Working with minors

I was recently on an outpatient’s musculoskeletal placement and dealt with new situations each day. I think the case I will describe is quite relevant to all of us, in particular the males. For one of my first initial Ax pts A 15 year old girl came in with a back pain complaint. I had not really seen many new patients to this point and especially not many back pain cases, so I guess you can all relate when I say I already wasn’t feeling the most confident due to a lot of unknowns. I actually walked passed the patient and her mother in the waiting room and heard them speaking. The young patient was saying that she didn’t want a male PT as she didn’t want to take off her shirt in front of a male. On hearing this all kinds of thoughts started going through my head. One of my biggest fears is not been able to gain patients compliance and not been able to build their confidence in me. As well as doing embarrassing things in front of patients which is quite common for me :P. I’m also the sort of person who doesn’t like to put people in uncomfortable situations. On top of this I really wasn’t comfortable with draping techniques due to years of “not bothering” with fellow students who don’t care what we see of each others bodies. So I’m really stressed that I won’t be able to figure out what is wrong with her (which is another story),that I will make her feel uncomfortable, do something really embarrassing or even get myself in trouble for doing something inappropriate (accidentally of course) and having her mum sitting in the room watching and listening to my every move that I made around her young daughter added to the crappy feeling.Anyways one of the great things about 4th year is we have no choice but to put ourselves in situations which we don’t feel comfortable with. So I tried to put on my biggest “good, mature, relaxed, non-Joe physio front” and introduced myself to the patient and her mother. When they saw I was going to be treating this girl they both looked at each other as if to say “oh no a guy”. After intro the first thing I asked was whether the mother would like to join us as she had not stood up as if to suggest she wanted to watch in on the session. Even though personally I’d feel less pressure with out the mother watching I thought it would help decrease the patient’s anxiety.During the subjective examination things went pretty well and I think I built quite good rapport with mother and daughter as well as builing their confidence in me. During the objective exam I had no choice but to ask the patient to remove her top if I was to Ax her effectively. I did this by giving the patient a towel and explaining to her exactly what I wanted her to do and made it really clear that I would not see anything inappropriate, then asked her “are you okay with this?” and then stepped out of the room whilst she disrobed. During Ax I made sure the patient could see my eyes the whole time she was disrobed. Throughout my time working with this patient I had many challenging situations arise including some involving bra straps and another involving teaching pelvic floor exercises to the young patient and her giggling little sister. But I will save these scenarios for later. I guess the point I’m trying to make is as a male it is really important to be very careful how we approach our contact with female patients especially with younger ones, as it is so easy for someone to misinterpret an innocent action or word. This was a really good learning experience for myself, firstly it put me in uncomfortable positions but also added to my clinical exposure in a very important area. After going through this once I think I will feel a lot more comfortable in the future working with teenage girls, not only am I more confident in my ability but also I realized that teenage girls won’t just giggle and act like fools but can also act mature when in a situation like this. Thanks and have a good week ?