Medical chaperones during intimate exams

I'm with Jds. I don't have any data but cases of sexual misconduct by doctors are causes célèbre but are few. I suspect that false accusations are more common. I don't know of any of my partners or fellow docs who have been accused. It is after all pretty much the kiss of death.

These cases of accusations against doctors are probably so blown up in the media partially because they are uncommon and therefore newsworthy, especially if it turns out to be true. If it were a common enough occurrence, it would not be that newsworthy anymore. Robberies, muggings, drug arrests are a dime a dozen, hardly worth reporting unless especially juicy somehow or violent.

If doctors were that prone to misconduct, there would be less news interest.

But we do live in the age of scandal. And the less scrupulous media have been known to take an issue and milk it for all it's worth. It's easy to cry wolf and get a media outlet to show interest in your story.

And then there are always uncharitable thinking people who see harm and bad intentions in the most innocent of situations because they expect something bad to happen or who are suspicious by nature.

First, I don't think I've ever had a chaperone when I was seeing a male doctor. Only on some occasions when seeing a female. My dermatologist always has a female nurse in the room with her when she's conducting her full body exam -- I get those every 6 months. The nurse takes notes and assists the doctor if I have any moles that need to be cut/frozen off, so she actually does assist. But most of the time, her duty is really as a chaperone.

My current female internist does not use a chaperone, but the very first time I saw her she asked if I wanted one. She asked just at the point when she was about to do the genital and hernia exam and was already pulling on her exam gloves when she casually asked me if I wanted a chaperone. I remember thinking at the time that it was actually a funny question, as if I wanted a chaperone to protect me from my evil doctor that was about to do unspeakable things to my genitals! I declined the chaperone and she's never asked again.

I have had chaperones in the past with previous female doctors, or NPs. But to be honest, I don't remember many of the specifics, what they said, when they came in, how long they stayed, etc. It's actually been quite a few years since I've had one (outside of my dermatologist visits). But IIRC, they would typically be called in when my examiner was getting to the genital exam. She would step out into the hallway for a minute and bring a nurse back with her. And I do remember a few times in the distant past that the doctor would simply press a button on the wall. That was back when exam rooms typically had a set of several lighted buttons on the wall that they doctor could press to summon some assistance. I haven't seen buttons like that in a long time. I suppose whatever button she pressed meant "hey, I need a chaperone because I'm about to grab this guy's balls" -- or something like that. Anyway, a minute later the door opens and in walks a female nurse. Either way, the chaperone would stay during the genital and hernia exam, and also the prostate exam (once I was old enough to get those). Then she would leave. But in a lot of cases, that was also the time for the doctor to finish up and leave, so some times they would exit the room together.

Thanks jds and liquidsky. That's what I suspected. Too bad we live in such a litigious society. Too bad there's no way to require competency in patients.

One of the Docs I called on bought a computer program that allowed him to look up new patients to see if they had ever sued any other doctors for any reason. It's sad that society has gotten to this place.

One of the Docs I called on bought a computer program that allowed him to look up new patients to see if they had ever sued any other doctors for any reason. It's sad that society has gotten to this place.

That's OK, I look up my doctors, including how much money they take from drug and medical equipment companies as well as their malpractice history.

That's OK, I look up my doctors, including how much money they take from drug and medical equipment companies as well as their malpractice history.

I would love to know how you do that. What site? I check online reviews when selecting a new doctor, but that's about it.

Unfortunately, online reviews are only as good as the person writing them. And I think a person is more likely to write a review if they have something negative to say. That goes for any reviews, hotels, restaurants, doctors, even products on Amazon. You rarely get enough information in a review to know if you'd reach the same conclusion.

I would love to know how you do that. What site? I check online reviews when selecting a new doctor, but that's about it.

Here's the compensation database http://projects.propublica.org/docdollars/ click on show all and you'll see even meals paid for by drug companies. My PCP got a $10 meal from Merck in 2011.

Many of the doctor search engines like Healthgrades.com list malpractice and sanction histories.

Here's the compensation database http://projects.propublica.org/docdollars/

Great site Jds! I'll certainly check that out from now on. Looking at my doctors, my PCP got just under $300 from Pfizer for meals and a specialist I see got over $17K from a couple of pharma companies. Interesting stuff.

Great site Jds! I'll certainly check that out from now on. Looking at my doctors, my PCP got just under $300 from Pfizer for meals and a specialist I see got over $17K from a couple of pharma companies. Interesting stuff.

The meals are usually incidental - attend a seminar, get fed. The $17k is questionable. I could see it if it were a medical equipment company. Maybe a cardiologist being sent to training for a new stent or technique at a resort somewhere sponsored by the manufacturer.

I've only been offered a chaperone once, for a rectal exam when I was 27. I turned it down, I'd known the doctor concerned for twenty years and trusted her. I'm not sure if I would have one if offered in the future though, probably not.

Never had a chaperone when seeing a male doctor. I have also seen female NPs and they never brought one in when doing rectal or genital exams. Last year the doctors office that I go do brought in a female partner. I have seen her several times and she always calls in a nurse or assistant whenever she does anything that involves my genitals or rectum. I don't know if its just her preference or if laws have changed in california. Also, when I see my urologist for any type of procedure I am always prepped by a female with no chaperone in the room.

Meals and rectal exams mentioned in the same thread...Ugh! That is like an advertisement for mens chewable multi vitamins: "Tastes great for that healthy prostate."

Haha Turkent. Actually the favorite topic in surgery is food. I know of a resident whose attending was using the electrocautery unit too much. He quipped "pass the barbecue sauce ". He was fired on the spot!

One time a NP (that I had not seen before) told me she would go get the nurse for the last parts of the exam.

I was in my forties and she said something like "we could skip the prostate exam unless I wanted it" and I replied that since I was there and it was probably a good idea to do...........I wonder if that triggered the chaperone ?

I haven't ever had a chaperone sit in on my visits. Female doctors but I haven't ever needed to go in for anything other than regular physicals.

Ive had medical scribes in the room during exams. They mostly just look away.

A few years ago I had to go to a clinic to get a DOT exam for a commercial license renewal. A female NP was doing parts of the exam. She brought a male technician into the room while she did the hernia/cough check. She barely touched my scrotum when she had me cough. I think she was new and in training. Looking back I probably should have told her to press in more. That was the one and only time there has ever been a chaperone. I have had scrotal ultrasounds by females without others in the room.

I was offered a chaperone at my last physical but I declined, I told them I trusted my doctor to behave herself which got a laugh from all involved.

I've had a female NP do a genital exam without a chaperon. One was not offered, but I was fine with it either way.

Last year when i had a physical it was just me and my female doctor no charparones were in the room with us and everything went just fine i wouldnt want another person in the room with us

During any invasive exam here it seems to be policy that doctor or nurse practitioner must have nurse with them wile giving exam in hospitals here in gp they ask

Since so many procedures and exams simply do need someone else in attendance for strictly assistance purposes anyway, say to hand instruments or other things, take notes maybe or whatever, wouldn't the question of needing a chaperon be moot? I'm wondering if maybe the practice of 'offering' a chaperon isn't another way of putting a patient on notice not to try anything in the way of complaints? Sort of like a polite warning without actually saying it out loud?

That said, I still find the practice, seemingly normal in some places, of insisting on chaperons to be just a bit mistrusting, as if the assumption of uncharitable actions is the most normal thing in the world.

Agracier one should trust no one in our biz. Defending yourself in a sexual impropriety case is so much harder than preventing it in the first place. An ounce of prevention...

That's the attitude I mean. Trust no one. Sounds like something that Fox Mulder would say ... 😃

My wife worked for decades in the medical profession and I've been around her friends and mine who were also doctors or nurses. I just haven't seen evidence that medical professionals are structurally mistrustful of their patients by default.

It sounds horrid to have to be on the lookout with everyone.

Perhaps I gave the wrong impression. Be good but if you can't, be careful. Also perhaps in Belgium people aren't so litigious.

Not for the examination itself but until about age 15 I had to bend over the receptionist's lap for injections.

Also perhaps in Belgium people aren't so litigious.

It's not only like that in Belgium, but about everywhere I've been. When people in other countries see characters in American TV shows saying: 'I''m gonna sue you for every penny you've got!', that is really something so far removed from normal experience as to seem far-fetched for many viewers. I don't know how many times I've been asked about that by friends here. I usually tell them that when I lived in the US, in what is now almost a mythical past which present day inhabitants wouldn't recognize, I had the impression that there was no widespread general mistrust. That it must be an attitude that has grown since I left.

That said, I still find the practice, seemingly normal in some places, of insisting on chaperons to be just a bit mistrusting, as if the assumption of uncharitable actions is the most normal thing in the world.

I agree. It's one thing to offer a chaperone to a patient in order to make THEM feel more comfortable (if that's possible). It's another entirely for the medical provider to insist on bringing one in without even asking the patient. When that happens, then you know that the provider is simply covering their ass to prevent some type of litigation later. It really does show a lack of trust on the part of the medical provider. But at the same time, I can understand that in our society today, it might be necessary to protect yourself.

I have never had a "chaperone" per say for an exam by either a male or female practitioner. When I was a child, my mother was present until I was about 10, and occasionally a nurse, student, or resident may be present. (In the case of the last two, I was always asked prior to the exam if I consented) In the Navy, of course, you didn't question. You just followed instructions.

When I did exams, I did not usually have a stand by when examining females, unless it was a specific exam of the breasts, genitalia, or a DRE, and there was a female Corpsman available. Again, my patients were all military, so it was no big deal to them, but we had a female doctor in one clinic I worked in who always said "Lawyers are Doctors." (She must have missed the part that said as an MO, she can't be sued by a military patient. Ironically, she ended up marring a JAG lawyer.) The chaperone was more for my protection than the patients. Female military/Naval personnel have no problem stripping down in front of a male Corpsman if necessary.

As noted, there is, and has always been, a double standard. If a female examines a male, no big deal. If it's the other way around, it is (or was) once virtually a requirement. However, I am begining to see a change, and stand-bys are being used less and less frequency, and, as I noted before, it is more for the practitioner's protection than the patients. There have been cases where doctors have abused their patients, and also cases where they have been falsely accused of doing so.