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Dr. Don Shifrin addresses attendees at the SMAHRT Conference this month in Seattle. (SMAHRT Conference)
Dr. Don Shifrin addresses attendees at the SMAHRT Conference this month in Seattle. (SMAHRT Conference)

Your teen’s pediatrician can talk about a good diet, exercise and even tricky stuff like alcohol and safe sex.

But what about smartphones, Snapchat and Facebook?

“A lot of them are not going to open that Pandora’s Box, either, because it could subvert the clinical visit or because they don’t have the tools to deal with it,” said Bellevue pediatrician and pediatric media adviser Dr. Don Shifrin.

I met Shifrin at a Seattle conference of pediatricians and pediatric researchers this month where heads nodded, all around me, to two assertions: that many teen tech issues are also teen health issues, and that many pediatricians have no idea how to address them.

It was a good reminder that when technology transforms society at every level, parents are hardly the only ones who have to rethink their roles in response.

And when a whole profession needs an upgrade, pushing for change can be slow work.

Dr. Megan Moreno knows all about it.


The director of the Seattle Children’s Research Institute social-media research team that put on the conference, Moreno has for years studied the technology issues that can affect teens’ well-being: namely, the host of ways either unbalanced screen time and device use or the wrong shared content can disrupt instead of enhance their mental, physical and emotional health.

She’s also one of three Seattle-area physicians who sit on the 11-member executive committee of the American Academy of Pediatrics’ Council on Communications and Media. Among that group’s big jobs: adding more modern and useful media-related guidelines to its influential Bright Futures handbook for American pediatricians.

When teens create and access whole worlds minute by minute on their smartphones, passing mentions of TV and computer use just aren’t enough.

And it’s past time their doctors made those worlds part of the conversation. Is tweeting while researching a paper affecting their concentration? Is texting late into the night stealing their sleep? Are friends’ posts on social-media sites making them feel mocked or excluded?

“Pediatricians know to ask these questions, but they don’t know what to recommend,” Moreno told me.

Moreno’s interest in social media grew out of a 2007 meeting with a strong teen student who stopped going to school when her friends had posted a picture on MySpace of her trying alcohol for the first time.

Dr. Megan Moreno
Dr. Megan Moreno

Years later, she met a teen who set her phone alarm to go off in the middle of every night so she could open her Facebook page, delete new negative comments about herself, and go back to bed.

Parents don’t have it easy these days. I’ve got 11 years ’til my son turns 13, and already, I’m terrified.

Doctors, too, have it rough. It’s not easy to fit media straight talk into 20-minute clinical visits. But more and more, parents and teens come prepared with questions, or reveal their own tech tensions when one, the other or sometimes both pull out their phones mid-visit.

That’s why Moreno’s first tip is to set a family plan around tech use. I’ve seen parents act like teens are the only ones who need boundaries. But who are they kidding?

“Parents will say, ‘I have to take this,’ and I don’t think it’s an emergency,” Moreno said.

Consensus is building among savvy pediatricians — “mediatricians,” as Shifrin and others like to refer to them.

The best approach begins, they argue, with a lot of listening, and smart but neutral information to help each family set its own rules.

Rose Ibarra moderates a panel of young cancer survivors discussing the role of social media in health. (SMAHRT Conference)
Rose Ibarra moderates a panel of young cancer survivors discussing the role of social media in health. (SMAHRT Conference)

As youth tech researcher danah boyd argues in her latest book, “It’s Complicated,” teens aren’t addicted to technology as much as they’re addicted to connecting with other teens.

If parents take tech issues seriously, know the impact their own tech use has on their teens’ and seek understanding before control when something seems off, they’re in a good spot.

The key for pediatricians, meanwhile, is to know what they need to know to be what we all expect them to be — advocates for children’s and teens’ best health.

More informed pediatricians can help parents steer teens away from unhealthy habits. But I hope they also help them see beyond the fear and hype that can make a normal teen behavior appear more risky than it is.

“We have to get past the idea that we can gleefully gloss over these issues,” Shifrin said.

Only then can pediatricians help us work on them.

Mónica Guzmán’s column appears in Sunday’s Seattle Times. Got a story about living with technology in the Northwest — or know someone she should meet? Send her an email, follow her on Twitter @moniguzman or send her a message on Facebook.