title: Physician Knowledge and Attitudes around Confidential Care for Minor Patients.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI. Electronic address: marriley@med.umich.edu.
authors.forename: Margaret
authors.initials: M
authors.lastname: Riley
authors.affiliation: Department of Pediatrics, University of Michigan, Ann Arbor, MI.
authors.forename: Sana
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Barbara D
authors.initials: BD
authors.lastname: Reed
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Quint
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D003219:Confidentiality; D005260:Female; D006801:Humans; D008297:Male; D033282:Parental Consent / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011247:Pregnancy
keywords: Adolescent health services; Confidentiality; Informed consent by minors; Parental notification; Privacy