Pediatric and adolescent gynecology for the primary care pediatrician

This review represents the author's personal style of practice in a new and evolving field, where the standard academic framework is still in its infancy. When there is no prior established practice to follow, good clinical care needs to come from listening very carefully to patients and empirically judging appropriate treatment by actual outcomes. The information provided here that is not cited represents 14 years of careful clinical listening and observation, as well as public health training in maternal and child care and epidemiology. Health care is more effective, thereby improving its quality, if the following principles are applied consistently to the pediatric or adolescent gynecologic patient. 1. The developmental stage of the patient dictates clinical practice. 2. Confidentiality is paramount in caring for adolescents and may necessitate referral. 3. Autonomy in medical choices leads to responsible self-care.