There are often many questions regarding the use of a chaperone such as who, when, why, what (if the patient refuses/is the chaperones role) and how often? This article will attempt to answer these questions by examining the recommendations of SVMIC and the AMA. In the current environment, it is important that the provider understand the multiple purposes a chaperone serves as well as the need for gender identification when selecting the appropriate chaperone.
The use of chaperones during physical examinations has three benefits:
Taking steps to help a patient feel comfortable during a physical examination is helpful in building a solid and trusting relationship. It also allows the patient to assume ownership of his/her/their care. Equally important is providing the patient with information about the various types of examinations and the details of what to expect, which can alleviate anxiety and help prevent a misunderstanding as to the appropriateness of certain actions during the examination. Having this discussion may also increase the patient’s comfort with the presence of a chaperone. Likewise, the chaperone must understand the purpose for being in the room during the examination and stand at a vantage point that would prevent later claims that he/she could not view what the provider was doing.
Historically, chaperones were offered when patients were of the opposite sex of the provider and most often when a male provider was performing a sensitive examination on a female patient. But that is no longer the case. Today, consideration must be given to the sexual orientation/identification of the patient and whether he/she/they are/have transitioned. The easiest way to avoid confusion is to ask the patient whether he/she/they would prefer a chaperone who is male or female?
The risks to the provider who chooses not to have a chaperone during a sensitive examination are significant. Providers can potentially face medical malpractice claims, assault/battery claims, and disciplinary actions by State Boards. Very often these types of salacious allegations “make the news” and can be detrimental to a provider’s reputation even if the provider successfully prevails against the allegations. With no chaperone to support the provider, it becomes a “he said/she said” battle.
To evaluate the need for a chaperone, the Council on Ethical and Judicial Affairs (CEJA Report 10-A98), American Medical Association (AMA) suggests weighing the following considerations:
The Council recommends the following guidelines:
With these considerations in mind, SVMIC recommends:
When in doubt, err on the side of caution and have an appropriate chaperone present. If there are any questions or concerns regarding the use of a chaperone, providers are strongly encouraged to contact an SVMIC Claims Attorney to discuss the specific situation.
 AMA CEJA Report 10-A98 Use of Chaperones During Physical Exams.
Jeffrey A. Woods is the Director of Risk Education in the Risk Education and Evaluation Services Department at SVMIC. Jeff received his Bachelor of Science degree from the University of Tennessee Martin and his Juris Doctorate degree from the University of Tennessee Knoxville. Following graduation, he practiced law in Knoxville for almost 15 years, advising physicians and healthcare providers and defending them in malpractice claims. He is licensed to practice in Tennessee and all Federal courts, including the United States Supreme Court. He is a member of the Tennessee Bar Association.
Jeff joined SVMIC in 2003 and was a Senior Claims Attorney until 2015 when he transferred to his current position.
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