The Importance of Chaperones in a Medical Setting
January 30th, 2019
As allegations of sexual misconduct throughout the healthcare industry continue to make headlines, the use of medical chaperones during physical examinations has become more important than ever.
Physicians have an obligation to provide patients with a safe and comfortable environment while under their care, and by remaining sensitive to patients’ individual needs, doctors can help generate a relationship of mutual trust and respect. Using chaperones during intimate examinations is one highly effective approach to fostering a secure environment and building a foundation of trust and confidence with patients.
Incorporating Chaperones Into Medical Visits
The principal responsibility of a medical chaperone is to protect patients against potential abuse by functioning as an observer of the physical examination. However, chaperones provide benefits that go well beyond this core function. Medical chaperones promote an overall sense of safety and comfort for patients. In addition, their presence can help prevent misunderstandings of physician intentions while protecting the patient’s dignity and providing clear communication during sensitive exams and procedures.
Whether or not to use a medical chaperone during an examination should be a shared decision between the patient and the physician. During this conversation, physicians should explain the practice’s policy as well as the purpose and role of the medical chaperone. While friends and family may be invited to stay at the discretion of the patient, physicians should not solely rely on them as chaperones. Doctors are not obligated to continue providing care to patients who refuse chaperones if they feel uncomfortable with this decision.
When using a medical chaperone, proper documentation is critical, particularly following sensitive examinations and procedures. Physicians should document all conversations and wishes of the patient, as well as any individuals who are present for each interaction.
General Guidelines for Establishing an Effective Chaperone Policy
- Physicians should inform patients that they are entitled to have a chaperone present for any physical examination. Additionally, doctors should either strongly advise or require the presence of a chaperone during examinations of the breasts, genitalia, or rectum.
- Chaperones should be trained health professionals who are members of the medical team. For example, nurses or medical assistants are often requested to serve as medical chaperones.
- Physicians should provide patients with the opportunity to discuss personal matters privately, minimizing sensitive inquiries and history-taking during chaperoned examinations.
- Practices should establish discharge policies in the event a physician feels uncomfortable proceeding after a patient refuses a chaperone.
- Practice leaders should inform and educate staff on the role and purpose of chaperones and provide guidance regarding how to communicate this information to patients.
- Physicians should appropriately document both the presence of a chaperone as well as his or her identity.
In the U.S., seven states—Alabama, Delaware, Georgia, Montana, New Jersey, Ohio, and Tennessee—have implemented legal mandates for the presence of medical chaperones during sensitive physical examinations. Failure to comply with these regulations can result in significant legal consequences for physicians and their practices.
Before implementing a formal chaperone policy, practice leaders should contact their malpractice insurer for comprehensive information regarding state laws and regulations. For further guidance on this issue or to receive a sample chaperone policy, Medical Mutual members are encouraged to reach out to our Claims and Risk Management Departments at 800.662.7917.
Sharon Nichols is a Medical Mutual Senior Risk Consultant based in Raleigh, NC.