As your child approaches their teens, our relationship with your family will evolve to encourage your teen to feel comfortable enough with us to ask personal questions and share uncomfortable concerns. We believe we can provide your child with the best possible health care when there is an opportunity to speak with your teen alone, with their confidentiality assured.
Every adolescent annual checkup includes confidential time between the patient and provider. This time will include discussion of topics such as:
When your child turns 13, you will notice a change in your access to the MyChart patient portal. You will still be able to message your child’s doctor, print the health form for school, and view certain non-sensitive lab results. But other areas of MyChart will be private, for your child to access using their own login. Please see proxy access grid at the bottom of the page for all access details.
As parents, you are the experts about your teen, and we want to work together with you to optimize their health. However, certain health information is, by Massachusetts law, confidential. That means that if your teen talks with us about certain issues, we need their permission to talk to you about it. These include drug addiction, family planning, treatment for sexually transmitted infections, and mental health concerns. However, we will inform you if we believe there is danger of serious risk to your child’s life or health.
Our providers always counsel teens about the emotional and health risks involved with sexual activity and substance use and encourage them to make the best choices. We strongly encourage teens to discuss their choices with their parents. However, when a teen is at risk of pregnancy or sexually transmitted disease, we will provide appropriate, confidential medical care.
When a teen reaches their 18th birthday, by law their medical information belongs to them and cannot be shared with a parent without their consent. The transformation to the age of majority should not happen without preparation. We’ll work together with you and your child to prepare for this event. Years before turning eighteen, teens should become comfortable having private conversations with their pediatrician.
We recommend that beginning in their mid-teens children become involved in scheduling their appointments and keeping track of them on their own calendar. Make sure that your teen knows their own and their family’s important health history. They should know names and dosages of their medications, whether they have any medication allergies, and how to obtain prescriptions at a pharmacy.
If your child is leaving for college, make sure that they are ready to manage their own health care. College packing should include:
Make sure your teen knows how to get in touch with their primary care provider at Brookline Pediatrics and how to access college health services. Talk to them about the importance of adequate sleep and nutritious eating. Talk frankly about alcohol availability and the dangers of binge drinking. All teens regardless of their gender need to understand the risk of sexual assault and particularly the role that alcohol plays.
Our practice encourages young adults to see their pediatric provider up to age 22 years. Between 18 and 22 we will help your young adult prepare for the transition to adult care. We will begin to discuss with them how to choose an adult doctor and how to transfer their medical information.
Rest assured that our relationship with you, the parent, does not end when your child turns 18. Many young adults give us permission to discuss issues with their parents, however we will not disclose confidential information without your teen’s permission.
Children with special health care needs may require additional planning for transition to adulthood due to a more complicated medical history and sometimes cognitive challenges. It is important that children with special health care needs be included in the team planning for their future. In addition to planning for transition of healthcare to an internist, a plan should be made regarding what educational needs the child will have going forward; what employment opportunities may be available considering a child’s abilities and challenges; and ensuring access to the child’s preferred recreational activities.
Transition to adulthood is a process, therefore transition planning and discussions should begin around 12 to 14 years old. At this age, cognitively-abled children should be able to name their chronic conditions, allergies, and medications. If they have an IEP, they should begin to attend some meetings. In middle adolescence, they should learn how their chronic conditions affect their health and what their medications are used for. They should be able to take medication independently and learn how to refill medications. The goal is for the patient to slowly begin to manage their own healthcare, if they are able. By age 15-17, the adolescent should begin to keep records and notes of their medical visits and issues. They should learn to write down questions to ask when visiting their health care provider. If possible, they should be responsible for performing their own self-care procedures.
By age 16-17, the adolescent’s family should begin the process of obtaining guardianship or conservatorship if they have a disability significant enough to compromise their ability to make important financial or personal decisions, including medical decisions. A judge in a probate court will determine if the adolescent is legally competent to make their own decisions on these matters. Obtaining guardianship or conservatorship is a long process, so it is important to begin to work on this long before a child reaches the age of 18. A report of the person’s abilities by a licensed social worker, psychologist, and physician must be completed and submitted to the court along with other documentation. There are various resources for legal assistance. The adolescent’s school can often help as well.
Ensure that your child continues to have health insurance after age 18. Your child may also be eligible for Supplemental Security Income (SSI). SSI is money from the Social Security Administration to help low-income disabled children and adults. If eligible for SSI, a person is automatically eligible for MassHealth. It is also important to make plans for adult living and vocation/work.
Brookline Pediatrics will care for your child until age 22; by age 21, you should identify an internist who will be ready to assume your child’s medical care. Other families you know with children with special health care needs may be able to recommend an internist or your pediatrician may recommend someone. It would be helpful to schedule an interview with the internist so you and your child can determine if they are a good fit for your child. Have your child’s medical records transferred to the person you choose so they will have all of the pertinent medical history. We are here to help you as you make these plans for your child.
The grid(s) represents the type of access a proxy/patient will have dependent on age for Non-Clinical and Clinical Information.