We are losing our teenagers. We are losing them to drugs and alcohol, cigarette smoking, sexually transmitted diseases, motor vehicle accidents, suicide, homicide, depression, anxiety, eating disorders, unplanned pregnancy, gun violence, gang violence, bullying, peer pressure.
Adolescence is a difficult time for teens and parents alike. Your child is often dealing with very adult issues without your knowledge or input. They often look to their friends to learn how to deal with adult problems instead of seeking counsel from adults who have been-there-done-that. I haven’t parented a
teenager yet, but I have been one and I have counseled hundreds in my office. The antagonism inherent to the parent-teen relationship often makes open communication difficult. Hopefully, your child has an adult, if not one of his or her parents, to confide in – perhaps a coach or teacher, or in my case, a doctor.
August means it’s time for the yearly back-to-school physical. Pediatricians’ waiting rooms all over the country will be jammed up with ear-bud-wearing pre-teens and teens just waiting to roll their eyes when the doc performs his exam.
The yearly physical exam by your child’s pediatrician or family doctor is a unique opportunity for a trusted adult to capture the teen’s attention and screen for high risk behaviors. It is imperative that a physician build rapport with pediatric patients in their early childhood years so that by the time they are teens, they will trust the relationship as unbiased and non-judgmental. Those children who trust their doctor become teens who trust their doctor, and even when they feel like they have a question they can’t ask their parents, they know they can ask one of us.
My goal is that my teenage patients will see me not only as a doctor, but an advocate, a counselor, someone they can turn to with questions. My teenage patients must know that for the most part our discussions will remain confidential barring the idea of hurting themselves or others of course (I give them all that disclosure early on). This once-yearly encounter may be the only time anyone is asking about these behaviors. Yes, everyone talks about drugs and alcohol in school – there are programs and videos and assemblies. But it’s in August, at the doctor’s office when someone directly asks, “ARE YOU USING DRUGS?” It may be the only time your child answers honestly, and it may be the one and only chance she has to get professional help. (Side note: It is common for parents of teens with drug or alcohol addiction, depression, anxiety or mental illness to believe that they can “fix” their child without professional help. You cannot love away addiction or mental illness. The earlier professional help is sought, the more likely your child is to be successfully treated and / or survive).
Most teens who display risky behaviors are afraid and desperately want someone to notice. Your child may be waiting for someone they trust to ask the tough questions. Being prepared for the annual physical is one of the best things you can do to ensure that your child is getting the most of out the visit. Rule #1 – Make sure that your kid’s doctor is asking you to leave the room, so they can take the most honest appraisal. Kids will never admit that they are sexually active if mom is standing there with a frown before the doctor even finishes the sentence. Rule #2 – Request that your doctor spend time with anticipatory guidance. Most teens are physically healthy, but it’s the risky behaviors that get them injured or make them ill. Screening for and educating about the most significant teenage health hazards (drugs, alcohol, safe sex practices and smoking) are the best way to keep them healthy.
Here is a list of questions I ask every adolescent starting around age 10. Of course, the questions depend on the child’s age and his or her risk factors…
- Do you wear sunscreen?
- Do you always use a bike helmet?
- Do you always wear your seatbelt?
- Do you ever drive under the influence of prescription or illegal drugs or alcohol?
- Do your friends ever pressure you to do things you don’t want to do?
- Do you use drugs, alcohol or smoke cigarettes?
- Have you tried any other substances such as huffing, bath salts or vaporizing?
- Are you or have you ever been abused – emotionally or physically? At school, at home or elsewhere?
- Do you ever harm yourself? Have you ever thought about hurting yourself or others?
- Are you sexually active? With men, women or both? Do you use protection every time? Do you use effective birth control every time?
- Are you comfortable with your sexuality?
- Is there a gun in your home or in your friends’ homes?
- Are you involved in gang activity?
- Do you suffer from depression or anxiety?
- How do you feel about your body image?
- Do you binge and purge or go long periods without eating?
- Is there an adult that you trust and confide in?
- How are your grades?
- Are you being bullied at school?
Establishing open lines of communication is the best way to survive the teenage years. Turning a blind eye to unsafe or illegal behaviors equals permission in the eyes of a curious teen. Don’t lose your teenager to high risk behaviors. Talk to your child’s doctor about screening and make sure he or she is asking the tough questions. Be aware that, depending on your state’s law, the physician may not be required to divulge conversations they’ve had with your teen especially as they relate to sexual activity, pregnancy, and STDs.
Happy August!
Alexis Hugelmeyer, D.O. is the wife of Michael, mother of Isabella, 5, and Lance, 3, and a family physician whose passion is hands-on manipulation for treatment and healing of any and every type of medical problem. She is the director of community outreach education at Peconic Bay Medical Center and also a private practitioner in Riverhead, where she has founded The Suah Center for Natural Healthcare. A graduate of Villanova University and New York College of Osteopathic Medicine, she lives in Baiting Hollow.
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