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Ask the patient the questions directly, with her mother still in the exam room
1%
1/109
Ask the mother to step outside into the hall for a portion of the visit
90%
98/109
Give the patient a social history questionnaire to fill out in the exam room
3%
3/109
Speak softly to the patient so that the mother does not hear and the patient is not embarrased
0%
0/109
Disallow the mother to be present in the examination room throughout the entirety of the visit
Select Answer to see Preferred Response
Teenagers should have an opportunity to speak with the physician alone during their visit; this is especially important for topics that might be uncomfortable to discuss in front of parents. A good strategy is to ask the parent to leave the room for the physical exam portion of the visit and ask questions regarding more sensitive topics at that time. Assurance that the adolescent's visit with the physician is confidential will invoke the patient to give a more accurate history, allowing for improved care and counseling that the physician is able to provide. Although laws vary by state, there are several issues on which parental consent is generally not required for adolescents, including: pregnancy management, sexually transmitted disease treatment, substance abuse, psychiatric disorders, abuse, and contraception. Alexander et al. studied physician-adolescent discussions about sexuality during health maintenance visits. Sixty-five percent of visits breached the topic of sexuality, and the average time of the discussion was 36 seconds. This leaves one-third of patients without any discussion of sexual health from the healthcare provider. The authors recommend additional research to determine how physicians can increase the frequency and length of these discussions to promote healthy sexual development and decision making. Berlan et al. discuss issues of confidentiality and consent as they relate to caring for adolescent patients. HIPPA covers some portions of the care of adolescent patients and allows for lack of parental consent so long as these conditions/situations are met: 1) the adolescent has the right to consent for their own care under applicable federal and state law and does provide consent, 2) the adolescent may legally receive care without parental consent, and 3) when a parent has agreed to an agreement of confidentiality between the healthcare provider and the minor. Incorrect Answers: Answers 1,3-5: The adolescent patient should always be given the opportunity to speak with the physician in private, without the presence of a parent or guardian.
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