To be a little shocked surgeon is happy to see 15 year old alone?

[Anonymousy121]

That’s it really, dd has had a complicated injury and lengthy recovery after an accident. We have been advised she needs surgery, we had a terrible appointment last time where I left the room convinced he wasn’t recommending surgery, dd left convinced he was and him and a colleague were clearly disagreeing about what was needed while we were sat in the room in front of them, without either of them taking the time to speak to us just continually going in and out of each others rooms and raised voices! It was very difficult. She is due to be reviewed next week. To discuss surgery and decide whether to proceed. I have a family emergency out of town I am dealing with, DHL has a work thing he really can’t get out of. I contacted surgeon saying sorry can we come the week after and his secretary has replied saying he is happy to see dd by herself! Dd is certainly Gillick competent in general (except surgery might have long term complications which I don’t think she really understands the implications like any 15 year old) but I am a bit shocked he doesn’t feel we need to hear what he has to say! Dd has watched enough ops on tick tok and you tube she could probably assist, she’s also put ChatGPT through it’s paces for the last 6 weeks and has a list of over 20 questions and is pretty feisty. Dh thinks he’s keen to see her without me because I’m difficult but we both know he’ll revise that opinion after she’s been leading the show!

So how common is it for surgeons to see 15 year old children alone? Anyone else surprised?
(adding dh is going to cancel his work thing, I will try and zoom in and I’ve just remembered I used to go to the hospital myself when I was at school for a long term thing years ago! Shocked at that too now!)

If your daughter is Gillick competent, then that’s probably all they need. I understand your anxiety though!

Yeah probably true! Honestly I am probably more shocked because she’s my youngest, so weird to think he’s happy to see her alone though!

I’m a HCP and would think a 15 year old going to see a surgeon alone is highly unusual, especially at an appointment in which a big decision could be made. Even the vast majority of fully fledged adults would bring their partner or a friend as there is often so much information to digest at consultant led appointments. My DD has seen spinal surgeons regularly since she was 16 - it wasn’t until she was 19 that she felt confident/comfortable enough to go without me! She was more than capable of managing things herself but liked having a bit of support and back up. I would’ve gladly let her go alone from a younger age if she wanted though since they were surgeons that I personally knew and trusted.

In other words yes, it’s allowed given she’s Gillick competent but it’s not a very common scenario!

He may well not have any alternative clinic slots available for many weeks.

Agree with this.

Often we're pressured to leave children to sort things out themselves when adults would take a relative or friend with them...

As an adult, it's often a good idea to take somebody with you so someone else has a note of all the doctor talk.

Can anyone else go with her if that's the only available slot? Or she could record the conversation if they're agreeable.

They are completely misinterpreting the Gillick competence test in my view.
a child is just that until they are 18.
However if a doctor deems child is competenent they can agree to medical intervention without consent of parent.
this does not mean every child between 14 and 17 should be seen without a parent

Kindly, if you can't make it its not their issue so probably why they aren't bothered and its all standard stuff to them. Personally I'd make every effort for someone to be there.

Good point true (not relevant I know there are lots I checked first but yeah could easily be an issue!)

I have concerns about the way some Doctors use Gillick or Fraser competence.

Whether a child has G/F competence is decision dependent, a bit like capacity - understanding one simple decision e.g to take antibiotics for earache is entirely different to making a more difficult decision e.g surgery that may have different options/long term side effects

Because it only works in one direction - the child can only agree to the intervention, it does not stand if they refuse something the Dr thinks they should have/do (especially if parents agree) , it can be used to coerce a child into an intervention without fully exploring their understanding 'oh they seemed okay with it' and can also be used to dismiss parental invovlement, even though parents will be doing the majority of aftercare.

Sometimes it is more about it being quicker and simpler for the Dr to gain consent from a child than an adult/parent and that is definitely NOT what it is meant to be.

Yeah absolutely true, dh is going to go along and I will try and be on zoom or WhatsApp so I can at least hear what is being said. I am annoyed I can’t be there though lots of unsaid clues and that can be helpful.

Yeah there’s stuff I didn’t add because it just turns into an essay otherwise, it’s certainly not standard stuff not least because it’s going to be one of those ‘I’ll open you up, take a look and do what I feel like on the day. Trust me I’m a Doctor’ consent forms hard to properly inform a lot of people for that. There’s more but it’s long and boring if it’s not your kid.
@Womblingmerrily (love your name) yeah all good points. It did cross my mind that he thinks I’m anti surgery for various reasons and it would be easier to explain to a kid! Dd has a list of things she wants him to photograph while he is in there and is requesting the video of the op as well! 😁

I agree, I'd take someone else with me if I was having surgery. People might not think of the different benefits/risks with each option, often you might miss something, misinterpret something or feel nervous etc. I'd also take all the questions you want answered written down for this reason and write down the answers.

Even as an adult, I think it’s a good idea to bring someone you trust with you when talking about surgery. It helps to have backup to make sure you don’t forget any of your questions or to prompt you if you start to get overwhelmed. Also to take notes and be a second set of ears in case you leave feeling confident but suddenly start second guessing yourself.

in other words, even if the surgeon will see her, you should move heaven and earth to make sure there is a parent at that appointment.

Hcp here we see transition pstiets who have been under peads from 16 years, and all new effects of 16 years and over come to us not peads. How close to 16 is she? At 16 I lost all access to my dd med records as she was judged an adult. I'm not suggesting she shouldn't have someone there we encouge all our younger patients to bring somebody, but she is nearly at a point where the decision is hers only.

Maybe they have experience on parents doing all the talking and thinking for the child and not letting the child speak, so they may speak to you separately afterwards

This. I don’t think it’s appropriate at all for a 15 year old to see a surgeon alone. That’s a difficult appointment for adults and most would take someone with them. Plus surgeons can be dismissive and arrogant while being in a position of authority, and it can take a very strong minded and together person to advocate for themselves or others with them. There’s also long term/permanent consequences that 15 year olds may not be capable of comprehending or understanding.

I advocate quite strongly for children’s independence and being allowed to do things in their own, and that they are generally cosseted these days (to their detriment) and are capable of much more than they are given credit for; however I don’t think this is one of those scenarios when a 15 year old should be left to go it alone.

The surgeon is possibly thinking she could take a friend, grandparent, or other relative with her.
He's probably wouldn't actually expect her to rock up alone.

I wouldn't be letting my 15yo go into a male doctors room alone, especially in your scenario as he sounds forceful, arrogant and unprofessional, arguing with a colleague in front of you etc.

Definitely go with her.She may be 'feisty' but she is still only 15 and vulnerable.

How did you check?

To me, this shows that your DD doesnt have the maturity to make such serious decisions - why on earth would she think a surgeon has the time or opportunity to take photos of the patient’s insides during what you indicate is a serious operation???

Would you be free to be dialled in to participate via speaker phone?

Exactly this. She's not seeing the operation for the importance thing that you think it is. Someone definitely needs to be there with her.

Also, if she's investigated requesting photographs and video, it's essentially making everyone's life difficult due to the legal documentation required, and that's even if the surgeon agrees to it in the first place. There's a lot of issues surrounding Dr/patient confidentiality as well as someone wanting to use the recording to potentially sue in the future. Please explain this to her. The surgical team is there to save/improve the quality of her life, not for her entertainment.

This! The surgeon probably doesn’t have another appointment for weeks, if not months. Maybe they are extremely keen to get your DD either into surgery or off the list.

As a parent I would always put a hospital medical appointment before my work OR I’d ask a trusted relative to go with them.

I asked his secretary/clinic organiser/appointment person.