Why Honor Confidentiality With Teens?

I would assume that when parents are asked to leave the room for a few minutes during a preteen or teen physical, they know their child or the doctor will bring up sex, drugs, and anything else that may be a concern and is not easily discussed with parents.

Fair is fair - and it is the law in many states. The parent has to trust that if the child reports some behavior that puts them at risk, the doctor will insist that the parent is told. But, what about the grey areas - bullying, drinking, trouble at home, preteens, or a lack of friends?

Doctors want their patients to trust them and youth need adults they can trust, but where is the line between having to report something to a parent, and being able to "manage" it with the preteen or teen, when it is not covered in the state law? I suspect the answer changes based on how mature the child is, the level of the health risk, how much parental monitoring there is, and whether the parents might be part of the problem, but none of that helps the clinician decide how to handle the situation.

Teens should ask their doctor and the staff in the office if what they say to the doctor is confidential and clinicians should tell patients the kinds of things they would have to report, so that there is a chance for trust to build. Clinicians likely have decided how to handle general situations and train the staff they work with on how to protect the confidentiality of the teens, but I worry that not having a clear policy leaves the door open for errors.

Whatever your policy is .. tell your teen patients and let me know, too - I am curious!

Happy Holidays!

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