So what is a parent to do? Ideally, you find a doctor that respects your values and your role as a parent. If the doctor is treating you like an adversary instead of an equal partner in the health of your child, run away fast. However, in these days of managed care, the choice of physicians is often severely limited or nonexistent. As a military family we have no choice in who provides our health care. When the kids got to that adolescent stage, there was always the "time alone" with the doctor at their sports physical visits. As a physician, I know this time is necessary. But as the mom of my children, I also know that I have their best interests at heart, the culture does not support our family values, and I do not need another person in a position of authority undercutting our parental influence and undermining our faith.
Think I am being paranoid? My experience is that numerous practitioners make erroneous assumptions about my children. They ask my thirteen-year-old daughter if she has a boyfriend or my thirteen-year-old son if he has a girlfriend. If they answer "no" then they proceed with questions to determine if they have same-sex attractions. Did these medical professionals ever consider that not every middle schooler is chomping at the bit to have an exclusive romantic relationship? A female physician fussed at my high school daughter for wearing a sports bra because it didn't enhance her bust. This woman wanted to see my daughter in something more Playtex--you know--"lifts and separates!" My daughter's choice was not a body-image issue. It was a matter of comfort. This same physician scolded me when I didn't jump at the chance to have my daughter receive the HPV vaccine. I said I wanted to wait until after it was in use a few years so I could assess the safety profile. She scoffed because the meningitis vaccine I was agreeing to was newer than the HPV vaccine. Why wasn't I waiting on that one? Because the results of foregoing the meningitis vaccine could be deadly while the results of skipping the HPV vaccine are minimal. It was a simple risk-benefit analysis. Then there are the offers of contraception in spite of the fact that my child denies any sexual activity. "You know I can get you birth control. Your mother never needs to know." I know about these exchanges because my children told me about these exchanges.
I think the most successful approach is to prepare my child for these questions with words like this:
The doctor does not know you and does not know our family. He/she cannot tell who has a good relationship with parents and who doesn't. They don't know who is making good choices and who is making bad choices. So they treat everyone like they have a dysfunctional family and are making choices that are incompatible with our family values. Adolescents who are in these situations have special medical needs and the doctors do not want to miss helping these teens because they failed to ask. The fact that they ask you these questions does not mean they think these questions actually apply to you. If they do more than just ask questions and try to to convince you to do something that makes you uncomfortable, tell them you are not interested and tell them you want me back in the room. (As an aside--I have friends who reported physicians/PA's/nurse practitioners that tried to browbeat their daughters into accepting a prescription for contraceptives or who have suggested to their non-sexually active teens that they try masturbation) Because these health care professionals often see young people in trouble because of bad choices, they sometimes forget that lots of young people make the same good choices you make.I have taken care of the teens from the dysfunctional families as well as the teens who are making poor choices. I know that it is difficult to get important health information when their parents are in the room. But I do not do this teen any favors if I then normalize the risky choices and enable them to continue. I also do not help the situation when I marginalize parents. By and large, even the most imperfect parent loves and cares for his/her child more than any health professional ever can. Part of the job of providing health care to adolescents is also enabling constructive ways for parents to express this love. As a parent, you should demand such a level of cooperation.