||Dr. Rhonda Cambridge-Phillip
Dr. Rhonda Cambridge-Phillip, a pediatrician who specializes in adolescent medicine at Kings County Hospital Center, talks about common risky behaviors among teens and how to meet their medical and mental health needs. Her patients are between the ages of 12 and 21.
Q. How healthy are today's teenagers?
A. For the most part, most teenagers are healthy, although some populations are disproportionately affected by certain chronic diseases. A lot of what we do in adolescent medicine is making sure they stay healthy. As children get older they see the doctor less frequently. Yet we believe if you have a healthy adolescent you will have a healthy adult. We want to foster good health practices, deal with risky behaviors that we know this group engages in, promote healthy eating habits, and praise positive behavior.
Q. How is a doctor's visit with you different than if a teenager goes to another pediatrician or general practitioner?
A. As adolescent medicine specialists, our visits may be longer; we may talk more with the patient. Yes, we take care of the physical problems. But the true definition of health encompasses not just the physical body but the emotional and psycho-social factors. We have a mnemonic called the HEADS assessment. To me it means we're trying to get inside the heads of the adolescents. It stands for: Home environment; Education, Eating habits and Employment; Activities - what do they do for fun?; Drugs and Depression; and Sexuality and Safety. We talk to them about all these areas and develop a list of issues that can be explored over time.
Q. What is the biggest health danger for teens?
A. The major danger comes from risky behavior. In this age group, the top three causes of death are accidents, suicide and homicide. For example, most of the motor vehicle accidents involve alcohol or drugs. So we focus a lot of our counseling to help teenagers avoid the pressures of drinking and doing drugs. And we talk to them about ways to avoid other risks: wear seatbelts; don't smoke; don't have unprotected sex.
Q. How can you tell if a teenager is depressed or just moody?
A. It's about their degree of functioning. You have kids who are moody but they're still able to concentrate and perform in school, in sports, in an organized activity. Those kids who have an underlying mental illness are irritable, aggressive, have problems concentrating, falling asleep and staying asleep.
Q. Asthma is a prevalent chronic condition in New York City. How do you treat teenagers with asthma?
A. Teenagers may not want everyone to know they have asthma and they certainly don't want it to be a big deal. We stress the importance of staying on their medication. Some patients will be able to take their controller medication in the morning and evening, so they don't have to take it during school. We advise them to avoid triggers such as smoking and second-hand smoke. They should get regular medical care, including the annual flu shot, and know when to seek emergency care.
Q. What about obesity?
A. Obesity has become a common chronic disease in adolescence. By intervening in adolescence we can prevent a lot of the morbidity and mortality that we see in the adult years. It's important to involve the entire family. We educate teens and their families about healthy eating and portion control, and the importance of physical activity. And we stress the importance of follow-up visits to monitor and reinforce these principles and help them to succeed.
Q. What do you want teenagers to get out of their adolescent years?
A. My goal is about helping adolescents develop healthy lifestyle behaviors they can take into adulthood. As their physicians, we can help them get there. With young children, parents have to do the talking. But adolescents can speak for themselves and that allows us to develop a direct relationship. Hopefully, we can use that to influence their health habits for the long term.