Shortchanging adolescents: Room for improvement in preventive care by physicians

Background and Objectives: Behaviors developed in adolescence influence hea lth Inter in life. Adolescents seldom visit physicians to discuss health-re lated behaviors. Instead physicians must incorporate health counseling into the exams for which the adolescents do come. We studied the frequency and duration of adolescents' consultations with family physicians and pediatric ians involving counseling about diet and nutrition, exercise, weight reduct ion, cholesterol reduction, HIV transmission, injury prevention, and tobacc o use. Methods: Data were analyzed from the National Ambulatory Medical Car e Survey for the 3-year period from 1995 through 1997 This sun,ey uses a mu ltistage national probability sample of patient visits to nonfederal, offic e-based physicians. We described patterns of counseling provided to adolesc ents and compared patterns for family physicians/general practitioners and pediatricians. Results: Of 91,395 physician-reported visits analyzed 4,242 (4.6%) were by adolescents ages 12-19. Visits to family physicians and pedi atricians accounted for 1,846 (43.5%) of these visits. Counseling about any of the seven areas studied was included in 15.8% of family physician visit s and 21.6% of pediatrician visits. The length of consultation increased fr om 13.8 to 17.6 minutes if counseling was included. Conclusions: Adolescent s visit physicians infrequently When they do, few receive counseling on cri tical adolescent health issues. Both family physicians and pediatricians ha ve room for improvement.