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Discussion

Does your office require parental consent always for pt's under 18?

Just started in a primary care office in Maryland. Often, patients under 18 are coming in without parents, and without any sort of parental consent form on the charts.

Coming from the Minute Clinic environment, I always thought kids had to be accompanied by the parent. I realize this is not true for teenagers seeking birth control, pregnancy testing, STD testing, etc .....but for routine medical visits, shouldn't they be accompanied by a parent? We get a lot of the school physicals also being done without the parents of the older teenagers. To me this can be fraught with issues when kids are unreliable historians, uncooperative, clueless about their family history, etc.

Looking at our state consent laws, it's very confusing.

I'm finding lots of trouble with parents not present during these visits ...

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    • Featured Replies

    Each state varies. Many states allow for treatment of minors for STIs, pregnancy, emergency situations, mental health, and drug counseling. For routine medical evaluation and other non emergent treatment parental consent is generally required. There are caveats. For instance when I worked in psych I was allowed to evaluate and provide therapy to a minor, but needed parental consent to use medication. Some states have a "mature minor" law. Basically stating that if you can determine the minor has the proper maturity/mental capacity/understanding of the condition and the treatment then parental consent may be waived. I generally always request parental consent unless it is an specifically defined situation that says I do not need the parents consent.

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    • Experts

    I would think your best bet would be to clarify the state consent requirements with the practice's legal counsel. I think it's perfectly reasonable to expect parents to be present for routine visits, to give consent and, as you note, provide history with which the kid may not be familiar, receive instruction about treatment and medication, etc.

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    • Guides

    I won't see a minor without a parent present. I don't cover sensitive issues that a minor may not want a parent there for, and I need to know about things such as medication compliance, symptoms, medication reactions, etc. Teenagers can be lousy historians and usually don't know what medications they're on. It makes me angry when a patient drops their 15 year old off at the office and then takes off to do errands. Sorry...you're going to have to reschedule. Our new patient paperwork clearly states that minors cannot be seen or treated without a parent or guardian present.

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