Abstract

On a recent evening, while working in a children's hospital emergency department as a pediatric emergency medicine physician, I picked up the chart of yet another patient without a true emergency: a sixteen-year-old with vaginal discharge. After reviewing her chart, her nurse and I spoke with her in her room. Her story was all too familiar. She was sexually active. She did not use contraception. She had also been treated for pelvic inflammatory disease three times before, but luckily, she had not yet been pregnant. And like many adolescents, she did not have a primary care physician, so the emergency department was her primary care clinic. I informed her that she would need a pelvic exam and a pregnancy test. I ..