Be patient Let kids talk to doctor
Iwork with young people. Interactions with them are a joy, and I truly feel excited about the future as their intelligence, optimism and sense of what is ‘‘right’’ is inspiring. However, am amazed at how little some of them understand about healthcare.
There is certainly a spectrum, with some wellinformed users at one end, and the very naive at the other. It has highlighted to me as a parent that it is my job to equip my children to do this successfully, and it’s never too early to start. So as a parent, and a doctor, here are my top tips:
Firstly, get the young people in your life used to the idea of accessing health providers before they become unwell.
This doesn’t mean you want to create adults who are dependent on doctors for everything, but it is beneficial to understand that health promotion, screening, vaccinations, contraception and other ‘‘check-ups’’ are a part of staying well. Even if you have no symptoms, your family doctor can have an important role to play.
This can start from a very young age, when you take your pre-schooler for an ear and eye check, for example. As well as demonstrating a sensible approach to disease prevention, this will enable your children to see that health providers aren’t scary people you only see when you feel dreadful.
Secondly, try to enable your child to speak up when they are at an appointment. As hard as it may be for some, encouraging them to describe their symptoms or discuss their feelings from a young age is an important step to take, and will lead to more confident, health-literate teenagers.
They won’t be able to do this if you are talking on their behalf, so think about letting them take the lead, and even ‘‘rehearse’’ a few questions before you go into the consultation if you think that might give them more confidence.
Aim to equip your teenagers with a good basic knowledge of health. Sometimes I feel like I spend half my day educating young patients about what their symptoms might mean – reassuring them it’s unlikely they are dying if they have a sore throat, informing them that viruses don’t respond to antibiotics, telling them how to manage their period pain, and so on.
This isn’t because they are a population of ‘‘worried well’’ but because they genuinely don’t have the knowledge to know when and how to seek medical help, or when it’s safe to stay home, take a couple of Panadol and go to bed.
I try to encourage conversations with my kids when any of us is unwell, explaining what it might be and how to treat it, so that health is a natural thing we discuss.
If you don’t feel able to do this (or you are lucky enough to be in a family that never gets sick!), then use the massive online knowledge base that is out there – health navigator (healthnavigator.org.nz ) has an entire section on the health of teens and young adults, including specific bits on mental health, acne, periods, contraception, alcohol and other topics.
It’s super easy to read and holds great information. If you are looking for information specific to sexual health, I would recommend justthefacts.co.nz, another fantastic resource, and for mental health topics I’d go to The Lowdown (thelowdown.co.nz) – it covers everything from anxiety, depression and suicidality to relationship break-ups and issues around eating. Giving your teens access to this information is empowering for them, and can open up a whole lot of important conversations quite naturally.
Make sure your teens know that they can at any stage go to the doctor or nurse without you present. This can be quite hard for parents, especially if your 13-year-old still seems really young – but the sooner you can step back and allow them to have conversations on their own, the better.
It doesn’t mean you won’t be involved at all, but it does give them space to discuss what is going on for them, not what you think is going on for them.
I have approached this with my kids by taking them in, starting the appointment with them, and then leaving after a few minutes so they can have time on their own. I’ve always pre-warned them so they don’t get alarmed, but I hope it’s been effective in terms of letting them develop their own rapport and way of talking about their health concerns.
Understand the boundaries of confidentiality and consent – many parents don’t know the rules around this either, so it isn’t surprising that most young people don’t!
But the bottom line in New Zealand is that at 16 years and up you are considered an adult in terms of your health and, as such, are entitled to make decisions about your health without your parents’ input. Even younger than this, you can make decisions about your sexual health and contraceptive needs, as long as you are deemed of a developmental age to ‘‘understand and consent’’, and can also make other health decisions if appropriate, depending on the situation.
This can be super hard for a parent, who has previously been used to making all these decisions on behalf of their child – but it’s crucial to make sure your teenager understands this. You may not agree with their decision to have sex and use a
Encouraging your children to describe their symptoms from a young age will lead to more confident, health-literate teenagers.
contraceptive, for example, at the age of 15 or 16, but they are entitled to make that choice, and have the support of good health providers to enable them to do so.
In all situations, especially with very young or vulnerable teenagers, I encourage them to involve an adult in their decision-making, but sometimes they don’t want to, and sometimes if they do, it turns out to be someone in their life who isn’t a parent, and that’s fine too.
This rule doesn’t apply if there is considered to be a significant risk to the young person (someone who is suicidal, for example) – in that situation, a doctor is obliged to share this knowledge with parents and caregivers, but other than that everything that is discussed in a consultation can be kept private if that is what the young person wants.
Lastly, let your teenager choose where they want to go to get health advice and support. This may not be the family doctor you have taken them to for years – they may prefer a local youth clinic, or to be booked into family planning or a sexual health clinic, depending on their needs.
Many youth clinics provide drop-in services that are much easier for teens to access, and will often have holistic teams working there who understand the specific needs of this age group.