Setting up an Adolescent Friendly Practice
Caring for the adolescent patient can bring unique opportunities and challenges. Below are resources that will assist with developing an adolescent-friendly practice.
In its Achieving Quality Health Services for Adolescents statement, the AAP 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.
Advocates for Youth has also developed guidance on Best Practices for Youth-Friendly Clinical Services. This document provides information on confidentiality, respectful treatment of youth, integrated services, culturally-appropriate care, free or low cost services and easy access to care.
The Centers for Disease Control and Prevention has developed a webpage offering resources and support to deliver a teen-friendly reproductive health visit. A related downloadable infographic can be found here.
Confidentiality and Consent
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.
The San Francisco-based Adolescent Health Working 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.
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 has developed guidance around these issues that can help providers navigate this with their patients and their families.
Consent for Health Services and Confidentiality and the Law
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.
The Guttmacher Institute provides an overview of state laws regarding consent for minors. Additionally, the Guttmacher Institute has tracked state laws on minors' access to sexually transmitted infection (STI) services.
More information on reproductive health laws can be found on the Guttmacher Institute site.
In addition, Physicians for Reproductive Health has outlined the complex laws that relate to minors' access to reproductive health care in select states.
Insurance and Billing Services
The Society for Adolescent Health and Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists have developed a policy that provides guidance on Confidentiality Protections for Adolescents and Young Adults in the Health care Billing and Insurance Claims Process.
The National Adolescent and Young Adult Health Information Center has 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.