The Informed Patient
March 29, 2011
No longer children and not quite adults, teens face a combustible mix of physical and mental-health issues that can set the stage for long-term problems in adulthood, ranging from obesity and chronic disease to substance abuse and depression. Only about 650 doctors nationwide, a tiny fraction of the total number, are board certified in adolescent medicine.
Now, government agencies and medical associations, including the American Academy of Pediatrics, are developing programs to train primary-care doctors to more effectively treat adolescents. Doctors are changing how they talk with their teen patients and coming up with phrasing that they think encourages teens to discuss feelings.
“The opportunities to influence the long-term health of the population are greater in caring for adolescents than in any other age group,” says Lawrence J. D’Angelo, head of adolescent and young-adult medicine at Children’s National Medical Center in Washington, D.C. and president of the Society for Adolescent Health and Medicine.
Nearly one in five teenagers is obese, more than triple the rate from 1980, according to the Centers for Disease Control and Prevention. High blood pressure and cholesterol, once considered problems that began in middle age, are increasingly turning up in younger people. And many teens’ penchant for engaging in risky behaviors, including sexual activities and illicit substances, has helped fuel the spread of diseases and mental disorders. Some 80% of teen deaths are related to behavioral issues such as alcohol and drug use that result in injury and accidents, says Kenneth Ginsburg, an adolescent-health specialist at the Children’s Hospital of Philadelphia.
It can be difficult for parents to make sure sometimes secretive adolescents get proper care and screening. Long accustomed to participating in their children’s doctor visits, parents may suddenly feel shut out. Once kids turn 13 years old, a complex mix of federal and state privacy laws allows them to seek confidential family-planning and mental-health services without their parents’ consent, and certain parts of teens’ health records are off-limits to parents.
A recent study in the Annals of Family Medicine found that one-third of teens in a large Midwestern health plan had no preventive-care visits from age 13 to 17, even though they had insurance without a deductible or co-pay. Another 40% of the teens had only one such visit in those years.
This may be an idea whose time has come. Hopefully, doctors will share menstrual cycle information – as well as other relevant information instead of pushing drugs/vaccines and ‘new syndromes’ on a new market. Hmmm.