tough question on the interview, help!

[DimaDrill]

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"If your best friend's 14 year old daughter comes to you and asks for birth conrol pills, what should you do?"

I said that I would give her the pills but only after I had a chance to examin her in my office. I told them that I would warn her that birth controll pills do not protect against STD's and that she should be carefull about that.
Do you guys think that's a decent answer? What would you have said?

 

[DD214_DOC]

I would give them to her and explain them and so on. Be sure to include they don't protect against STDs.

I'm not positive, but do parental notification laws vary by state?

 

[JonnyG]

Shes a minor.......can get you in trouble

 

[TAI786]

Although the question has a "right" answer, they aren't asking you it to have you regurgitate out the legalities of the issue. They wanted to see that you *had* an opinion and logic to back it up. You did well, so I wouldn't be too worried about your response.

 

[Donvb]

"If your best friend's 14 year old daughter comes to you and asks for birth conrol pills, what should you do?"

I said that I would give her the pills but only after I had a chance to examin her in my office. I told them that I would warn her that birth controll pills do not protect against STD's and that she should be carefull about that.
Do you guys think that's a decent answer? What would you have said?

NO, i don't think it is a decent answer... Lets put this in a different perspective, outside the realm of political battles... A 14-year-old comes up to you and says she needs a strong pain killer, what would you say? I damn well wouldn't give a 14-year-old girl any pain killers without talking with her parents or having consent, there is a potential for lawsuits(death from overdose, sickness, adverse reactions)... I don't see why you wouldn't do the same with birth control?? If she has to get consent to watch R-rated movies at school, then why not consent to have serious drugs from a physician? Seems like an easy answer to me... 🙄

 

[Doctor Bagel]

"If your best friend's 14 year old daughter comes to you and asks for birth conrol pills, what should you do?"

I said that I would give her the pills but only after I had a chance to examin her in my office. I told them that I would warn her that birth controll pills do not protect against STD's and that she should be carefull about that.
Do you guys think that's a decent answer? What would you have said?

I got that exact same question at CCOM and gave a pretty similar answer to yours. I just got my acceptance package today, so it worked out. 🙂

 

[Doctor Bagel]

NO, i don't think it is a decent answer... Lets put this in a different perspective, outside the realm of political battles... A 14-year-old comes up to you and says she needs a strong pain killer, what would you say? I damn well wouldn't give a 14-year-old girl any pain killers without talking with her parents or having consent, there is a potential for lawsuits(death from overdose, sickness, adverse reactions)... I don't see why you wouldn't do the same with birth control?? If she has to get consent to watch R-rated movies at school, then why not consent to have serious drugs from a physician? Seems like an easy answer to me... 🙄

What's the better answer -- ignoring the fact that she's sexually active, letting her wind up pregnant or worse, HIV positive, or giving her some bc pills and talking to her about std's? Being sexually active at 14 isn't ideal, but pontificating or turning away a girl in this situation isn't going to have positive outcomes.

Also, birth control pills are no more dangerous than any other routine thing you'd prescribe to a 14 year old, so, no I don't think you're more likely sued. Even if you are, I still think it's right to address the issue rather than just turn this girl away. However, since bc pills are probably as safe as antibiotics and safer than anti-acne meds like accutane that teenagers get all the time, I don't see safety as an issue.

 

[Donvb]

What's the better answer -- ignoring the fact that she's sexually active, letting her wind up pregnant or worse, HIV positive, or giving her some bc pills and talking to her about std's? Being sexually active at 14 isn't ideal, but pontificating or turning away a girl in this situation isn't going to have positive outcomes.

However, since bc pills are probably as safe as antibiotics and safer than anti-acne meds like accutane that teenagers get all the time, I don't see safety as an issue.

I think if you take all of the political factors out of it, and the fact that a 14-year-old being sexually active shouldn't be ignored, and that bad things can happen from her being sexually active, a 14-year-old isn't going to be asking for/recieving medications that require a prescription on her own... Have you ever seen a 14-year-old come in for Accutane w/o a parents permission? Or, even the "safe" antibiotics? no, so why is this any different... sometimes peoples' political and social vigor cloud their judgment in situations, a 14-year-old should not be making lifechanging decisions on their own(LEGALLY BACKED).

 

[Timbo0984]

I would argue that further examination of her situation would be necessary. I would discuss with her how long she has been sexually active, if her parents are aware, has she shared this with her parents, would be she okay if we discuss this with her parents for her own safety, and after slowly rationalizing with her, i am confident she would agree to sharing the idea with her parents before going forward. I would also discuss with her the many risks associated with being in the pill, other than STDs, and hopefully she will be responsive.

 

[alohaknight1]

just thought it was interesting that acutane and birth control were used as countered reasons for someone to need a prescription. Just an FYI, in order to be on Acutane, a woman, or teen, first has to be on birth control to legaly be given the prescription. Maybe the 14 year old wasn't sexually active, she just had acne. 🙂 haha

 

[Tallulah]

I think if you take all of the political factors out of it, and the fact that a 14-year-old being sexually active shouldn't be ignored, and that bad things can happen from her being sexually active, a 14-year-old isn't going to be asking for/recieving medications that require a prescription on her own... Have you ever seen a 14-year-old come in for Accutane w/o a parents permission? Or, even the "safe" antibiotics? no, so why is this any different... sometimes peoples' political and social vigor cloud their judgment in situations, a 14-year-old should not be making lifechanging decisions on their own(LEGALLY BACKED).

Ultimately though, a 14 year old chooses HERSELF (or himself), if she will have sex. What would be your liability as a physician if the 14 year old ends up pregnant because you would not prescribe birth control without parental consent?
BTW I think the OP's answer was right on because she backed up her statement. an opposing answer would be just as right as long as it was backed up (i think someone else suggested this too)

 

[Doctor Bagel]

NO, i don't think it is a decent answer... Lets put this in a different perspective, outside the realm of political battles... A 14-year-old comes up to you and says she needs a strong pain killer, what would you say? I damn well wouldn't give a 14-year-old girl any pain killers without talking with her parents or having consent, there is a potential for lawsuits(death from overdose, sickness, adverse reactions)... I don't see why you wouldn't do the same with birth control?? If she has to get consent to watch R-rated movies at school, then why not consent to have serious drugs from a physician? Seems like an easy answer to me... 🙄

your first sentence sums up my whole problem with your post. these tough ethical questions are hard just because there is no one right answer. telling the op that she didn't give a "decent answer" because she gave an answer that was different from one you would give is just plain rude and not helpful. i hope you never participate in these interviews because it seems like you'd nix someone just because they disagree with you, in spite of their reasoning.

 

[FS-Pro]

You can still talk to her about STD's and not give her birth control pills. And you would not have any liability if you didn't prescribe birth control pills and she got pregnant. Remember, birth control pills are not 100%. So, would you be liable if you gave her birth control pills and she still got pregnant? NO.

 

[Barfalamule]

Absolutely spot on in my opinion. You have educated her on the effects of the medication and you have worked in a physical exam. The consequences of talking down to the girl through preaching, dismissal, or refusal have worse case scenarios much stronger than simply examining her and giving her the meds. You are really showing a thought process that puts the patient's health and best interests at #1.

 

[PlasticMan]

Does doctor-patient confidentiality apply here or is that in breach since she is a minor? Ie, are you required by law to inform her parents of the medication you are prescribing her since she is a minor?

 

[sort_timer]

BOARD QUESTION 101:

minors can be treated w/o parental knowledge or permission for STD's, pregnancy, and substance abuse. I have been asked this question at least a dozen times.

birth control is not on this list. however, if the minor is imancipated, then you can give her the OCP's.

answer: what is the law in my state? that is what i will do?

i don't think they are trying to find out your "right to life" views, but rather can you follow the rules.

MSIV

 

[Doctor Bagel]

BOARD QUESTION 101:

minors can be treated w/o parental knowledge or permission for STD's, pregnancy, and substance abuse. I have been asked this question at least a dozen times.

birth control is not on this list. however, if the minor is imancipated, then you can give her the OCP's.

answer: what is the law in my state? that is what i will do?

i don't think they are trying to find out your "right to life" views, but rather can you follow the rules.

MSIV

I agree that I don't think they're trying to find out your right to life views or whatever, but I don't think they're asking about legality, either. For one, we're not expected to know the law when we're interviewing -- we don't even know what state we'll be practicing in. I think adcoms want to know what you'd do provided that it is legal to make the prescription. Saying you'd follow the law is sort of a cop out for a difficult question.

 

[Donvb]

Saying you'd follow the law is sort of a cop out for a difficult question.

Or a great way to show the admissions team you analyze and think things through before acting on pure emotion... Look at the law first, before you make a decision, then based on what you find, solve the issue... If your mind is clouded by emotion and beliefs, this could make you a liability for the University as well as your future business... These qualities are good if you learn to keep them at bay until after you have professionally analyzed the situation... To say that following the law is a "cop out," would raise a red flag in numerous interview circumstances.

 

[Donvb]

telling the op that she didn't give a "decent answer" because she gave an answer that was different from one you would give is just plain rude and not helpful. i hope you never participate in these interviews because it seems like you'd nix someone just because they disagree with you, in spite of their reasoning.

I was asked if I thought it was a decent answer, and what I would have answered... I though I answered her question?? I don't necessarily have to agree, negative feedback can often times be positive! 😀 And if the op didn't like my solution, then brush it off, just another view point that no one has to agree with I hope I can participate in interviews just to see what people say, and your wrong... I would never nix someone because they disagree, although I could think it wasn't a "decent" answer in my mind, and still accept them! 😎

I hope I didn't come across as rude op, I was just answering the question honestly...

 

[Stratus2675]

Do you have to advise her? I would put her in contact with another physician. To me, its a conflict of interest.

 

[nerdgrrl]

"If your best friend's 14 year old daughter comes to you and asks for birth conrol pills, what should you do?"

I said that I would give her the pills but only after I had a chance to examin her in my office. I told them that I would warn her that birth controll pills do not protect against STD's and that she should be carefull about that.
Do you guys think that's a decent answer? What would you have said?

Having held the hands of many many teenagers having abortions, my answer to this is very obvious. I would absolutely encourage her to speak to her parents, and give her the tools to do that. but I know that witholding birth control doesn't stop teenagers from having sex, and I couldn't in good conscience turn away a sexually active teenager.

 

[libo1369]

I like the idea about referring her to a third party. If I felt that she would not get them otherwise I would upon an exam and a "lecture". My personal belief is that upon pubesence you should have the right to BC without parental consent. I also think I might put my daughter on it when she starts getting her period to "regulate" things. The girl sounds like an intelligent one and responsible and I would encourage her to talk to her parents about the situation. If at all possible I would also think of a way to hint to the parents about giving the talk. Maybe using the excuse that another girl came in with her parents to talk to myself about BC and how responsible I thought it was.

 

[Duchess]

NO, i don't think it is a decent answer... Lets put this in a different perspective, outside the realm of political battles... A 14-year-old comes up to you and says she needs a strong pain killer, what would you say? I damn well wouldn't give a 14-year-old girl any pain killers without talking with her parents or having consent, there is a potential for lawsuits(death from overdose, sickness, adverse reactions)... I don't see why you wouldn't do the same with birth control?? If she has to get consent to watch R-rated movies at school, then why not consent to have serious drugs from a physician? Seems like an easy answer to me... 🙄

You wouldn't be able to talk to the parents on this topic due to doctor-patient confidentiality issues. You can go to a free clinic and get birth control without your parents, even if you are a minor. I remember that being a big "hush-hush" thing with girls in high school.