Seventeen-year-old Giulia Bertoli is sure to get her checkup every year. And if she were to forget, her mother would be the first to remind her.
While some of her friends say that an annual physical is a waste of time when they're feeling perfectly healthy, Bertoli thinks differently.
"My father died from liver cancer, so my mom always likes to keep a count with regular blood tests and stuff," said Bertoli, a high school senior from New Jersey. "Plus, I like to know how my body is, if it's OK and I'm in good condition."
The teen years are filled with growing pains, with changes in hormones, moods and emotions. With such transformation, many would think that all teens, like Bertoli, fit an annual physical exam into thier regular routine. But a new study from the HealthPartners Research Foundation found that this is not the case for many adolescents.
The research, published in the Annals of Family Medicine, examined data of 300,000 Minnesota teenagers. Study authors found that one-third of those teenagers did not go to even one routine checkup between the ages of 13 and 17. Forty percent of the teens had only gone to the doctor for preventive care once during those four years. And insurance wasn't a factor -- every teenager in the system had insurance that did not require a deductible or co-pay.
"I was surprised that so few kids are in regularly preventive services," said Dr. James Nordin, lead author of the study and a pediatrician with the HealthPartners Health System in Minnesota. "I think this could be because teens think of themselves as invulnerable and many parents consider this a very healthy period in life."
The American Academy of Pediatrics' Bright Futures' and the American Medical Association currently recommend that teenagers get a routine physical exam once a year. But, some past studies have suggested that 13- to 17-year-olds visit the doctor less than any other age group.
"Yes, it's true, teens hate coming to the doctor," said Dr. Carolyn Eaton, a general practitioner in private practice in San Antonio, Texas. "Since they don't need any vaccinations for school after age 11 or 12, there is not much incentive to come in if they do not participate in sports."
"Adolescents disappear after routine child care, usually about age 8 or 9, then occasional visits for sports exams, then nothing until after college," said Dr. Thomas Schwenk, a professor in the Department of Family Medicine at the University of Michigan.
But could the teens' absences from their primary care physician affect their long-term health? Some doctors say yes.
"I would bet that we are falling down on immunizations, tetanus, pertusis, and HPV," said Dr. Daniel McCarter, associate professor of Clinical Family Medicine at the University of Virginia.
Dr. Marcie Billings, a pediatrician at Mayo Clinic, said that it is during these visits where doctors, teens, and their families have the opportunity to talk about more than just acute pain and illness.
"[Teen health issues] that we see and deal with often are risk-taking behaviors such as alcohol use, substance use, and sexual activity, depression and other mood disorders, obesity, eating disorders, and chronic medical illnesses," said Billings.
And while the risk-taking behaviors are important teen discussion points, it is often just as important to involve the parents in the conversation as well.