"Although some pediatric, family medicine and internal medicine practices provide confidential services for teenagers, many physicians do not relay this information accurately or consistently to the office staff answering their appointment lines," said senior study author Tina Cheng, M.D., M.P.H., director of the Division of Pediatrics and Adolescent Medicine at the Johns Hopkins Children's Center.
Following a survey of physicians and their office staff at 170 randomly selected pediatric, family medicine and internal medicine practices in the Washington, D.C. area, Cheng and a team of researchers found that in as many as 63 percent of practices, office staff answering telephones gave responses that contradicted doctors' responses when asked if they offer confidential services to adolescents.
"These findings are troubling, because teens should know they have a right to confidential care and because the information they get about confidentiality when trying to schedule an appointment may be a deciding factor in whether to seek health care," Cheng says.
"Whether or not a teenager suspects he or she may have HIV, or if they're simply looking for contraceptive information, any delay to medical care could have serious consequences," she added. Cheng conducted the study with Lara Akinbami, M.D., while at Children's National Medical Center in Washington, D.C.
She suggests that establishing written office policies on adolescent confidentiality may ensure consistency within a practice and improve access to confidential care for adolescents.
Cheng's team also reported that fewer than half of all pediatric practices provide pelvic exams, contraceptive services and STD testing to adolescents, citing a lack of equipment, expertise and patient demand. Family medicine and internal medicine practices were more likely to provide these services to adolescents.
"Pediatric practices unable or unwilling to provide pelvic exams or testing for STDs must at least be able to offer adolescents a referral to a specific practice or specialist who can provide the necessary care," said Cheng. "Our study also reinforces the need to provide both adolescent medicine training in pediatric residency and continuing medical education to ensure that future pediatricians feel confident treating adolescents."
All 50 states legally entitle adolescents to consent for treatment for "medically emancipated conditions" that may include contraception; pregnancy; diagnosis and treatment of STDs, HIV, or reportable diseases; treatment of substance abuse problems; and mental health issues.
Cheng and her colleagues emphasize that teens are usually best served if they can safely discuss these issues with a parent or guardian.
Media Contact: Jessica Collins 410-516-4570
Email: jcolli31@jhmi.edu
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