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The Vital Importance of Chaperoning in General Practice for Doctors

What is a Chaperone for General Practitioners?

A chaperone in medical practice, is defined as an appropriately-trained independent person who is responsible for observing the examinations and procedures performed by the doctor or medical professional. Their main job is to assist in strengthening the relationship between the doctor and the patient and enhancing the standards of conventional medical practice.

Need for Chaperones in Medical Profession

Medical examinations are becoming increasingly challenging for the doctors and the patients. The main reasons for this are the detailed doctor-patient discussions, accompanied by increasing the autonomy of the patient and their right to making decisions independently for medical and surgical treatment. This is noticeably affecting the traditional doctor-patient relationship that we know of.

These reasons have made maintaining a transparent and open relationship between the doctor and their patients and is increasingly difficult. The boundaries that govern an ideal and healthy doctor-patient relationships are becoming blurred and making consultation is more challenging for the doctors.
A chaperone works excellently to make the doctor-patient relationship stronger and more trustful. However, reports show a surprising lack of awareness amongst the medical community.

According to a survey published by BMJ (2015), shows that:
• Around 37% of general practitioners admitted to having a chaperone policy.
• While 68% of male general practitioners offered a chaperone when performing an intimate physical examination, only 5% of female general practitioners admitted to it.
• Only 54% of male and around 2% of female general practitioners admitted to having a chaperone when performing examinations.
• Over 70% of female and 8% of male general practitioners admitted they never use a chaperone when conducting an intimate examination of patients.

When the general practitioners did use a chaperone, the sources were varied, such as:
• 22% of interviewed general practitioners used general practice registrars or students as chaperones.
• 47% used a family member or a person accompanying the patient as chaperones.
• 43% of general practitioners used non-clinical practice staff as chaperones.
• 78% of general practitioners normally used qualified female nurses as chaperones.

The main reasons that the general practitioners gave for not using a licensed and qualified professional medical chaperone for chaperoning in general practice are:
• Availability
• Confidentiality
• Time constraints
• Doctor-Patient relationship

Importance of Chaperoning in General Medical Practice

The use of a chaperone during an intimate examination, especially of female patients, is an essential step towards building a stronger, healthier and more transparent relationship between the general practitioner (doctor/medical professional) and their patients.

These are the top reasons that detail the importance of having a chaperone present during an intimate medical examination of a patient:
• Protection – The presence of a chaperone during an intimate medical examination adds a protective layer for the doctor against false allegations of inappropriate behaviour/sexual harassment.
• Trust-building – Chaperones are a way of acknowledging the vulnerability that the patient might feel for their dignity during an intimate physical examination.
• Assistance – Chaperones are also trained to efficiently help the general practitioner for performing examinations.
• Assurance – Chaperones are meant to provide reassurance and emotional comfort to the patient.

The prospect of an intimate examination may result in anxiety and embarrassment to the patient. These types of examinations require immense care and sensitivity towards the patient’s feelings and emotional state.

Intimate examinations mostly consist of examinations or tests being carried out on the breasts, genitals or the rectum. Apart from this, it also includes any examination procedure which requires the doctor to be close to the patient, such as:
• Eye examination in dim lighting
• Putting on the cuff for measuring the blood pressure
• Palpating the apex-beat, etc

It becomes important to let the patient know beforehand in clear terms as to what the specific intimate examination will entail.

It is important for general practitioners and other medical professionals who require performing intimate physical examinations for patients to state their chaperoning policy clearly. It should be advertised sufficiently through informational leaflets for patients, websites and on notice boards inside the clinic or hospital. Ideally, it should be a routine practice for doctors to offer the services of a medical chaperone to every patient before starting the examination. Ensure enhanced levels of medical practice by having an effective chaperoning policy for your medical and healthcare centre.