Do medical-exam chaperon policies make sense?

As part of a set of reforms to ensure tragedies like the Dr. Earl Bradley case never happen again, Delaware's Beebe Physician Network has introduced a new chaperon policy for its medical center facilities. One of 16 recommendations from the hospital's Special Investigation Commission, the report provided that a chaperon, which would generally be a clinical health professional or hospital staff member, is required for children and infirm adults who are undergoing intimate examinations, such as those of the breasts, genitals or rectum when the patient is fully or partially disrobed.

The chaperon must be the same sex as the patient and is to offer reassurance and support during the exam, reports the Cape Gazette. Patients also can request a chaperon or decline a specific staff member chosen as a chaperon.

Despite the network's recent focus on preventing and reporting of unprofessional conduct, however, healthcare chaperon policies are hardly new. As a recent post in the New York Times Well blog points out, the official American Medical Association guidelines state, "From the standpoint of ethics and prudence, the protocol of having chaperons available on a consistent basis for patient examinations is recommended."

But in practice, adherence to chaperoning policies may be as low as 10 percent, while patient preferences vary dramatically depending on the gender mix of the doctor and patient, New York city internist Dr. Danielle Ofri writes.

"When I asked various female doctors whether they use chaperons, most responded that they knew they were supposed to but that it was just too hard to manage in a busy clinic day," she wrote. "Others commented that bringing a chaperon into the exam room felt awkward to them, especially with patients they knew well. They felt that it inserted a sense of mistrust into their relationship with the patient." Female physicians also revealed to Ofri a perception that most cases of physician sexual misconduct involve their male counterparts.

Research confirms that female patients are much more likely to want a chaperon present when being examined by a male physicians, she noted, but that male patients overwhelmingly do not want any third party in the room, regardless of the sex of the doctor.

Ofri concluded by stating that the medical profession may want to reconsider blanket chaperon requirements in favor of policies that consider the safety as well as comfort of the patient.

To learn more:
- read the post in the New York Times Well blog
- see the story in Delaware's Cape Gazette