Q: How do you deal with over-protective parents? I have a patient, a 14-year-old girl, who I suspect (based on previous discussions) is participating in risky sexual behaviour. I want to talk to her about contraception, but her parent wants to remain in the room.
JENNIFER FRITH – working as a GP for five years, RNZCGP fellow since 2016 and practising at Balmoral Doctors, Auckland
A: That’s a tricky situation, and I’m guessing if you’ve developed these concerns, so may her parents.
In younger teens, like your patient, what I would do is set the expectation at the start of the next consult. You could say, “We’ve met together a few times now, and I’d like to start encouraging you to look after your own health. If it’s all right with you, I’ll ask mum/dad to leave for a bit, then we can talk together at the end.”
Even if it turns out to be “just a flu” you can explain confidentiality and ask a few HEADSSS (home, education/ employment, activities, drugs and alcohol, sexuality, suicide risk, safety) questions.
In the older teens who come with particularly persistent parents, I sometimes ask while we’re still in the waiting room. It’s harder for a parent to kick up a fuss in a busy waiting room than in the privacy of your room.
Then, remember a few key principles of youth health – once you have the young person alone, explain confidentiality and the exceptions. Decide together what you will share with the parents. Check contact details are the patient’s and not the parents’ for follow-up of sensitive results.
And if all else fails, there’s always the urine test and quick chat in the bathroom/corridor while you “explain” how to take the sample correctly!