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Tomas Jose Silber, MD
Children's National Medical Center Washington, DC

JAMA. 1992;268(11):1410-1411.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Regarding the four models of the physician-patient relationship by Emanuel and Emanuel,¹ I suggest that they need to be expanded and/or adapted to the special case of the physician-adolescent patient relationship.^2-4 This is an important stage in life when abstract thought develops, the capacity for reflection grows, and the need to establish an identity (to which the development of a value system is essential) becomes first and foremost.³ What happens at the time of this "second period of individuation" will have a dramatic impact throughout adult life.⁴ Hence the importance of the interaction with parents, teachers, and physicians. For many teenagers, the physician-adolescent encounter may be the first time they experience being taken seriously "as persons."⁵ The deliberative model is a natural for adolescents.

Moreover, the deliberative model especially needs to be used with teenagers at any physician encounter because they are . . . [Full Text PDF of this Article]

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