Physician Knowledge and Attitudes around Confidential Care for Minor Patients

J Pediatr Adolesc Gynecol. 2015 Aug;28(4):234-9. doi: 10.1016/j.jpag.2014.08.008. Epub 2014 Aug 17.


Study objective: Minor adolescent patients have a legal right to access certain medical services confidentially without parental consent or notification. We sought to assess physicians' knowledge of these laws, attitudes around the provision of confidential care to minors, and barriers to providing confidential care.

Design: An anonymous online survey was sent to physicians in the Departments of Family Medicine, Internal Medicine-Pediatrics, Obstetrics/Gynecology, and Pediatrics at the University of Michigan.

Results: Response rate was 40% (259/650). The majority of physicians felt comfortable addressing sexual health, mental health, and substance use with adolescent patients. On average, physicians answered just over half of the legal knowledge questions correctly (mean 56.6% ± 16.7%). The majority of physicians approved of laws allowing minors to consent for confidential care (90.8% ± 1.7% approval), while substantially fewer (45.1% ± 4.5%) approved of laws allowing parental notification of this care at the physician's discretion. Most physicians agreed that assured access to confidential care should be a right for adolescents. After taking the survey most physicians (76.6%) felt they needed additional training on confidentiality laws. The provision of confidential care to minors was perceived to be most inhibited by insurance issues, parental concerns/relationships with the family, and issues with the electronic medical record.

Conclusions: Physicians are comfortable discussing sensitive issues with adolescents and generally approve of minor consent laws, but lack knowledge about what services a minor can access confidentially. Further research is needed to assess best methods to educate physicians about minors' legal rights to confidential healthcare services.

Keywords: Adolescent health services; Confidentiality; Informed consent by minors; Parental notification; Privacy.

MeSH terms

  • Adolescent
  • Attitude of Health Personnel*
  • Child
  • Clinical Competence*
  • Confidentiality*
  • Female
  • Humans
  • Male
  • Parental Consent / psychology*
  • Physicians / psychology*
  • Pregnancy