Most days GPs will see adolescents and younger teenagers and occasionally these patients will want to talk about private things, such as contraception, sexually transmitted diseases or abuse. It is important when you realise that the conversation is heading in this direction to maintain rapport. However, it is vital for you legally and for the patient’s benefit to state what you can and cannot keep secret on their behalf. It may help to use simple examples and simultaneously avoid discouraging the patient from further discussion. For example, you could say: “If you tell me that you have been subject to physical or sexual abuse, I am bound by law to inform the Department of Community Services. This is because you need extra help and support in this situation, to make things better for you, not worse.”
Another common scenario is the patient under sixteen years of age (for a girl) or under eighteen years of age (for a boy practicing homosexual sex) who presents with the possibility of a sexually transmitted disease from a consensual sexual relationship.