{Dr. Ivor Is In} What Your Pediatrician Says To Your Child When You Leave the Room


I have been at my current practice for almost 15 years. That means I have had the privilege of shepherding my young patients into and, in some cases, through adolescence. Sometimes it's a breeze, other times, there's turbulence but I'm always honored to be there as kids assert their independence, learn how to advocate and ask questions about their health and well being, and, of course, learn about and discuss their emerging sexuality. I try to serve as a safety net when they are afraid to discuss these things with their parents always conscious of the fact that I am a doctor to my patient first, but also aware that I'm a bridge that connects parents to their maturing children.

When my patients reach around age 13, I conduct at least part of the exam with their parents outside of the room. For those families that I have known many years, this is an easy transition; I give them fair warning in the years prior so it's not a shock, but it helps that we've established a level of trust. Between parent and doctor.  Between doctor and child. When an adolescent patient is new to me, this isn't always as smooth. I've even had friends come to me, upset and ready to fire their child's pediatrician:  Why can't I stay in the room?  That's my child! They tell me everything anyway! Basically, it can get ugly really quickly.

I get it. I'm a parent and I am not looking forward to the day when my daughter's pediatrician kicks me out of the exam room. But I know that adolescents need special care, as discussed in this informative Wall Street Journal article. I hope that she will always come to me, but I want her to know that her doctor is someone she can trust. Someone that I trust.

That's what I try to get across to my parents. Your pediatrician is not a barrier trying to take away your parenting authority. If your child's doctor is doing her job right, she's helping to prepare your child to navigate the medical system when you are no longer there to do it for them. I remind the parent and the child that I will keep our conversation confidential unless I feel that my patient is in danger or that something he tells me indicates that someone else is in danger. (Know, too, that most states have laws about adolescent confidentiality related to issues of sexual health and substance use. The age when that takes effect varies from state to state.)

Want to know what happens behind the closed door? It's nothing complicated, really. When I’m with the adolescent, I ask them what they think are their strengths. I ask about school and home what things are going well and where they are experiencing challenges. I ask how they are getting along with their friends, family and parents. We talk about the activities in which they're involved. And yes, I talk to them about normal development and ask if they have any questions about the changes in their body, especially the younger teens. We also talk about sex and drugs based on their developmental stage. Particularly, we talk about peer pressure and how to handle it. I also ask about their mood and screen for any signs of depression.


As kids get older the sex and drug conversations are a bit more specific. In my practice, which sees patients up to age 19 and, in some cases, to age 21, I get to stick around and enjoy watching my college-bound patients become young adults. I think the parents feel safe with a trusted provider as well, particularly as they watch their children become adults in their own right. Denene wrote a blog about those things we forget to teach our kids when we send them off to college. Then this New York Times article, about the lapse in medical care when a teenager graduates from pediatric care and into adult care. Each reminded me that there are some things I need to make sure my college bound patients know about their health, and that those adolescent visits when mom or dad is waiting outside provide a great time to practice them. For those with children heading to college this fall, if you haven't done these things already, it may be time for a crash course.

As you start shopping for things your college bound child will need in their new dorm room, make sure they are ready to fly solo when managing their medical care, too. An important question to ask yourself is, Would my child be able to fill out those medical forms that they give in the doctor's office?

Here are a few important things they will need to know:

  1. Their medical history.  Any past surgeries? Hospitalizations? Allergies?
  2. Their family medical history. What medical conditions do you have? Did grandma have hypertension? Cancer? What type? Diabetes?
  3. How to manage any chronic medical conditions on their own: asthma, ADHD, diabetes, severe allergies all of it.
  4. The names and dosages of their medications. Do they know how to get a prescription and get one refilled?
  5. How to get their medical records. Do they know how to contact their doctor's office without calling you? Do they have the doctor's name and office number?
  6. How to contact their insurance company.  Most young adults are pretty healthy, but they should know where their insurance card is and how to manage their coverage.  Fortunately, with health reform, many kids can be covered under their parents' insurance until the age of 26, so they can call for help to navigate the syste

If possible, ask your child's doctor to work with you to do a test run.

So, as you prepare to unpack the clothes and decorate the dorm room, make sure they have two important emergency folders to store safely in their room “ one with their financial information and one with their medical information.  You pray they never need to use either one, but if they do, you know they are prepared.

And know, too, that your pediatrician has your child's best interest at heart not just when they're newborns, toddlers or grade schoolers, but also as they make the long, slow march from teen to adult.

Ivor Horn is a mom, practicing pediatrician and researcher with several publications in medical journals. She has appeared on the Today show and Good Morning America Health discussing health topics such as childhood obesity, puberty and breastfeeding. She lives in Washington, D.C., with her husband of more than 20 years and their two children. You can follow her on Twitter @DrIvorHorn.

{Read the MyBrownBaby disclosure for Dr. Ivor Is In here.}

Photo credit: A.Drian for Flickr’s Creative Commons

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Denene Millner

Mom. NY Times bestselling author. Pop culture ninja. Unapologetic lover of shoes, bacon and babies. Nice with the verbs. Founder of the top black parenting website, MyBrownBaby.


  1. Barbara Soloski Albin

    Denene this is a wonderfu article, could you also make sure that parents of students who are college bound or travel bound in-between semesters have their health information with them. There are also special health policies available for the students while they are traveling in Europe. This is very important, as they can get sick and may need to see a doctor. We were faced with this years ago, fortunately my son had the policy and all the necessary information while in France. I know when your children are 18 they think they are adults, and they are by law, but when they get sick, it is a whole different story. I wish I had your article to read when my children were teenagers, I handled everything, but it would have been nice to have some advice from an outside source:-)

  2. There’s no way I would leave my child ALONE with anyone until they’re 18. No Doctors, Music Teachers, Coaches, etc. Too often adults abuse a child’s innocence (no offense to you personally) and my child (yet unborn) is too precious to risk.

    Why is it that we’re endorsing a culture where a child and parent don’t communicate; where a child is not taught important fact by their family? A culture wherein medical practitioners are closer to the child than their own parents? I don’t want a paid stranger (albeit a nice one) to shepherd my child into/through adolescence; that’s what her loving parents are for.

    Yes, if my pediatrician suggested seeing my child alone, we would have a serious talk about how my husband and I perceive our role and the role of the doctor; and we’d talk with our child too to garner their point of view. If the doctor was not receptive to our needs as a family, we would seek out another medical professional who did not insist on seeing our child “behind closed doors.”

  3. Great Post. As I read it, I find myself wishing that Dr Ivor is in…Chicago.

    Thank you for reminding me (in advance) that the day comes when our children will have a separate relationship with advising adults. There are some self-advocacy seeds that we parents ought to plant early, so that our children are ready to independently advocate for their health when the time comes.

  4. Imogen,
    I understand where you are coming from. The fact is, there are things that I told my first GYN (my mom’s) that I did not feel comfortable telling my mom, and we are very close. I had specific questions that Mommy could not or would not answer, but I knew Dr. Gyn would give me the straight up honest truth, and not old wives tales, or only what she wanted. As my daughter grows up, I want to give her the opprotunity, within limits, to stand up and speak for herself, not to have mommy do that for her until she leaves for college. That does more a disservice to her, IMO. I am grateful that I can speak up for myself and can call my mom for back up if necessary. We need ot be fostering a sense of self worth in our children so that they can learn that their voices matter. Just this mom’s opinion.

  5. Educating children of various risk at an early age seems to be a good practice. Great to see how active pediatricians are in the lives of their patients. Great post.

  6. THis was a great read. I have a ten year old so this doctor’s visit is around the corner. I didn’t realize it was coming but I think it’s great. Will give him a chance to talk about something he may not want to talk to us about.

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