Independence Day

Having a relationship with a regular family practice team is important for all of us, no matter our age. But there’s one group of people who can get left behind: whether it’s from shyness, fear of others finding out, or worries about being judged or told-off.

Building their own relationship with health care providers is one of many rites of passage that teenagers undertake as they begin to form some of their own networks and resources in the world.

Every family, teenager and practice is different – but the time will come for all, when visits become less shared, and more private affairs.

There’s no hard and fast rule for when the time is right, but certain ages and stages tend to start things rolling. Puberty is often a time when younger people crave more privacy and control over their own health. They’ll also be starting to take greater responsibility for their own health and lifestyle choices around this time.

Sometime between the ages of 12-16 is when many general practice teams suggest beginning to divide appointments up to allow a portion of time for the doctor and younger person to talk alone. Even just five minutes to start with can give either doctor or teen patient a chance to raise any issues that might not feel so comfortable in front of mum or dad.

Many factors, including ongoing or newly developing medical conditions, might influence whether or not it’s a good idea for a parent to attend when a young person is at that in-between age. It’s a good idea to check with your GP whether he or she is comfortable for your child turning up on their own, once you’ve started to make the transition.

Confidentiality and trust

Sometimes younger people will want to see a health care provider other than the one their parents or family do, as they are uncertain about whether GPs or practice nurses will keep their information private. It is important that they understand that it’s the law for health professionals to do this – but also that there are some limits to that confidentiality. In the same way as it applies to adults, if a child or young person presents a risk to themself or others, the healthcare provider may tell somebody else to keep them (or others) safe. If a doctor believes that a patient under the age of 17 is likely to suffer physical, emotional or sexual harm, he or she may refer the matter onto the police or Child, Youth and Family Services (CYFS).

Letting go

As your children begin to build their own healthcare relationships, you won’t automatically have access to their health records or information about their visits, regardless of their age. There is no set legislation about this in New Zealand, so it will be up to your practice team to balance their duty of care to the younger person, and the ethical and legal rights of parents. Regardless of the age at which your child is seeing a health provider – completely on their own or as a private portion of a visit – get as clear as you can about how patient confidentiality works. What can, or will, the doctor or nurse tell you if you ask about the visit? And what does your child want you to know? It’s not as simple as it sounds – in New Zealand there is no age at which children are automatically entitled to confidentiality, it’s up to the practice team to make a judgement. That may be something you wish to discuss with your doctor or practice nurse first, depending on the age or stage of your child.

Should they stay or should they go?

Whether your teenager decides to stick with the GP team they have seen with you all those years, or whether they choose to go somewhere else, practice teams would agree that what matters most is that these younger patients are comfortable. And bear in mind, the right thing for one teen may not sit well with another. Staying with the same practice affords your teen the benefit of an established relationship, notes already held, and an established family history that’s easy for their GP to refer to or share when necessary. Changing practices is another option. Having trust in the people they are seeing, and feeling open to be able to share any issues or questions they have, are key. If your teen does decide to change practices, encourage them to have their notes shared with the new practice, and to find a team they feel happy staying with in the long run. Or, they may choose an in-between option – perhaps visiting another practice only for sensitive issues or for a period of time, and returning when they feel more comfortable. Some areas around New Zealand have youth-specific services that young people may choose to use at times, as well as family planning and sexual health services. Any combination in which teens feel comfortable settling into a regular healthcare routine is encouraging for most doctors and nurses, who would like to see patients continue with providers they know, and who know them already.