Health

Should Parents Be Prepped to Leave the Exam Room During Their Teen’s Appointment?

Pediatrician Gives Suggestions at Conference for Physicians to Prepare Parents to Leave the Exam Room When Their Child Enters Teen Years

(Photo: Shutterstock)

It is relatively common for pediatricians to at some point ask the parent to leave the exam room during a medical visit, usually once the child becomes a teenager. This can be for more private parts of a physical exam and/or discussion of sensitive topics that the child might feel embarrassed to have a parent present.

Recently, Dr. Cora C. Breuner with the Seattle Children’s Hospital spoke at a conference sponsored by the North Pacific Pediatric Society as an expert helping physicians learn to prepare parents to leave the exam room. Pediatric News, and other websites for medical professionals, picked up the story in which Breuner suggests physicians begin preparing parents when their child is between the ages eight and 10. This way, when the time comes years down the road, they won’t resist leaving the room:

She tells parents, “I really need to be your child’s physician, and it’s really important that I have a rapport with him or her. I need the child to trust me, and I need you to trust me,” she said at a conference sponsored by the North Pacific Pediatric Society.

“I need you to trust that I’m going to tell you if there’s a serious medical problem that is uncovered when your child talks with me. I will bring you in on that. Sometimes kids tell me stuff as a provider that they might not necessarily share with you,” said Dr. Breuner, professor of pediatrics and adolescent medicine at the University of Washington, Seattle.

To build a trusted relationship with the patient, Breuner has another line: ”Everything you say is between you and me unless you say you hurt yourself or someone else, or someone is hurting you physically or sexually.”

Breuner reportedly uses these lines in every session with patients at these younger ages so everyone is comfortable with what’s to come. Most notably, the more uncomfortable situations in which Breuner and other pediatricians have to mitigate in the parent-patient-physician relationship are those of a sexual nature.

Breuner cites an example of a 14-year-old who was sexually active and wanted to receive birth control without her parents knowing. Birth control would of course show up as a medical expense. Here are the options Breuner would suggest giving the teen while they’re alone at the appointment:

First she helps the patient calm down emotionally and step back from the flood of feelings, then she gives her three options: She can go down the street to Planned Parenthood for contraception and screenings without being billed. “Or, I can bring your mom and dad in, one at a time or together, and have a conversation as your advocate, because I’m your provider. Or, you can stop having sex. It’s your call, but you need one of those three things to happen,” Dr. Breuner said.

Patients typically worry that their parents will get mad or upset.

“You have to trust me on that,” Dr. Breuner said. “I’m pretty good at doing this, I think, and can advocate for you to keep you safe. Or, you can have a really terrible car ride home” if the parents aren’t let in. “Maybe I can help you.”

The U.S. Department of Health and Human Services suggests alone time in the exam room as an important step to “teaching your child take control of [his or her] health care.”

The law on parent‘s rights regarding their minor’s medical privacy varies by state, but overall the Health Insurance Portability and Accountability Act (HIPPA) allows parents to access medical records of their minors with these exceptions:

  1. When the minor is the one who consents to care and the consent of the parent is not required under State or other applicable law;
  2. When the minor obtains care at the direction of a court or a person appointed by the court; and
  3. When, and to the extent that, the parent agrees that the minor and the health care provider may have a confidential relationship.

There are some who believe that laws at the federal level and practices within the medical profession are stripping parents of their rights over their children. ParentalRights.org is one such group that believes HIPPA and the Family Educational Right to Privacy Act (FERPA) are examples of laws that were “intended for good, to enact privacy regulations preventing third parties from accessing educational or medical records“ but were left with ample room for interpretation that can ”shut parents out of their children’s lives by denying them access to important information about their children.”

What do you think of parent’s being prepped to leave the exam room? Share your thoughts in the comments section below.

Comments (99)

1 2 3
  • Libertyluvnmomma
    Posted on May 14, 2012 at 12:31pm

    obviously, my spouse would not sit in on a gynecological exam….

    Report Post » Libertyluvnmomma  
    • Mike N
      Posted on May 14, 2012 at 12:55pm

      Until the children are 18, at least the 1 more suitable of 2 parents should be present, even if on the other side of a drawn curtain. Kids are too impressionable, and can be led to conclusions by those medical personnel who may unduly try to influence them.

      Report Post »  
    • godlovinmom
      Posted on May 14, 2012 at 1:34pm

      Not in a million years would I leave my thirteen year old alone with anybody outside our family..I don’t care if you do have a PHD…When I was young, my mom and dad just gave our doctors and dentist all power over their children…big mistake…even some “professionals” are wierdos…Having said that…NO WAY.

      Report Post » godlovinmom  
    • Taquoshi
      Posted on May 14, 2012 at 4:20pm

      Uh, God Loving Mom, the physicians are M.D.s, [Medical Doctors] not PhDs. [technically Doctors of Philosophy, however known on the street as "Piled High & Deep"].

      However, I agree with you for the most part. Our son has a seizure disorder and they keep asking him what happens during a seizure. Well, guess what, he doesn’t remember. We’re the conscious ones, not him. And if it happens to be a petite mal, he may not even know he had it. Also, I’m the one with some medical background, so many times they tell him something and he has NO idea what they just said.

      But they won’t tell us what medications they gave him, which was really scary the first time, as he was walking into door frames and almost fell asleep face down in his dinner plate one night. We were afraid to let him walk up and down the stairs alone for weeks. It would have been helpful if they allowed me to know what was going on so I could work with them to protect our son from the episodes rather than automatically labeling me as “over involved” and a “problem”.

      Report Post » Taquoshi  
    • mensa141
      Posted on May 14, 2012 at 5:03pm

      Until that doctor wants to take on the responsiblility of raising my child would I ever leave them alone.

      Report Post »  
    • Truthbeliever2
      Posted on May 14, 2012 at 5:21pm

      Should Parents Be Prepped to Leave the Exam Room During Their Teen’s Appointment?

      Of coarse they should leave the exam room. That “teenager” is part of a collective and should be taken care of by the collective.

      Parents? Who needs em???

      Report Post » Truthbeliever2  
    • lukerw
      Posted on May 14, 2012 at 9:30pm

      Home Life is about Social Fascism: If you live under my roof… sleep in a provided bed… and eat my food… I want to know all about you!

      Report Post » lukerw  
    • godlovinmom
      Posted on May 15, 2012 at 12:44am

      Taquoshi..thanks for clearing that up…I was wondering after I wrote it if I was right on the lettering…and of course I was not…Like I said… I don’t care what follows your name..my child will not conform..hense why I homeschool…which I’m a lot better at than blogging :)

      Report Post » godlovinmom  
    • godlovinmom
      Posted on May 15, 2012 at 12:53am

      One more thing…Taquoshi…Good luck with that kid of yours…My advise “stay over involved’!…I know I do.

      Report Post » godlovinmom  
    • mariAri
      Posted on May 29, 2012 at 11:10pm

      http://www.momlogic.com/2010/02/dont_leave_your_child_alone_with_a_pediatrician.php

      do not EVER leave your kid alone with the doctor. If you leave, say “Okay, doc. I’ll wait for the nurse.”

      NO doctor on the up and up WANTS to be alone with your child – too dangerous for THEM to get accused of something. A legit doc will get his nurse to be present.

      No Nurse? “Okay, I can come back when one is available” – and go get a new doc.

      Report Post »  
  • love the kids
    Posted on May 14, 2012 at 12:30pm

    I think it’s odd that if I had a party at my house and kids were to sneek some beers in from someone elses house and the kids got drunk and fell off the bike on the way home and broke their arm that I could be charged for endangering the welfare of a minor, but if a 12 year old girl goes to a doctor and wants to be put on the pill because she is having sex without her parents knowledge and the doctor tells her how to get free pills that the Govt. also is assisting in providing for these illegal activities, that they are not criminally liable for?
    Can anyone help? Someone will respond that it is inevitable that they will have sex, but I say that it is just as inevitable that they will try alcahol.

    Report Post »  
    • Valuable
      Posted on May 14, 2012 at 12:39pm

      It’s totally insane!!! The other side wants it every way.

      Report Post »  
    • claymoremacm
      Posted on May 14, 2012 at 3:39pm

      Doctor asks “tell me little Johnny, are there firearms in your house?”

      Report Post » claymoremacm  
  • Libertyluvnmomma
    Posted on May 14, 2012 at 12:29pm

    When my children pay for their own medical bills-they can go alone.
    as teens we knew that if we were going behind our parents back- we’d go to the health dept,
    12 year olds will learn this soon enough!

    Report Post » Libertyluvnmomma  
    • edbennion
      Posted on May 14, 2012 at 1:43pm

      Amen. I’m paying the bill, I want to be there for my child. This law only exacerbates the problem where people do not have to deal with the consequences that their choices make. Now they’re trying to expand it to our children by treating them as people who are capable of making adult decisions. The result is negating the importance of parents and of a family in general.

      Report Post » edbennion  
  • Ginger Taylor
    Posted on May 14, 2012 at 12:25pm

    Parents also need to understand that this “alone time” may be used in California to give your child vaccines that you may not want them to have. California AB499, quietly passed last fall, allows nurses and docs to give children the Gardasil and Hepatitis B vaccines to a child 12 and older (although I know of two 11 year olds who were given it) with out the parents knowledge or consent.

    Both vaccines can have severe side effects, with more than 100 deaths of “Gardasil Girls” now, and more than 25,000 adverse reactions, and with HHS ruling that Hep B vaccine can cause MS and Lupis, you have a senario where a child can fall very ill, and parents won’t know to even look for a vaccine injury, as they will never know a vaccine was given.

    And, of course, the parent won’t be able to apply for help to the federal Vaccine Injury Compensation Program, because they won’t know it may be a vaccine injury. Saves lots for money for the government that way.

    Report Post »  
    • ConservDadASD
      Posted on May 14, 2012 at 1:09pm

      If the Blaze had it… I would give this post a big “Like”.

      Report Post »  
    • deeberj
      Posted on May 14, 2012 at 1:58pm

      I did not know about that. How awful that a vaccine with so many bad side effects could be given without parental consent. Crazy.

      Report Post » deeberj  
  • funjumper
    Posted on May 14, 2012 at 12:22pm

    My children knew one thing, that NOBODY and I mean NOBODY has their best interest at heart and in mind. If my doctor had ever had the gull to say that to me I would have told them in no uncertain terms to forget it. I never did and especially in these times ever left my child in an examination room without one of their parents, NEVER. As far as trusting the doctor as some suggests, forget it, I don’t trust anyone with my children, teachers, doctors, especially politicians which is where this is coming from.

    Report Post »  
    • Mtroom
      Posted on May 14, 2012 at 12:36pm

      Yep… You can tell where this comes from…”I need, I have, I want, I will…blah, blah, blah”… That is total crap.. How about this…You won’t, you can not, and you will never treat my daughter…Ever.. She will never be left alone..Not with a doctor who speaks like that… Trust is earned not a given.. Who does this lady think she is?

      Report Post » Mtroom  
    • PaxInVeritate
      Posted on May 14, 2012 at 1:52pm

      As most physicians are ‘highly’ intelligent and have… let’s say… larger than normal egos, they are perfectly within their rights as ‘medical experts’ to assume responsibility form making the proper decision on the parents’ behalf (add copious amounts of sarcasm).
      I had my pediatrician tell me that I had lymphoma. My mom took me to an Infectious Disease Dr. for a second opinion. Turns out it was something entirely different, and if I took the first opinion I wouldn’t have my right arm. Thank God my Mom didn’t trust the first one… oh… and he had my best interest at heart.

      Report Post » PaxInVeritate  
  • love the kids
    Posted on May 14, 2012 at 12:14pm

    I took my 12 year old son to the doctor for his physical last year. They first called him and took him in the back. They said I could come in the room in a few minutes. Then I was called and escorted into the exam room and he was brought in the room around the same time. As normal, the Doctor was not in the room yet. I asked him what he did and he said he had to fill out a questionaire. I asked him what it asked and he told me that he was told not to talk to our parents about it. This all came as a shock to me, and I had not taken him before and I didn’t know if this had happened in the past. I didn’t want to make a scene about it there. When the Doc came in, nothing was mentioned about the questionare, again, I didn’t say anything. The normal physical continued.
    When I got in the car, I prodded him a little more and he was pretty quiet about what he was asked. So my mind went all over the place.
    When we got home, I talked to my wife in private about it and she said this has never happened before and called the Nurse practioner right away. She told my wife there are questions about sexual preference, sexual activity, abuse, drug use and things like that. She asked why our son was told not to talk to his parents about it and she said that he was told he doesen‘t have to talk to the parents if he didn’t want to. So this makes us think, is there something on there that he won‘t tell us and how am I to parent him if something is going on that I don’t know about?

    Report Post »  
    • sablegsd
      Posted on May 14, 2012 at 7:52pm

      Grow a spine. Quit giving the authority over your children to others, dr.s or not. And homeschool. Public schools are nothing but pus ridden indoctrination centers.

      Report Post » sablegsd  
  • Eric-n-OTown
    Posted on May 14, 2012 at 12:11pm

    I‘m surprised no one has commented on the doctor’s comment about the three choices she gave a 14 year old girl who was sexually active but didn’t want her parents to find out: #1, go to Planned Parenthood. Seriously?! Another poster made a comment about everything not being a Liberal conspiracy, but I’m sorry, their agenda pervades every aspect of our society, and this is no different. It is every parent’s responsibility to develop a relationship of trust with their children, and leave it to the family to determine when is and is not an appropriate time (if any) to leave a child alone with a physician, or anyone for that matter. Unless the doctor is going to take responsibility for the actions of the child (is he/she going to pay the expenses of a teen pregnancy when contraception fails?, how about the psych bills when that child deals with the emotional breakdown after having murdered their own child in an abortion), the parent needs to be involved in any and all discussions. If a parent feels that they trust their child enough to discuss with them what was said alone with the doctor than that is their choice to make, not the doctor’s.

    Report Post »  
    • Patriot of My America
      Posted on May 14, 2012 at 9:15pm

      Most doctors are well intended however I would not allow my child to be left alone with any one that is not family or otherwise well trusted. And a M,D, behind your name neither makes you family or well trusted. I stay with my kid , period.. Liberals go suck an egg…

      Report Post »  
  • ThinkingOutLoud2
    Posted on May 14, 2012 at 12:10pm

    ‘She tells parents, “I really need to be your child’s physician, and it’s really important that I have a rapport with him or her. I need the child to trust me, and I need you to trust me,” she said at a conference sponsored by the North Pacific Pediatric Society’
    The perfect set up line for an abuser pediatrician.
    Haven’t we learned the lessons from the Boy Scout and Church child abuse scandals? Even our most trusted leaders should not be left alone with our children.
    I haven’t seen any data to suggest pediatricians are any less likely than any other group to abuse a child.
    For this pediatrician to promote this approach suggests a tone deafness to the abuse issue. Above all, the pediatricians should be actively promoting child safety – including policies that keeps kids safe from abusers –yes, even doctors.
    So what do pediatricians do with our kids when they are alone with them and they have our trust?
    Here is one example: My sister was asked to leave the exam room during her son’s exam. Caught off guard by the unexpected request, she complied.
    Unknown to her, her child was peppered with inappropriate questions about his sexual orientation for some sort of study – which was not disclosed to her.
    Her child was very confused, not quite grasping what the doctor was talking about. When my sister found out, she was furious.
    She walked into the pediatrician’s office for a routine exam and came out having to spend a rest of the day explaining to

    Report Post »  
    • Valuable
      Posted on May 14, 2012 at 12:44pm

      Ooooohhhh!!! That is an EXCELLENT point!!!!! Thanks for posting it!!!

      Report Post »  
  • Gamaliel
    Posted on May 14, 2012 at 12:03pm

    Forget the trust. These devils tried to abort my grandchild behind my back; they treated me like an enemy. I knew what was going on only because of pro-life work.

    Don’t forget that YOU, the parent, are the one held responsible for EVERYTHING your child does until they are 18.

    Report Post »  
  • TEIN
    Posted on May 14, 2012 at 11:55am

    If I trust the doctor no problem, but if like Dr. Breuner, my physician as an option suggest that my daughter goes to PP to get medication that I would not know about?? Then the doctor and I would have to have a bit of a discussion…. This is still my child and responsibility, and until the state forces me out of the picture, I will take that responsibility….

    Report Post »  
  • txannie
    Posted on May 14, 2012 at 11:55am

    When did common sense die? Of course I left the room when the dr wanted to do a hernia exam on my teen son. No, I did not leave the room when the dr ask my teen daughter if she was sexually active. As parents we have to have the sense to do what is right for our children and if you are paying attention you know when it is wise to leave the room and when it is not and you should be in on the conversation between your child and any other adult. If you have cultivated a good relationship with your children you already know about the stuff they are experiencing and have helped them make the best decisions for everyone involved.

    Report Post » txannie  
    • deeberj
      Posted on May 14, 2012 at 1:54pm

      You don’t have to leave the room when you son gets a hernia exam. I stayed in the room and promised not to look and didn’t look. He was fine with that. He wanted me there. It was a new dr. and he felt uncomfortable allowing a dr. to do that exam when the two of them were alone.

      I agree you should know your own children enough to know if you should leave them alone in the room or not. But I would err on staying in the room.

      Report Post » deeberj  
  • PATRIOTMAMA
    Posted on May 14, 2012 at 11:55am

    Look. If I‘m going to be legally responsibile for my child then I’m going to be involved in their medical care, their education and every other decision that is made in their life! You can’t have it both ways. Not if you want me to go along with it. I understand that if you’re child and you discuss it and decide that they want some privacy then whatever, individual decision between parent and child. HOWEVER, if I‘m on the hook for them if they committ a crime then by god I’m going to be responsible for them I don’t do things half-ass so you don’t get it both ways. Either they’re responsible for themselves or I am, if I am then I’m going to be involved in ALL things that effect them. Sorry!!!

    Report Post »  
    • HorseCrazy
      Posted on May 14, 2012 at 1:05pm

      totally agree. my friends son became sexually active, discussed it with his pediatrician at the age of 14 and his mother was never told. he ended up with an std, how is this ok for the mother not to be made aware? he would have had schools switched etc but instead CHILDREN can discuss drug use, sexual activity etc with an adult who is not their parent and itis made unavailable to parents but if this same kid gets arrested for drugs now its the parents problem. Not in the best interest of the child or the family.

      Report Post »  
  • onecalledsam
    Posted on May 14, 2012 at 11:44am

    Under no circustance will I leave the room. At 13 or 14, were you able to fully understand and handle decisions concerning sex and outcomes? I am my child‘s parent and will remain so until they’re adults.

    Report Post »  
  • Misha
    Posted on May 14, 2012 at 11:39am

    Just crossed this bridge with my teenage daughter. I asked her what she was comfortable with before we went – and she wanted to handle it herself. I spoke to the doctor seperately to make sure a few issues I had were addresssed and that was that. Physicals are uncomfortable enough as it is – if you don’t trust the doctor alone with your kid, then get a new doctor. I like the approach of the doctor in the article.

    Report Post »  
  • IMCHRISTIAN
    Posted on May 14, 2012 at 11:38am

    The parents are head of the household and if children rights ever went over that of the parents rights then the devil like controllers has taken over.

    A guy that I used to work with said his teenage daughter threatened to sue him for something she wanted to do against parents wishes. He told her well I hope you enjoy getting out and paying your own bills when you leave home (soon). He wasn’t serious of course and neither was she after the confrontation.

    Report Post »  
    • IntransigentMind
      Posted on May 14, 2012 at 11:46am

      Here’s the only relevant question: Who’s paying?

      After that, the question of who is entitled to information, or to be present, or anything else is purely academic.

      Report Post »  
  • goodgrubguy
    Posted on May 14, 2012 at 11:37am

    ..will NEVER happen in my world!!

    Report Post » goodgrubguy  
  • fromtheburgh
    Posted on May 14, 2012 at 11:31am

    I don’t agree with this. When the doctor started to ask me to leave the room when my sons went to the doctor (which fortuntately only happens rarely) my husband started going to the appointments and staying in the room. I don’t need an outsider to talk to my boys about sex which is what they wanted to do. Empowering your child can be done by staying in the room and having the teenager control the appointment not the doctor.
    It can only happen if you let it happen.

    Report Post »  
  • Best_Patriot
    Posted on May 14, 2012 at 11:29am

    Look at these comments. Is there anything you people think is NOT a liberal conspiracy? Jeez, you are a bunch of scared little lambs. I’m surprised any of you leave your house. Get a grip!

    Report Post » Best_Patriot  
    • fromtheburgh
      Posted on May 14, 2012 at 11:34am

      I don‘t think it’s a liberal conspiracy. It’s taking control of the situation. Doctors are only men and women and although may be a terrific doctor may not have the same values as I do.

      Report Post »  
    • staythecourse
      Posted on May 14, 2012 at 11:49am

      @best_patriot It is obvious that you have not read the health care act.

      Report Post »  
  • tzion
    Posted on May 14, 2012 at 11:26am

    For me it’s a matter of trust. Do you trust your child and the physician? If not maybe it’s time to find a new care provider.

    Report Post »  
  • deeberj
    Posted on May 14, 2012 at 11:25am

    Wow, thank you so much for your very relevant comments. I appreciate posters like you who add so much to the discussion.

    deeberj  
  • deeberj
    Posted on May 14, 2012 at 11:24am

    I think it needs to be up to the parent and child, not the doctor. And I don’t think it should start at age 10. It should be brought up when the child is in puberty and the parent needs to have final say.

    The complete exam my son had at age 14 the doctor told the both of us what the exam would entail and did we want me to leave the room. My son asked me to stay and just not look for one part of the exam, which I did. I would have left if he asked me to because he was 14. Now that he‘s older he’d probably ask me to leave.

    Report Post » deeberj  
  • mom4times
    Posted on May 14, 2012 at 11:24am

    I will not comply

    Report Post » mom4times  
    • NEVER.GIVE.IN
      Posted on May 14, 2012 at 5:04pm

      love it!
      I will not comply either. When my oldest hit 12, we had a 3 person discussion with the physician about puberty at the next physical. It did her good to see us being frank and not embarassed, clinical and logical but still preserve humor, modesty and self respect. I prepare my kids for puberty logically, spiritually and practically. Then I make sure they get the information they need along with the practice of reviewing it and challenging it through spiritual, logical and moral reviews.

      Report Post »  
  • Frodo RinosBane
    Posted on May 14, 2012 at 11:20am

    We have to get parents out of that exam room so we can educate them on how to be sexually active without the parents’ objections.

    Report Post » Frodo RinosBane  
  • Frodo RinosBane
    Posted on May 14, 2012 at 11:18am

    Only leave if you’re ready to emancipate your teen and deal with the consequences.

    Report Post » Frodo RinosBane  
  • usalover
    Posted on May 14, 2012 at 11:16am

    No way, I just took my 16 year old son for a physical on Friday and I did not leave the room. I was not asked to leave at any point.But I live in flyover country.

    Report Post » usalover  
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