<p>Also, if my young teen is sexually active or on drugs I don’t see how that is none of my business.</p>
<p>If my teen was sexually active but didn’t want to tell me, I’d sure rather have a trusting doctor/patient relationship in place so that she could tell HER because I had total confidence that the doctor was going to give her good advice. </p>
<p>Our doctors always told us about medications. They knew that we were going to have to pay for it and would know that anyway. The exception was birth control, but I had to sign a permission slip basically saying “If my child ever comes to you for birth control, you have my permission to give it to her, along with appropriate accompanying education.” If they didn’t have that in hand, they wouldn’t have given it.</p>
<p>That practice sounds wonderful. We never even had a doctor we actually liked so that could be influencing my reaction. Whenever someone asks me who my family doctor is I have no answer or lie. But, that’s another issue.</p>
<p>^^^It is such a good place. I like the concept and think it would be a great model for an OB practice. You know, to have a nutritionist, lactation expert, massage therapist who specializes in pregnant mothers, exercise studio with classes and teachers designed with pregnant women in mind, etc, on site. Maybe even child care so that your other little ones are looked after while you are in your exam. One stop shopping, so to speak.</p>
<p>My guess is the reason there aren’t more practices like that is that all of those other services are expensive and have to be paid for. I’ll bet the office N’s D goes to has some canny coders who are able to make sure that all the services they offer are coded correctly and paid for by insurance companies. I’m also sure that they received some grants in the beginning to set up a practice like that (I know N’s D’s doc had an interest in this kind of thing for her fellowship and there were probably ways to set it up as a pilot). Time, money and savvy business people would be required to set up this kind of model practice. And I wonder how this model will be affected by ACA (no judgement-- I’m a fan of ACA).</p>
<p>We usually have long term relationship with our doctors. We changed gynecologist for D1 3 times before we found someone she/I liked. Each doctor has their own way of dealing with patients. The gynecologist D1 liked had 3 daughters about D1’s age. He was very good at putting D1 at ease. He also didn’t have any problem in discussing D1’s concerns with me. D2 and I currently share the same doctor. She likes him better than I like him. He also likes her better. My girls would tend to come to me with their issues before they would share with any doctor. I was sitting with them and their doctors when they were prescribed birth control. They wanted me to hear what the doctor had to say and help them choose.</p>
<p>I found a very upscale Fifth Ave ob-gyn through high recommendation. According to my colleague, the doctor wore Chanel suit, the office was spotless, and they gave prescriptions and samples in nicely wrapped package. But I found out they were so stick in the mud about confidentiality that they wouldn’t even allow me to make appts for my daughters. So we crossed that one off our list.</p>
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<p>That’s just silly. I wouldn’t go for that either.</p>
<p>I was with both daughters when they got birth control. But if they hadn’t felt comfortable with that, I wanted something in place for them so that they could get what they needed. </p>
<p>Nrdsb4 - I also left it up to my kids if they wanted me to be there.</p>
<p>I am a bit squirmish with shots and blood. When kids were younger I used to maneuver it so it would be H’s turn to take them whenever they were due for shots. D2 used to scream bloody murder whenever she got a shot. The whole office could hear her. After a while, H and the girls figured it out.</p>
<p>I find this whole discussion fascinating and especially appreciate the docs chiming in. No suprise that CC has parents who are on the educated and involved side of child rearing.
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<p>oldfort, I am a nurse, and I can’t stand to see my kids get shots. I always had to look away. D1 was stoic. Always the pleaser, she didn’t want to upset anyone and would take her shots silently, with tears streaming down her face. D2 was having none of that, and had to be held down. Even so, she always managed to get a few kicks in. Poor nurses.</p>
<p>I once had to draw blood on a little patient (the lab couldn’t do it) and even with help from nurses, he was able to kick me hard right in the boob. The next week, my nurses made me a present-- a pointy gold brassiere like Madonna’s (but made from cardboard). We took a photo and showed the little guy’s mom and she laughed her head off. </p>
<p>^^^That’s really funny. LOL.</p>
<p>nrdsb4, that is some amazing practice. </p>
<p>Some of the discussion reminds me that it isn’t just sex that docs may want to discuss with teenagers alone. There are also drugs, body image, cutting, mental health issues, plenty of things that kids may be hiding from their parents but want to talk about with some adult. </p>
<p>My first thought was sex, but it could be any number of issues. </p>
<p>Okay, so what happens if it is depression or cutting or eating disorder or something like that. Does doc share concerns with parents? </p>
<p>Well, now it sounds like it’s up to the individual practice and if you don’t like it you can find another doctor. Interesting. </p>
<p>The difficulty for me is in the OP’s post the parent was there and the child was fine with the parent being in the exam room. Maybe, even wanted her in the room. I do understand that from the physicians perspective the patient is the child and they don’t want anyone getting between them and important medical information. But, I would not be okay with a doctor that saw me as a possible threat rather than a valuable partner in my child’s healthcare needs. It’s one thing if a young girl wanders into a clinic but to think 5 minutes behind a closed door with a doctor is going change anything when “mean mommy” is driving her home doesn’t make a whole lot of sense. </p>
<p>I did go into the pediatrician’s office. That dr is awesome and d is very comfortable with her. When d when to a gyno, I waited out in the waiting room. She didn’t need a pelvic exam but I wanted those two to make their own relationship. However, I do have a now 20yo s who sees a neurologist. One of us does go with him still - it’s more complex, not private personal info and a lot of remembering of which drugs did what and side effects to go over, dosages, refills, etc. Plus this doc doesn’t take insurance so at $250 a visit we don’t want him forgetting the details when he walks out.</p>
<p>I imagine it must be hard for some kids. When my fiance was sick he was giving the doctor all the wrong answers and I had to bite my tongue. He said he didn’t really feel all that bad, hadn’t had a fever, and wasn’t really coughing. He coughed so much his lips turned blue and was crying like a baby, he had had a fever, abd he fell alseep with his head on my shoulder whimpering like a little boy at the pharmacy waiting for his prescriptions after the appointment. I wonder if his parents ever bothered to take him to the doctor when he was a kid, what’s the point. He would probably come out saying the doctor said he was fine and be in the ER 12 hours later. If my kids are like this it will make me insane.</p>
<p>When I think about it, I do remember a time probably around puberty when my doctors did get a little more pushy about not having mom come back with me. I really strongly wanted my mom with me at the time. I have to assume they were pushing the issue just in case it was really what I wanted and I didn’t feel that I could push for it myself. But they gave that up by the time I was in high school. </p>
<p>OMG! My husband always tells the doctor he’s feeling fine. Then comes back home and stays in bed for a week moaning. And has ended up in the ER more than once. But, he’ll always say, "Well, I went to the doctor, " Good grief. You also have to tell them what’s wrong. Hello.</p>
<p>Eating disorder or cutting is danger to the patient. I tell. I’m a pediatrician, though. If I was an internist and the patient was 35, I don’t think you can tell anyone. </p>
<p>So, imo, as a pediatrician:
-young teen: option of privacy discussed, default is parent inclusion, kid’s option, with privacy/confidentiality brought up to discuss
-older teen: option of privacy discussed, kid’s option.
-older than 18: default is privacy but if kid wants parent in, they’re in (so no matter what age imo if the kid wants mom in the room, mom’s in the room. I look for signs that they might really not want that, though.)</p>