To become savvy consumers of an increasingly complex healthcare system, teens need to fully understand what healthcare entails.
According to a report entitled "Partners in Transition: Adolescents and Managed Care," issued by Children Now, a nonprofit advocacy group based in California, there is increasing need for adolescent healthcare education. Approximately 20% of the teens interviewed for the report "had forgone care they thought they needed, placing them at increased risk of physical and mental health problems."
The report also found that teens often overuse or improperly use emergency room services, but underuse office-based services.
It's clear we need to teach our children about the healthcare system. But how, and when, should the lessons start?
James Farrow, MD, professor of medicine and pediatrics at Tulane University in New Orleans, believes that beginning with a child's annual check-up around age 12, parents and physicians should discuss with the child their expectations for regular follow-up visits.
Dr. Farrow says parents should also sit down with their teens to explain their family's health insurance coverage and to review with them any healthcare education materials supplied by their insurer.
Often, the healthcare system is confusing and doesn't give new consumers of healthcare a chance to become comfortable with the system, Dr. Farrow says, so parents must take an active role in educating their kids.
At the onset of puberty (around age 11 or 12), a physician should be given some time alone with a young patient as long as the child is comfortable with the situation. This gives the child the opportunity to ask or answer any questions he or she may not feel comfortable discussing with a parent in the room.
By age 14, Dr. Farrow says, teens should be able to make their own doctor's appointments, and by age 14 or 15, should be able to relate their own medical histories and describe any signs and symptoms they may be experiencing.
Also, by mid-adolescence, when teens are able to "relate to the notion of health risk behaviors," says Dr. Farrow, it becomes appropriate for parents to "kind of relinquish their control."
If your adolescent has a chronic medical condition, such as diabetes or asthma, it may be more difficult for you to relinquish that control. But, says Dr. Farrow, by age 15 or 16, even teens with chronic illnesses should begin developing one-on-one relationships with their healthcare providers. Better they learn now while still under your watchful eye.
Kids learn a lot from your example, so show your children you're serious about the importance of preventive care by scheduling, and keeping, appointments for regular check-ups and health screenings.
Confidentiality is always an issue in doctor-patient relationships. Every state has a set of legally protected confidential services available to minors at age 13 or 14, says Dr. Farrow. Some of these services may include diagnosis and treatment of sexually transmitted diseases, pregnancy-related services including contraception and abortion, and services related to drug or alcohol abuse. Check with your state legislators' offices to find out which confidential services are available in your state, and share this information with your teen.
Teens who have gained an understanding of the healthcare system fare better when they leave home. Dr. Farrow says they will have successfully learned the following:
- How to gain access to the system
- What legally confidential services are available to them
- How to give feedback to, and ask questions of, their providers
- What to expect during a medical examination
Dr. Farrow adds that, in general, kids with little knowledge of the healthcare system will be more anxious and more likely to have false expectations about the care available to them.
When teens go to college, Dr. Farrow says, they should be confident interacting with the system and know how to access healthcare at school. They should have health insurance and be educated about the limits, coverage, and use of their plans.
"When we teach our kids to drive, we have the expectation they're going to learn the rules of the road," Dr. Farrow says. "It's the same with healthcare services. Parents need to expect that their kids will know the rules of the healthcare system. Learning the rules should begin fairly early in adolescence, so they know them by the time they leave home."
