At what age cant u discuss patient history with parent

[Kobebucsfan]

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like if a 12 yr old girl comes to ur office with her mom, and u want to talk about her pubertal changes. is the mom allowed in the room or not ?

at what age u have to tell the mom to leave the room

 

[TheNsg300]

The usual cutoff age iz arund 11,,for school age kids between 7-11 it's ok for de physician to evaluate de patient in the presence of the parent/guardian,,for pubertal age group thou especially for issues relating to sexuality, drug use, body weight/eating disorders commonly occurring in 15-17 year olds the parent iz told to wait outside,,

 

[Macaroon_Berry]

I completely disagree with the poster above. There are clear guidelines, so I'll list what I remember briefly but you can read up on it more (my sources are: Kaplan & Step 2 Secrets):

The cut-off for not sharing patient history with a parent is on the 18th birthday.

The exceptions are: if a child is 13 years old or older and demonstrates that they are emancipated (whether emancipation is declared legally or not) like contributing to the household financially, married, raising kids, living independently, or serving in the armed forces.

Partial emancipation is obtained on the 14th birthday for 4 reasons: STD treatment, antenatal care, drug addiction treatment, and birth control.

In your example- the case of a 12 year old girl would absolutely have to be discussed with a parent.

 

[TheNsg300]

@Macaroon_Berry: The preconditions you posted regarding decision making (capacity/competence) related issues are true (xcpn being the cutoff ages might be given as 14 years old for full emancipation as well as for the mature minor doctrine). And if the post was asking whether the 12 year old girl was gonna make clinical decisions, issues of emancipation wud come into play. Instead the question pertains to methods on how to retrieve clinical history from adolescent patients or have discussions for sensitive issues, nothing to do with making decisions for themselves. The usual practice is to have the mother wait outside to make the adolescent child comfortable to open-up for topics like drug use, or appearance related issues. Let me give u a scenario:
:-Parents bring their 12-year-old daughter to the doctor. They are worried because the girl refuses to eat breakfast or lunch and has been losing weight over the past 3 months. The girl is 65 inches tall and weighs 110 pounds. Physical examination reveals that the girl is in Tanner Stage 3 and both this examination and laboratory test results are unremarkable. The next step in management is for the physician to:
(A) speak to the parents alone
(B) speak to the girl alone
(C) speak to the girl and the parents
together
(D) recommend a consultation with a specialist
in adolescent eating disorders
(E) reassure the parents that the girl’s
behavior is normal
Hope this helps u to solidify the point.

 

[Macaroon_Berry]

@Macaroon_Berry: The preconditions you posted regarding decision making (capacity/competence) related issues are true (xcpn being the cutoff ages might be given as 14 years old for full emancipation as well as for the mature minor doctrine). And if the post was asking whether the 12 year old girl was gonna make clinical decisions, issues of emancipation wud come into play. Instead the question pertains to methods on how to retrieve clinical history from adolescent patients or have discussions for sensitive issues, nothing to do with making decisions for themselves. The usual practice is to have the mother wait outside to make the adolescent child comfortable to open-up for topics like drug use, or appearance related issues. Let me give u a scenario:
:-Parents bring their 12-year-old daughter to the doctor. They are worried because the girl refuses to eat breakfast or lunch and has been losing weight over the past 3 months. The girl is 65 inches tall and weighs 110 pounds. Physical examination reveals that the girl is in Tanner Stage 3 and both this examination and laboratory test results are unremarkable. The next step in management is for the physician to:
(A) speak to the parents alone
(B) speak to the girl alone
(C) speak to the girl and the parents
together
(D) recommend a consultation with a specialist
in adolescent eating disorders
(E) reassure the parents that the girl’s
behavior is normal
Hope this helps u to solidify the point.

What is your resource? It'd help if you give some specifics on where you came up with that differentiation between competency in terms of making decisions versus a patient being old enough to take history from alone.

In the Kaplan videos, they specifically mention that everything goes through the parents for minors (obviously excluding those who have complete/partial emancipation). As far as I knew, if you want to take history from a minor alone, you have to seek parental consent prior to doing that.

The particular example about drug abuse in a minor that you pointed out - that's clear in my reply above in which I stated that drug addiction is one of the issues that a minor can speak to a doctor about without the presence of his/her parent.

Again, if you have a source that points out specifically that doctors can speak to minors about sensitive issues without the presence of a guardian, then please let us know since I think it may be important.

 

[ATypicalLymphocyte]

I got a question on UW the other day (spoilers ahead) where a mother wasn't letting her 13 y/o son with diabetes speak for himself and the solution was basically to ask the mother to leave for a minute in order to be able to speak with the boy about his treatment/diet/etc. without her constantly interrupting.