There are many challenges in communicating with adolescent patients, as detailed below.
Developmental changes and autonomy
Adolescents experience physical, cognitive and emotional changes that influence their decision-making capacities and desire for autonomy. Family physicians must navigate the delicate balance between respecting adolescent patients’ autonomy and considering their level of maturity in decision-making processes.1,2
Communication barriers
Lack of trust, language and literacy barriers, stigma and limited health literacy contribute to ineffective communication.1,3,4
Time constraints during appointments
Time limitations in busy clinical settings can impede effective communication. Allocating sufficient time for consultations, scheduling dedicated adolescent clinics and using support staff can optimise communication opportunities.3–5
Language barriers and cultural considerations
Cultural differences can affect communication dynamics. Physicians should be aware of cultural norms, beliefs and practices, respecting and adapting their communication style accordingly to ensure effective and culturally sensitive care. Training programs should address cultural differences and promote cultural sensitivity in healthcare communication. Doctors seeking family physician training should be educated on cultural norms, beliefs and practices to ensure respectful and effective communication with diverse adolescent populations.6
Power dynamics and perceived authority gaps
Teenagers often struggle with building trust and rapport with healthcare professionals, which can hinder effective communication. They might perceive doctors as authority figures or feel uncomfortable discussing personal issues openly. Consequently, doctors might find it difficult to gather accurate information and engage teenage patients in shared decision making.7–9
Limited communication skills
Family physicians might lack specialised training in adolescent medicine and encounter difficulties in communicating effectively with this age group. Adolescents might be less forthcoming in expressing their concerns, leading to incomplete information exchange and missed opportunities for early intervention.1
Privacy and confidentiality concerns
Adolescents often hesitate to discuss sensitive issues due to fear of breaching privacy, potential judgement or disclosure to parents/guardians. Maintaining confidentiality within legal and ethical boundaries is crucial to building trust and ensuring open communication.10–13
Stigmatisation and judgement
Adolescents might face stigma related to mental health, sexuality, substance use or other sensitive topics. Prejudice or judgemental attitudes from healthcare providers can hinder open communication and discourage adolescents from seeking care.7,8
Age of family physicians
Age concordance between physicians and adolescent patients can positively influence communication and rapport. Younger family physicians might better understand contemporary adolescent culture, preferences and communication styles.
Family physicians from different generations might have varying communication styles and approaches. Older physicians might use more traditional methods, whereas younger physicians might use newer technologies and modes of communication that resonate better with adolescent patients. Physicians closer in age to adolescent patients might share more life experiences and cultural references, potentially facilitating a sense of relatability and improving communication. However, older family physicians might possess more clinical experience, which can positively impact their ability to diagnose and treat adolescent patients. This experience can enhance patient trust and contribute to the establishment of rapport.6
Gender of family physicians
The gender of family physicians might influence communication dynamics with adolescent patients. Offering choices of healthcare providers to adolescents based on their preferences might enhance comfort and foster open dialogue. Adolescent patients might have personal preferences regarding the gender of their healthcare provider. Some might feel more comfortable discussing sensitive topics with physicians of a specific gender. Patient-centred care involves respecting and accommodating these preferences whenever possible.6
Reluctance to seek help
Many teenagers are hesitant to seek medical care due to a variety of reasons, including fear of judgement, concerns about confidentiality and the desire for independence. This reluctance poses a challenge for doctors in family medicine, because it might impede early detection and timely intervention for various health issues. Female family physicians might be perceived as more approachable for addressing gender-specific health concerns or sensitive topics, such as menstrual health or contraception. Sensitivity to these concerns can contribute to effective communication and trust.1
Emotional and behavioural barriers
Teenagers commonly experience emotional and behavioural barriers that affect their communication with healthcare providers. Mood swings, defiance and experimentation with risky behaviours can complicate the doctor–patient relationship, making it challenging to establish open lines of communication.
Strategies for overcoming communication challenges
Establish rapport and trust
Take time to build a rapport with the adolescent patient. Show genuine interest, respect their perspective and create a safe and non-judgemental environment. Adolescents are more likely to open up and actively participate in their healthcare when they trust their healthcare provider.3–5
Building trust, ensuring privacy and confidentiality, and providing a safe space for open communication can foster a positive doctor–patient relationship.
Tailor communication techniques
Using age-appropriate language, active listening, validating concerns, avoiding medical jargon, encouraging questions and involving adolescents in shared decision making can enhance communication effectiveness. Create a safe and supportive environment by demonstrating empathy, active listening and non-judgemental attitudes towards adolescent patients.9,14,15
In addition, using open-ended questions, active listening and empathetic responses can encourage adolescents to share their thoughts and concerns more freely.16
Incorporating adolescent-specific communication skills in medical education and offering continuing education programs can enhance doctors’ communication competencies.
Use technology and digital platforms
Integrating electronic health records, providing online resources and educational materials and offering telemedicine options can improve accessibility and facilitate communication.17
Allocate sufficient time
Schedule longer appointments for adolescent patients to allow for thorough communication and to build rapport. Establish a safe and supportive environment.
Incorporate privacy and confidentiality guidelines
Ensure adolescents understand their right for a confidential consultation and encourage them to be seen without the parent/carer when they present together (for at least part of the consult), with the consent of the patient, as part of the transition to adulthood. In addition, getting adolescent patients involved in discussions about sharing information with parents/guardians can promote trust and encourage open dialogue.10,11,13,18
Professional development and training
Continuous medical education programs should include training on adolescent health and communication skills, addressing the specific challenges faced by family physicians in engaging with this population.
Youth-friendly general practice
Create a welcoming environment by implementing age-appropriate waiting areas, displaying informational materials targeting adolescents and using a diverse healthcare team, all of which can contribute to a youth-friendly atmosphere.9,14,15
Involve adolescents in decision making
Engaging adolescents in healthcare decisions, including treatment options, goal setting and care planning, empowers them and encourages ownership of their health.16
Address sensitive topics
Adolescents might have concerns or questions about sensitive topics, such as sexual health, mental health, substance abuse or body image. Create a safe space for these discussions, using open-ended questions to initiate dialogue. Offer non-judgemental support, accurate information and appropriate referrals when necessary.19,20
Peer support
Including peer support initiatives, such as youth advisory groups or peer educators, can increase participation and give young people the chance to connect with and learn from their peers.
Health education and promotion
Giving adolescents access to health education materials, seminars and preventive programs that are tailored to their needs can give them the power to decide what is best for their health and wellbeing.
Continuous improvement
Monitoring the practice’s performance on a regular basis and receiving input from young patients can help pinpoint areas for development and guarantee that the practice performance remains adaptable to the changing requirements of young people.
Follow-up and continuity of care
Schedule regular follow-up appointments to monitor the adolescent patient’s progress, address ongoing concerns and maintain a supportive relationship. Continuity of care helps build trust and ensures that the adolescent patient receives consistent and coordinated healthcare.
Involving parents as partners
While respecting patient confidentiality, involving parents or guardians in the conversation can foster trust and provide a holistic approach to care. Collaborating with parents allows doctors to gain valuable insights into the patient’s home environment and address any concerns or misconceptions.19,20
Conclusion
Effective communication is paramount in providing comprehensive healthcare to teenage patients in family medicine. By using active listening, empathy, non-judgemental attitudes and age-appropriate language, physicians can enhance their ability to connect with adolescents.3
Building trust, respecting confidentiality and involving parents or guardians are also crucial aspects of effective communication. During adolescence, individuals undergo various physical, cognitive and emotional changes that can influence their communication patterns. Healthcare providers must be cognisant of these changes, including increased self-consciousness, desire for autonomy and peer influence. Understanding these dynamics can help tailor communication styles to meet the unique needs of adolescent patients.4,5
Overcoming common communication barriers, such as lack of privacy, time constraints and cultural differences, can further optimise communication with teenage patients. By investing in effective communication strategies, family physicians can promote patient engagement, improve health outcomes and foster positive doctor–patient relationships during the critical adolescent years.
It should be remembered that each adolescent is unique, and that building rapport requires adapting to their individual needs and preferences. By implementing the strategies detailed above, healthcare providers can establish a strong rapport with adolescent patients, facilitating effective communication and promoting their overall wellbeing.
Key points
- Building trust through respectful communication, acknowledging their concerns and involving teenagers in decision making can foster effective communication and encourage active participation in their healthcare.
- Family physicians should create a welcoming, non-judgemental and supportive environment for their adolescent patients.
- Adolescents are often comfortable with digital platforms and might prefer alternative methods of communication.
- Generational gaps and cultural differences can create barriers to effective communication between family physicians and teenage patients.
- Family physicians should create a safe and confidential environment, assuring teenagers that their information will be kept private.