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If your child is on the cusp of puberty, gone are the days when she was placated by a lollipop after a doctor’s visit. Now you likely have to badger or bribe her to see the doctor or outright drag her to medical appointments. Even more challenging for parents is making sure the doctor is a good match for their growing kid’s needs, medically and emotionally.
When Palo Alto, Calif., mom Sally King (not her real name) started thinking about getting her two daughters, 16 and 18, vaccinated against human papillomavirus (HPV) infection (a major cause of cervical cancer), she realized it was time to change doctors. “I had been taking them to a male pediatrician. I didn’t feel it was comfortable for them.”
So she made an appointment with Sophia Yen, MD, MPH, a clinical instructor of pediatrics at Stanford University School of Medicine in Palo Alto and an adolescent medicine specialist. Yen made the teens feel at ease, answering their questions as their mother sat in the waiting room.
After a childhood of doctors’ visits aimed at preventing disease and tracking developmental milestones, teens and preteens need a different level of medical care. “We move from a prevention model to a sick model,” says Warren Siegel, MD, chair of the department of pediatrics and director of adolescent medicine at Coney Island Hospital in Brooklyn. Most teens, he says, don’t consult doctors regularly unless they are sick or need physicals for sports participation or jobs.
But the “well visit” model should continue, Siegel and other experts say. “All adolescents should see their health care provider at least once a year,” Siegel says. During those visits, your teen or preteen’s doctor not only should evaluate your child’s physical and mental health and any need for immunizations but also should ask about school performance and discuss puberty, sexual activity, contraception, drugs, tobacco, and alcohol.
Once your child hits puberty, the doctor may close the door in your face -- literally. “The 12-year visit is really a time when adolescents should be seen alone,” Siegel says -- even earlier if they have already entered puberty.?
Granted, the transition to the solo visit is not always easy for parents, Yen says. “What we talk about,” she tells parents about her closed-door conversations, “is confidential unless they are hurting themselves, someone is hurting them, or they are hurting someone. Then I will definitely tell you.”
Here’s the good news: Learning to navigate the doctor’s office as a teen is good practice, Yen advises parents. “They will end up in the emergency room without you ,” she says. “They need to know their medical history and how to interact with a physician.” Having time alone with the doctor also makes it easier for your child to broach delicate questions about new hair growth, odd smells, periods, and sex.
Enlisting a doctor who really understands teens can ease the process of turning over the medical reins. Was it difficult for Sally King to cut the cord and give her daughters the privacy they needed? “No,” she says. “Dr. Yen made it easy for them to take responsibility.”
After they left the doctor’s office, the trio celebrated with a ritual that appeals to all ages: ice cream.
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