Adolescent healthcare at Hyde Park Pediatrics
As your child approaches their teens, our relationship with your family will evolve to encourage your teen to feel comfortable enough with us to ask personal questions and share uncomfortable concerns. We believe we can provide your child with the best possible health care when there is an opportunity to speak with your teen alone, with their confidentiality assured.
Every adolescent annual checkup includes confidential time between the patient and provider. This time will include discussion of topics such as:
- diet, exercise and body image
- fighting, danger and violence
- sexuality and sexual behavior
- safety and driving
- smoking, drugs and alcohol
- depression and stress
- school/grades/peer pressure
- dating and relationships
- family life
When your child turns 13, you will notice a change in your access to the MyChart patient portal. You will still be able to message your child’s doctor, print the health form for school, and view certain non-sensitive lab results. But other areas of MyChart will be private, for your child to access using his/her own login.
As parents, you are the experts about your teen and we want to work together with you to optimize their health. However, certain health information is, by Massachusetts law, confidential. That means that if your teen talks with us about certain issues, we need their permission to talk to you about it. These include drug addiction, family planning, treatment for sexually transmitted infections, and mental health concerns. However, we will inform you if we believe there is danger of serious risk to your child’s life or health.
Our providers always counsel teens about the emotional and health risks involved with sexual activity and substance use and encourage them to make the best choices. We strongly encourage teens to discuss their choices with their parents. However when a teen is at risk of pregnancy or sexually transmitted disease, we will provide appropriate, confidential medical care.
When a teen reaches their 18th birthday, by law their medical information belongs to them and cannot be shared with a parent without their consent.The transformation to the age of majority should not happen without preparation. We’ll work together with you and your child to prepare for this event. Years before turning eighteen, teens should become comfortable having private conversations with their pediatrician.
We recommend that beginning in their mid teens children become involved in scheduling their appointments and keeping track of them on their own calendar. Make sure that your teen knows their own and their family’s important health history. They should know names and dosages of their medications, whether they have any medication allergies, and how to obtain prescriptions at a pharmacy.
If your child is leaving for college, make sure that they are ready to manage their own health care. College packing should include:
- a list of any chronic or recurrent medical problems
- a list of any medications and dosages
- a list of any allergies
- a record of immunizations
- proof of health insurance and a pharmacy card
- a first aid kit including bandages, antibiotic ointment, digital thermometer, and acetaminophen or ibuprofen
Make sure your teen knows how to get in touch with his primary care provider at Hyde Park Pediatrics and how to access college health services. Talk to them about the importance of adequate sleep and nutritious eating. Talk frankly about alcohol availability and the dangers of binge drinking. Both girls and boys need to understand the risk of sexual assault and particularly the role that alcohol plays.
Our practice encourages young adults to see their pediatric provider up to age 22 years. Between 18 and 22 we will help your young adult prepare for the transition to adult care. We will begin to discuss with them how to choose an adult doctor and how to transfer their medical information.
Rest assured that our relationship with you, the parent, does not end when your child turns 18. Many young adults give us permission to discuss issues with their parents, however we will not disclose confidential information without your teen’s permission.
Transition planning for children with special healthcare needs
Children with special health care needs may require additional planning for transition to adulthood due to a more complicated medical history and sometimes cognitive challenges. It is important that children with special health care needs be included in the team planning for their future. In addition to planning for transition of healthcare to an internist, a plan should be made regarding what educational needs the child will have going forward; what employment opportunities may be available considering a child’s abilities and challenges; and ensuring access to the child’s preferred recreational activities.
Transition to adulthood is a process, therefore transition planning and discussions should begin around 12 to 14 years old. At this age, cognitively-able children should be able to name their chronic conditions, allergies, and medications. If they have an IEP, they should begin to attend some meetings. In middle adolescence, they should learn how their chronic conditions affect their health and what their medications are used for. They should be able to take medication independently and learn how to refill medications. The goal is for the patient to slowly begin to manage her own healthcare, if she is able. By age 15-17, the adolescent should begin to keep records and notes of her medical visits and issues. She should learn to write down questions to ask when visiting her health care provider. If possible she should be responsible for performing her own self-care procedures.
By age 16-17, the adolescent’s family should begin the process of obtaining guardianship or conservatorship if she has a disability significant enough to compromise her ability to make important financial or personal decisions, including medical decisions. A judge in a probate court will determine if the adolescent is legally competent to make her own decisions on these matters. Obtaining guardianship or conservatorship is a long process, so it is important to begin to work on this long before a child reaches the age of 18. A report of the person’s abilities by a licensed social worker, psychologist, and physician must be completed and submitted to the court along with other documentation. There are various resources for legal assistance. The adolescent’s school can often help as well.
Ensure that your child continues to have health insurance after age 18. Your child may also be eligible for Supplemental Security Income (SSI). SSI is money from the Social Security Administration to help low income disabled children and adults. If eligible for SSI, a person is automatically eligible for MassHealth. It is also important to make plans for adult living and vocation/work.
Hyde Park Pediatrics will care for your child until age 22; by age 21, you should identify an internist who will be ready to assume your child’s medical care. Other families you know with children with special health care needs may be able to recommend an internist or your pediatrician may recommend someone. It would be helpful to schedule an interview with the internist so you and your child can determine if he or she is a good fit for your child. Have your child’s medical records transferred to the person you choose so they will have all of the pertinent medical history. We are here to help you as you make these plans for your child.