Adolescent Medicine Staff Relate to Teens On Their Level

from The Children's Hospital (TCH) News, April 2005

Reliving the teen years is many people’s worst nightmare, but for Children’s Adolescent Medicine staff, it’s all in a day’s work.

From acne and headaches to eating issues, this staff deals with the simplest issues to the most complex.

While many adults feel uncomfortable discussing growth and development issues with adolescents, the Adolescent Medicine staff value the time they spend teaching adolescents about this stage in their lives.

“We enjoy the things that are difficult about teenagers,” said Liz Romer, Adolescent Medicine family nurse practitioner. “I think there is an element of our teen years we’re all still hanging onto.”

The Adolescent Medicine Clinic provides a range of primary, secondary and tertiary healthcare to patients ages 12 to 21. The clinic provides a space for adolescents to go when they no longer feel comfortable with their pediatricians but are not yet comfortable going to their parents’ physicians.

The clinic also gives adolescents a stronger sense of independence, said Romer, who has been at TCH for two years. All of the Adolescent Medicine patients have a right to confidentiality, so if a doctor calls the patient with lab results, the doctor will ask for the teen patient instead of the parent. Patients then can decide if they want to share the news with their parents.

The staff uses a non-judgmental approach to help patients make the best possible choices when it comes to their health, said Amy Sass, MD, a new physician in the clinic.

We’re that one person in many kids’ lives who sees the positive,” Dr. Sass said. “We’re looking for something hopeful even when the circumstances aren’t.”

Building patient rapport hasn’t been difficult for Dr. Sass. She is the only female doctor in the clinic, so female patients who were once timid to speak to male doctors about reproductive health issues can now go to her with their concerns, she said.

“It’s just talking to kids about common issues,” she said.

Along with her interests in growth and reproductive health, Dr. Sass also is researching ways to combat obesity in teens and ways to effectively screen teens for STDs.

The Adolescent Medicine Department also runs the nationally known inpatient and outpatient eating disorder program. Staff in this program receive inquiries from as far away as Alaska and Boston , said Eric Sigel, MD, Adolescent Medicine physician. The clinic treats between 12 and 20 patients at a time.

In conjunction with the eating disorders clinic, Dr. Sigel and others are currently researching the effects of the prescription drug Risperidone on anorexia. Risperidone is currently used in treating mental illnesses; Dr. Sigel said he hopes the research will find that this drug can help affect the mental dimension of anorexia.

Most adolescents who come to the clinic do not understand that their bodies and emotions are intertwined.

“So much of what’s going on with them emotionally shows up physically,” Romer said. “Patients will often come in with headaches or stomach problems, but after an exam it comes down to them being diagnosed with depression.”

Often adolescents come to the clinic concerned about stomach pains, but after talking with the physicians for a few minutes, the conversations end up turning to contraception or substance abuse, Romer said.

“A lot of kids will come in with hidden agendas,” said David Kaplan, MD, director of the Adolescent Medicine department. “Adolescents are great to take care of, but sometimes it is hard to get them engaged.”

The staff strive to provide a safe place where adolescents can come and ask questions about their health concerns. Though all five physicians provide treatment for every adolescent who walks through the clinic doors, they also strive to educate their patients and the community about prevention programs and family planning.

“We’re educating others about how cool adolescents can be and allowing people to look at teens through different lenses,” Dr. Sass said.

Adolescent Medicine physicians must keep up with pop culture to relate to their patients. Tuning into MTV is a part of each staff members’ self-imposed job description. Romer often jokes with her friends that she has to be up on MTV so she can relate to her patients, she said.

Many staff conversations lead to building trust and respect with patients. Every year, staff receive phone calls and letters from parents thanking them for positively impacting their teens’ lives.

“We get phone calls from patients five years later telling us we saved their lives,” Dr. Sigel said.

One of the self-imposed job duties of the Adolescent Medicine Staff is watching MTV so they can relate to the teens they see.