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What You—and Your Teen—Should Ask at Annual Checkups

Photograph by Getty Images/Uppercut

When it comes to checkups, those all-important doctor visits aren't just for little ones. That goes for vaccines, too. Millions of adolescents—as many of 25 percent to 30 percent of kids ages 10 to 17, according to the 2008 National Health Interview Survey—are skipping out on doctor appointments each year. And that could be putting them at risk for preventable illnesses.

Dr. Richard Chung, who specializes in adolescent health at Duke University, spoke with mom.me about why it's so important for teens to visit their doctors annually, what risks they might be exposed to and the questions teens ask most.

Why are annual checkups so important for teens?

One of the most important reasons is it gives the teen, the parent and the health care professional a great opportunity to discuss a variety of health topics that are near and dear to the teen’s heart. These are topics that they’re making decisions about every single day, like nutrition, physical activity, emotional health and coping, sexual health and others. In addition to conversation, these visits include a comprehensive exam to make sure that the teen’s body is truly healthy, and typically there’s an opportunity to get updated on teen vaccines. There are many teen vaccines available that many parents and teens don’t know about.

What kinds of vaccines do teens need?

The teens' specific vaccines we talk about are against meningitis or the meningococcal vaccine. There’s the HPV vaccine, which counters a virus that’s linked with a variety of cancers. There’s the yearly flu vaccine, and then there’s the tetanus/diphtheria/and acellular pertussis vaccine, which counters tetanus and whooping cough.

What are some risks when teens don’t get their annual checkups?

One of the big categories is related to the decisions that they’re making related to their health, and when teens make decisions based on partial truths or things that are entirely false—maybe things they got from the Internet or otherwise—there are health risks as a result.

The other source of risk is related to health conditions that crop up in a subtle way and linger without being noticed for too long. They become bigger issues than they should have been in the first place, so there’s added risk there that’s unnecessary, and so these routine visits really place a bookmark in the teen’s life where they can really take a step back and make sure these things can be proactively addressed.

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What are the top questions, in your opinion, that teens ask in these appointments vs. their parents?

A lot of stuff is going on in terms of transitioning physically, emotionally, socially—and that naturally leads to a lot of questions. Even the most reticent teens typically during the visit will have a lot on their minds, and part of the art form of engaging teens in this way is to encourage them to come forward to voice their questions and concerns in a safe manner, and so questions around sexuality, sexual health, emotional health, nutrition, healthy relationships, physical safety, violence—those sorts of things come up frequently. This doesn’t always imply that the teen has an acute risk to their health. Sometimes it’s just out of curiosity.

Teens often get stressed about school and don't get enough sleep. How can parents help them make healthy choices?

Part of what we try to do in these visits is to develop trust, and when those sleepless nights happen, when the stress increases later in adolescence, you really want your teen well positioned with a trusted health care professional onboard to make these decisions and to think about life with that advocate along their side.

If you’re encouraging your teen to try to sleep more, it’s not just about telling them to do so—it’s about why, and really getting to the fundamental roots of it, because at the end of the day we’re not simply about modifying a teen’s behavior up until the point they leave for college. It’s about ensuring that these habits get ingrained so that in college and beyond they continue to be healthy. I would encourage parents to take a look at MyTeensHealth.com—all sorts of great resources on there about these very topics.

How much is the checkup devoted to mental health?

Mental health is really crucial, and many teens struggle with what we call “sub-clinical” or somewhat more mild forms of emotional-health issues. Those are still very crucial for us to find out and to address proactively. It varies from patient to patient, certainly, but at every single visit there will be some degree of check-in about not just physically how are you feeling, but how are you feeling emotionally, because emotional health is the underpinning of how physical health emerges. If you’re not feeling well emotionally, you’re not going to be taking care of yourself.

What are the biggest differences between teen and younger child checkups?

Teens are in this brisk transitional period, and it’s not just about how their body is transitioning between puberty, pubertal stages, but it’s also how their health care is transitioning. The reality is that at 18 or 21, teens need to be fully prepared to engage in their own health care—to ask their own questions, to make their own appointments—those sorts of things.

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