5 things to know about doctors for teens

Martin Fisher, chief of the division of adolescent

Martin Fisher, chief of the division of adolescent medicine at the Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park. (Sept. 7, 2011) (Credit: Newsday/Karen Wiles Stabile)

Teenagers can be ornery in the best of times, making it tough to get them to go to the doctor.

But medical checkups are crucial for adolescents. Here's what you should know to make sure they happen -- and are productive:


1. AIM FOR ANNUAL CHECKUPS


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The American Academy of Pediatrics suggests a checkup each year for teens. Why so often? Dr. Martin Fisher, who helped draft the academy's recommendation, says the guideline makes sense because young people's health can evolve quickly in terms of issues like substance abuse, sexual activity, mental health and nutrition.

"The chance that things change is gigantically high," said Fisher, chief of the division of adolescent medicine at the Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park.


2. PEDIATRICIANS TREAT MORE THAN SNIFFLES

Pediatricians treat the usual colds and flu cases in adolescents along with problems such as acne and sports injuries, Fisher said. They also see teens with high blood pressure, chest pain, headaches and abdominal pain, although these conditions are rarer.

Weight is another common topic in pediatric offices. The number of overweight and obese children has increased locally, he said, though not as much as in some other areas of the country.


3. TEEN MENTAL HEALTH ALSO MONITORED

Three decades ago, pediatricians tended to focus purely on physical health, Fisher said. Now, they explore such issues as depression and anxiety, substance abuse and sexual health.

Many medical issues cross the line between physical and mental health, he said. On Long Island specifically, eating disorders are a major problem, he said, and not just girls are affected. According to Fisher, about 10 percent of children affected by eating disorders are boys.

To Fisher, the most challenging part of his job is unraveling the connection between the physical and the mental. "When you talk about abdominal pain or chest pain, for example, there's the combination of making sure that you're considering all the medical possibilities while at the same time evaluating what may be playing a role from a psychological viewpoint and considering how they interact with each other," he said.


4. A TEEN SHOULD FEEL COMFORTABLE WITH HIS OR HER DOCTOR

"Some teens can be put off by the general emphasis on very young kids in a pediatric practice, like circus-themed wallpaper, child-friendly exam tables and Band-Aids with cartoon characters on them, not to mention the waiting room typically filled with very young children," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the children's medical center.

It's important to talk to both your teen and to the pediatrician about how they're getting along, Adesman said. "If there seems to be a gap in communication or trust between a pediatrician and a particular teen, then this can be discussed openly with the goal of remedying it. Or the family -- at the teen's request -- might seek out another pediatrician, possibly one who specializes in adolescent medicine."


5. RESPECT DOCTOR/TEEN CONFIDENTIALITY

Parents should encourage private, one-on-one discussions between a pediatrician and their adolescent, Adesman said. After all, it's the pediatrician's job to ask "personal and potentially awkward questions," he said. "This will hopefully facilitate a discussion about peer pressures, sexual activity and sexually transmitted diseases, drug and alcohol use, responsible driving, and goals and responsibilities immediately and beyond high school."

In fact, he said, it's perfectly OK for parents to request privacy for their teen during an exam. "They can make an explicit statement that they want their teen to be comfortable speaking with their pediatrician and that they plan to leave the room for a few minutes so that any private concerns can be discussed," he said. "Even if teens do not open up to the pediatrician the very first time that the parents leave the exam room, it sets the precedent and the expectation for the next visit that indeed the patient-physician relationship has been forever redefined."

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