Ana is an engaging 14-year-old girl who does well in school. That is, until recently. She used to run track but stopped because she has too much homework to continue with sports. She often doesn’t finish her homework until after 11 p.m., and is up early to catch her 6:30 a.m. bus. Teachers are concerned because she doesn’t seem to focus, and sometimes they catch her sleeping at her desk.
Ana has gained 10 pounds since her last doctor’s visit, and Ana’s mom is worried that Ana is beginning to hang around with boys. She complains that Ana is constantly texting. She’s concerned that her daughter is becoming distracted from her future goal of becoming a pediatrician.
Does this sound familiar? How do parents address these issues? Is Ana an unfocused child with Attention Deficit Disorder who needs medication? Or rather is she a young teen who needs guidance in setting schedules, eating habits and fitness activities?
These are the issues that pediatricians confront and help families resolve every day at well visits. While Ana is not a real patient, she could be. Many parents think of well visits as obligatory doctor’s appointments for immunizations so you have the necessary forms for school. But they are much more than that.
By working with families, pediatricians are able to help parents and their children make changes in their lifestyles. For example, Ana and her mother may be given information showing that teens who exercise tend to do better in school, which inspires Ana to start running a couple of miles a day at the local park.
In my practice we give our patients healthy recipes designed for children and teens. These new recipes could encourage Ana and her mom to plan ahead for the week’s meals, rather than picking up takeout after work and school. Ana can help mom by doing the cooking one or two days a week, while at the same time learning how to eat healthy food. And if takeout happens once a week, so be it.
Mom can be empowered not to buy soda for Ana, who often drinks it for the caffeine to stay awake to complete her homework. At a well visit Ana’s mom could be given information explaining that teens don’t have the impulse control of adults. Teens are often unable to choose water instead of a sugary drink.
School issues and socialization are also topics of conversation at well visits. When students are struggling, doctors can provide suggestions such as meeting with teachers to prioritize work load. Identifying a homework coach or tutor might be a solution.
As for the boys, like many families with teenagers, Ana and her mom have not talked much about dating and sex. This is a wonderful opportunity to start the conversation. Sometimes parents speak to their teen with the doctor in the room as a way to begin addressing issues that may be uncomfortable.
At UHealth, the well visit is an opportunity to help address not only the runny nose or allergies, but also how to prevent long-term, chronic issues such as obesity, sleep deprivation, school failure and early sexual behavior. This starts from the very first newborn visit and continues through adolescence as we work to promote nutrition, fitness, development and environmental safety.
The well visit requires a partnership between the pediatrician and the family. It can and should be so much more than shots and forms. Together we can help kids like Ana be healthy and achieve their dreams.
Gwen Wurm, M.D., MPH, is a board certified general and developmental/behavioral pediatrician. She focuses on working with patients and families on nutrition and integrative strategies to promote health and wellness at the University of Miami Miller School of Medicine. For more information, visit UHealthSystem.com/patients/pediatrics.