problems, but only 20 per cent of those kids are getting help. Pediatricians should screen adolescents for depression, anxiety, attention deficit disorder and suicidal thoughts. Kids who are teenagers now may also have missed some of the newer vaccines that became available after their early childhood inoculations against diseases like polio, mumps and measles. The AAP recommends that kids 11 to 12 and older be vaccinated against meningitis, a disease that can spread in settings like sleepaway camps and college dormitories, according to Dr. Meg Fisher, a member of the AAP committee on infectious diseases. Fisher says AAP also recommends that girls get the human papillomavirus vaccine, which protects against cervical cancer. And kids who were not inoculated against tetanus, diphtheria and pertussis when they were little need a one-dose combination vaccine against those diseases. By the way, some doctors are interested in parents' behaviour too. If you do meet the doctor with your teen, you might just get asked whether you smoke, or whether you wear your bike helmet. So while you're out there in the waiting room thumbing through a copy of Babies magazine that no longer holds any meaning for you, don't just worry about what's going on with your kids. Take a look at yourself as well.