Caring For Teen Patients: 'Helicopter' Parenting Can Get in the Way

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C.S. Mott Children's Hospital National Poll on Children's Health at the University of MichiganCredit: C.S. Mott Children's Hospital National Poll on Children's Health at the University of Michigan

A new discussion of teen health issues focused, in one of its presentations, on the boundaries that are in place (and others that perhaps should be) between privacy in medical/health counseling and parents need-to and desire-to know what's going on in their child's life. In a "spoiler alert" title, the survey supervisors called the results "Back Off: Parents Impeding Teens' Healthcare Independence."

Parents of teens often struggle to relinquish control of healthcare decisions, even when the "child" exercises independence in many other areas, as older teens are wont to do. However, it is remarkably tough for most parents to ease up on control regarding their children's health checkups, a new national poll suggests (see Graphic).

Just 34 percent of parents say their teenager discussed health concerns privately with a doctor, without them in the room, and less than 10 percent say their teens can complete their health history form independently. These data are contained in a new report from the C.S. Mott Children's Hospital National Poll on Children's Health at the University of Michigan, which is based on a nationally-representative group of 1,517 parents of teens ages 13-18. The project, conducted in September 2015, was led by Matthew M. Davis, MD, MAPP, and Sarah J. Clark, MPH.

The completion rate was 40 percent, and the estimated error range was +/- four percentage points.

"The majority of parents are managing teens' health care visits, and their teens may be missing out on valuable opportunities to learn how to take ownership of their own health," Ms. Clark said. "Speaking with the doctor privately is important, not only to give teens a chance to disclose confidential information, but also to provide the opportunity for them to be an active participant in their own health care, without a parent taking over. When parents step in to manage the healthcare interaction, teens do not have the opportunity to develop confidence and comfort in having discussions with the provider, asking questions about their condition or treatment, and taking responsibility for their own health."

This is not, however, a one-way street. Speaking as a parent of an erstwhile bunch of teens (OK, now all in their 30s), there is good reason for parents to want to keep their kids' health issues, and the ramifications thereof, a subject for the whole family unit to weigh in on.

One clear prerequisite for privacy in the doctor-teen "cone of silence" is the participation of a caring, informed, sensitive physician which is not always the case. Even in the best case scenario, however, the decision being discussed in private may have major repercussions in the teen's life; many agree that such important issues need the input of parents again, they too are hopefully caring, responsible and sensitive parents, also far from automatic.

And what about the fairly common situation where parental values are very different from those of the caregiver, whose sympathies may lie closer to the desires of their young patient, but which would arouse the ire of the parents in a strict or close-knit family?

As a former clinician, I strongly believe that teen patients, especially older teens, need and deserve privacy in healthcare matters. Absent such, the free flow of information will be stymied by the presence of the "helicopter parent" in the room. And of course, the youngster will then go out and do whatever they would have done anyway, but without the (hopefully) wise professional counsel. Parents should indeed back off and allow at least a modicum of private interaction between the teen and his or her doctor, in the best interests of the patient and of course, therefore, the parents as well.