"Adolescence is at the intersection of fundamental issues for society: if you make it through successfully, you're set up for life," Santelli said. "If you don't, you could go to prison or end up in the underclass."
These doctors are also clear-eyed about their patients. This is, after all, a patient population whose three leading causes of death — accidents, homicide and suicide — are often related to psychosocial problems, rather than traditional medical diagnoses.
That is why a doctor-patient relationship with the teenager based on trust and confidentiality is so crucial, Ginsburg said.
"Adolescents are incredibly thoughtful, creative, and absolutely challenging," he said. "They get when you're insincere really quickly. The tough kids are not used to adults not fearing them. But if you just love being with them, they melt. The attitude goes away because it's just a pained, defensive posture."
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