I have what I consider to be the best solution to this question. But then as its my methodology I'm bound to say that anyway, lol.
As a play doctor of some 20 years experience I have always kept the examination non sexualised whilst accepting that a patient will almost always arrive in an anticipatory state of arousal and that such arousal may be enhanced during the examination if the patient is agreeable to intimate parts being examined.
Arousal which is noticed is never commented upon and certainly I never attempt to enhance such arousal.
At the conclusion of the examination phase, which can last upwards of an hour I always use a period of resting to report any findings and to give the patient an opportunity to discuss issues such as those which he or she may have revealed in IMchat before the consultation.
If the queries should reveal an interest in sexual matters, as it most often does, then the consultation can, by agreement, move into a 'treatment' phase where my alter ego, Karl the Sex Therapist, takes over.
Thus the consultation has three distinct phases, examination - resting/discussion - treatment, with two 'different' specialists involved. I feel this is useful in maintaining an illusion of professionalism.
On a personal basis I will never indulge in penile penetrative sex. That's not to say that its right or wrong to have intercourse in a consultation. It's just that as a happily married man I prefer to reserve something for my private life. Others must determine their own preferences.
Feel free to discuss my methods either here or in YIM where my ID is BigK148@yahoo.co.uk