Challenges of Providing Confidential Care to Adolescents in Urban Primary Care: Clinician Perspectives

The Article in Brief

Challenges of Providing Confidential Care to Adolescents in Urban Primary Care: Clinician Perspectives

M. Diane McKee , and colleagues

Background Adolescents with privacy concerns are less likely to talk openly with a clinician about important health issues. Many youth, however, do not have time alone with clinicians during medical visits. This study explores clinicians� perspectives on delivering confidential services to adolescent patients.

What This Study Found Interviews with 18 primary care clinicians in urban health centers elicited clinician perspectives on the challenges of providing confidential services to adolescents. Despite competing time demands, clinicians reported a commitment to offering time alone during preventive visits, and to infrequently offering time alone during other types of visits depending on the chief complaint and parent-child dynamics. Clinicians cited time constraints as a major barrier to offering time alone more frequently, and they perceived parents were receptive to time alone. Many clinicians noted feeling conflicted about providing confidential services to adolescents with serious health threats and regard their role as facilitating adolescent-parent communication to optimize health outcomes.

Implications

• The authors call for the development of office systems to enhance the consistency of the delivery of confidential services to adolescents.