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Dishing It

Too old for pediatricians, what's a teen to do?

By ALISON FREEHLING

Date published: 9/19/2006

DAILY PRESS (NEWPORT NEWS)

ORFOLK--The health concerns that are Dr. Joel Brenner's specialty are, to his patients, often blush-worthy.

Acne, irregular periods and sexually transmitted diseases are on the list. So are depression, substance abuse and eating disorders. Brenner's job is to get the teenagers he treats to trust him, talk truthfully and find the medical help they need.

This is the world of an adolescent-medicine specialist, a small but growing breed of doctor with in-depth training working with teenagers. Brenner is the head of a new regional adolescent-medicine clinic that opened this summer at Children's Hospital of the King's Daughters in Norfolk.

"This is a group of patients that can kind of get lost in the health-care system," he said. "We need to take care of them better and also help pediatricians and other doctors be more comfortable with them."

To be clear, many types of doctors spend plenty of time with teenagers, including psychiatrists, gynecologists, diabetes specialists and physical therapists. Pediatricians and family practice doctors also see patients from infancy through old age.

But adolescent-medicine specialists say they tend to operate a little differently. Their waiting rooms aren't stuffed with toys and decorated with cartoon murals like a typical pediatrician's office. They have more experience with sensitive problems such as hormonal imbalances, ovarian cysts and abnormal menstruation. They also ask very specific questions about sex, drugs and drinking.

Instead of telling a patient not to smoke marijuana, for example, adolescent-medicine specialists might ask how many of his classmates have used the drug and how he would deal with a friend who offered him a joint. And they'll direct most of their questions to the teenager, not his parents.

"When you get them alone and talking with no outside pressures around, you can really find out what interests them and stresses them," Brenner said. "If you don't ask the direct questions, you're not going to get the answers--but then you have to know what to do with those answers."

Medical schools and residency programs have added training in adolescent medicine in recent years, but the country still needs many more specialists, said Edie Moore, executive director of the Society for Adolescent Medicine. The national group has certified about 1,000 doctors in the subspecialty since first offering an examination in 1994.

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Date published: 9/19/2006