Article Figures & Data
Tables
Variables No. % Sex Female 14 78 Male 4 22 Type Family medicine 9 50 Pediatrics 5 28 Adolescent medicine 4 22 Race/ethnicity African American, black, or Caribbean 5 28 Asian or Pacific Islander 3 17 Hispanic/Latino 2 11 White 8 44 Variables No. % a Annual visit for preventive care services (check-up or physical examination). b Scheduled visit for follow-up of previously identified condition. c Appointment obtained by calling for same-day access. d In 144 cases a parent/guardian attended the visit with adolescent. e Physician indicated parent left room without being asked in an additional 3 cases. Type of visit Annual preventive care visita 88 43.3 Follow-upb 55 27.1 Same-dayc 36 17.7 Walk-in 24 11.8 Not classified by physician 12 5.6 Adolescent’s reasons for visit Acute visit 58 27.0 Preventative care examination 71 33.0 Reproductive health mentioned at all 43 20.0 Routine care or chronic disease management 35 16.3 Other 8 3.7 Parent/guardian attended visit with adolescent 144 67.0 Confidentiality explained to adolescent during visitd 120 83.3 Confidentiality explained to parent during visitd 60 41.7 Parent asked to leave roomd,e 93 64.6 Identified needs requiring confidential care follow-up 85 39.6
Additional Files
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.
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