Cultivating the trust of adolescent patients.

In a qualitative study of adolescents' perspectives on health care, we conducted 55 open-ended group interviews with 747 adolescent participants, of whom 476 were females. Analysis of comments on confidentiality showed females made more comments than males about physicians violating confidentiality and both males and females cited more violations for reproductive than for general health care. Teens mistrust physicians because of their previous experiences of being accompanied to the doctor by parents. Family physicians wishing to cultivate the trust of their adolescent patients should begin while patients are still children, talk directly to the child, rather than exclusively to the parent, and see the child in privacy for portions of each visit.