Patients Under 18 in Retail Healthcare
We are doing lots of sport physicals as school is about to start in many of the surrounding counties. I think that sometimes when something like a sport exam is offered at such a low cost and at very convenient times people do not take them as seriously as they should. Maybe the low cost and convenience devalues the importance of what is taking place. Every time I clear a child for sports I say a prayer that this child will stay safe while they are exerting themselves out in the Georgia heat. To me, and I'm sure I am not the only NP that feels this way, these exams should not be taken lightly.
A common problem that I am encountering is no parent or guardian present on sign in. Sometimes the child presents with someone who is not their guardian or with no one at all. I sometimes have to remind parents that even though their child is bigger than they are and can drive they are still minors if they are under 18. As a parent it makes sense to me that if my child were under 18 I would need to be there for a physical exam and to give the appropriate health history information.
So often parents will say they can't come in because they work. I remind them that they have the opportunity to come in after work or on the weekend when we are also open. There is the option of the telephone consent but I am not comfortable with that.
I prefer that the parent be present to give me important health information about the participant. The parent or guardian is really our most important resource for this information in this setting. They also need to be present for any part of the exam that the child may be nervous about. We often pick up abnormalities that make it necessary to stop the exam and refer the child for further evaluation. The parent should be present for that as well. It is also important for them to receive the same information we give our patients regarding safety and health while playing sports.
We can offer these physicals with convenience but at the same time keep our athletes' health and safety in the forefront. As nurse practitioners a large part of our role is to advocate for our patients, especially the ones who cannot always speak for themselves.