Adolescent medicine is a subspecialty of pediatrics, internal medicine and family practice that focuses on this unique group of patients, ages 10 to 21. Two of Loyola's experts in adolescent medicine, Jennifer Buhrke, M.D., and Susan Jay, M.D., addressed some questions parents may have about health care for their teens:

What is different about a teen check up?

Teens often have a lot of questions about what is normal and what they should be experiencing, especially with menstruation, so the check up includes a heavy emphasis on health education.

Because accidents are the number one cause of death in this age group, Buhrke discusses basic safety such as wearing seat belts, bike helmets, the dangers of drinking and driving, and the risks of sex. She uses a standard mental health screening to detect problems with home life, school, depression and drug use.

What is the most effective approach with teens?

"It is important to establish a rapport with teens. Often, an authoritarian approach turns off teen patients, and you may lose a windowof opportunity to discuss hidden agendas. They may come for a sports physical, but the underlying issue may be an eating disorder or a problem at school," Jay said.

"Teens in early adolescence tend to be concrete thinkers," Jay said. She tailors
her approach to that way of thinking.
For example, rather than focusing on lung cancer and a shortened life span, she talks about more immediate down sides to smoking such as bad breath and yellow teeth.

How often should a teenager see the doctor?

Annual visits are important for monitoring the teen's health but also for developing a relationship with the doctor as a trusted source of information. "It is hard to get teens to open up the first time you meet them; they are just checking you out," Buhrke said, "but if they know their doctor is a valuable resource who respects their confidentiality, they feel more comfortable to ask questions. They are more likely to open up and confide in a doctor they see regularly."

Why should the teen have private time with the doctor?

"Learning more independence is part of adolescence. We want teens to learn to become responsible for their own health care," Jay said.

Some parents may worry about what the child may reveal to the doctor. "If this idea makes parents uncomfortable, they should be reassured that the adolescent is making the responsible choice of getting information from a good source rather than from friends," Buhrke said. "Discussing issues with a doctor is a pretty responsible thing to do. Not getting all the facts about risky health behavior presents a far greater problem."

Should teenagers see a doctor of the same sex?

The most important thing is that the teenager feels comfortable enough with the doctor to ask questions. A girl may feel secure with the male doctor she has seen regularly for years. On the other hand, she may suddenly be awkward talking about menstruation and weight concerns and may wish to see a doctor of the same sex.

"Most importantly, the physical exam provides an opportunity to educate an adolescent about his or her changing body, and the physician, adolescent and family can work together to transition the teen through positive health practices into productive adulthood," Jay said.

To make an appointment with Buhrke at Loyola's Primary Care Center at Darien, call (630) 985-4989. To make an appointment with Jay at Loyola's Outpatient Center in Maywood or the Oakbrook Terrace Medical Center, call (708) 216-8563.

On Loyola's staff are male and female primary care physicians specializing in adolescent medicine, as well as adolescent gynecologists, adolescent gastroenterologists, adolescent psychiatrists and other specialists who focus on the health of adolescents. To make an appointment with an adolescent medicine specialist, call (708) 216-8563.

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