Preserving confidentiality for adolescent patients is an important part of the health care visit experience and allows for open communication about sensitive topics. It's important for pediatricians to understand the benefits and limitations of confidentiality, and to allow for private time with the adolescent during the visit. It is also important for pediatricians to encourage their adolescent patients to talk to a parent, guardian, or other trusted adult about their health care needs and concerns.
Consent and confidentiality can be complicated, particularly with difficult decisions that the adolescent and his/her parents/guardians need to make around important issues such as reproductive health, contraception, and teen pregnancy. The AAP, CDC, and others have developed guidance around these issues that can help providers navigate this with their patients and their families. Below are some resources that may be helpful.
When caring for minors, it is important to understand applicable state laws that affect whether/when minors can consent to testing and treatment for sexually transmitted infections. Some states require that the parents are notified if the minor has requested to be tested or is receiving treatment.
AAP Clinical Guidance for Primary Care Providers
Bright Futures Guidelines for Preventive Services: Provides information and guidance on a family-centered approach to care.
Confidentiality Protections for Adolescents and Young Adults in the Health care Billing and Insurance Claims Process: The Society for Adolescent Health and Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists have developed a joint policy that provides guidance on protecting confidentiality.
Sexual and Reproductive Health Care Services in the Pediatric Setting: This clinical report outlines how a pediatric practice can make their office teen-friendly.
Achieving Quality Health Services for Adolescents: This policy statement provides guidance on delivery of developmentally-appropriate care; importance of and strategies to preserve confidentiality; location of adolescent care; the types of providers who offer such care; the role of research in advancing care; and the transition to adult care.
CDC Resources for Providers, Adolescents/Young Adults, and Families
For Providers: The CDC offers several resources and publications to provide guidance around confidentiality.
Parent Portal: Provides several resources for parents and teens.
Other Helpful Resources for Providers, Adolescents/Young Adults and Families
Adolescent Health Working Group: This San Francisco-based group created a series of resources intended for health care providers to use in their practices to notify patients and parents about services and confidential discussions that may be included as part of the adolescent well visit.
The Guttmacher Institute: Provides an overview of
state laws regarding consent for minors and tracks
state laws on minors' access to sexually transmitted infection (STI) services.
Physicians for Reproductive Health: This presentation highlights strategies for making a practice adolescent-friendly.
Physicians for Reproductive Health: They have outlined the complex laws that relate to minors' access to reproductive health care in select states.
Advocates for Youth: Provides information for youth to help them advocate for their reproductive and sexual health care.
National Adolescent and Young Adult Health Information Center: They have developed a Compendium of State and Local Strategies to improve access to health insurance and the quality of preventative visits among adolescents and young adults.
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