"Ain't Nobody Got Time for the Drip": The Art of the Teenage/Young Adult Wellness Exam

As a healthcare field we are stressed to get enough patients in for the day, phone calls, follow up labs, charting and on I could go. When providers see a teenager/young adult wellness exam on their schedule a sigh of relief and a time to "catch up" is felt. Though, I tend to take this time to educate and help a teen know that healthcare providers are here to listen.

I go through the routine typical wellness exam topics. We discuss food choices, exercise, sports, bullying, vaccinations and mental health. One of the things that I try to emphasize in emotional health is safe sex , safe alcohol use and avoiding drug abuse. I am not condoning sex or alcohol use for teenagers at all, but I want those that may partake in such an escapade to be safe. Being a teenager is a journey we all must remember. Alliances with friends, fitting in and "experimenting" are all part of the teenage rite of passage.

I start off with letting the patient know that birth control does not "mean the person is clean". The use of condoms is a better option because "ain't nobody got time for the drip." STD's or STI's are around and even though a person is "clean" does not mean they have been tested. Most are asymptomatic. I talk about chlamydia, gonorrhea, trich, then mention syphilis and HIV. With a special shout out regarding warts and "the herp." Most are curable but some are forever. You don't want to make your first "forever" to be an STD.

Most teenagers at this point are laughing and nodding their head. Some have questions regarding the different STD's and the best ways to help prevent transmission. If time permits, I also show pictures of common manifestations of STD's to help facilitate discussion, though this can backfire if using a Google search engine and click on images. I suggest having paper handouts or previously saved images when venturing to show pictures.

I also mention safe drinking. I do not condone drinking in underage but advise that when they do turn 21 years old that there should be some safe practices. There should always be a sober person in the group. Regardless if driving or not. Poor decisions are made when inebriated. Having that sober person to help others make better decisions is always welcomed the next morning. Again, "ain't nobody got time for the drip." This is a time I also bring up the HPV vaccination.

Along with safe drinking and a sober person I emphasize the trend of young adults walking home alone at bar close and ending up dead in a river. This may sound harsh but I am always overcome with sadness when I hear of young adults drowning when on their way walking home, alone, after a bar crawl or a party. Please do not drink. If drinking, drink with a sober person, do not walk home alone and let others know where you are.

I tend to conclude with "you don't want to end up dead in a river with chlamydia." Most teens/young adult are laughing and more open by the end of the visit. I tend to get more questions and "real" conversations with the patient after going through my speech.

Next time when a teenager/young adult wellness exam happens on your schedule take the time to help gain some trust with the patient. Time to develop a strong working foundation for a future healthy adult. I have had many teens/young adults in my office say "my mom made me come." Emphasize the wellness aspect, discuss the routine but make sure to mention sexuality and drugs. Parents do look to healthcare providers to help instill these ideas also.