Implementing Chaperones

College of Physicians and Surgeons of Alberta Ethics 101, Messenger 5 Comments

You’re a family medical doctor and recently several of your employees completed the Medical Office Chaperone course through MacEwan University. You see the benefits of offering your patients a chaperone during visits for both their care and your practice. You have posted this notice in your office waiting room and your employees advise patients when they check in that a chaperone will be present during exams such as pap tests.

A few months after you implemented this, a patient has denied a chaperone to be present. She has concerns about privacy and is wondering why you needed to implement this process. She has looked at your physician profile on the College’s website and there are no conditions placed on your practice requiring a chaperone. You explain to her the benefits from both a patient’s side and your own. She still insists on not having a chaperone present.

What do you do?

  • Proceed with the exam
  • Have her sign a waiver and proceed with the exam
  • Refuse to proceed with the exam and advise her to consider seeing another physician
  • Or another action?

Join the conversation below or email info@cpsa.ab.ca and tell us how you would respond.

Do you have an ethics scenario you would like to see discussed? Email your idea to 
info@cpsa.ab.ca

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Rameshwar Sharma

Not allowing a chaperone present possibly raisessome red flags medico legally. I will seek immediate advise from CMPA and College if possible. In my personal opinion It does not appear an urgent life threatening situation.If the patients insists not allowing a chaperone present even after explaining the need for it I will decline the exam and advise patient to find a nother physician ASAP who has different or no policies in
regards to chaperones. All this conversation must be in presence of a witness then documented and signed both by the physician and the witness.

MC

This is a reasonable objection by the patient, and isn’t likely to pose much additional risk to your practice. Make a note of the patient’s choice and reasoning on the EMR in case there is future scrutiny about not having had a chaperone.

JB

Proceed with the exam. I don’t see this as an ethical challenge! Simply document your discussion.

Dave W

I come at this differently. I went to med school in the early 90’s and it was expected all throughout my training that as a male physician, I would always have a female chaperone present for “sensitive” exams for female patients. I have always done this and my patients expect it. I will (most of the time) ask the patient to appropriately disrobe, and advise that I will leave the room and be back with “the nurse” for the exam. Frankly, for paps it’s quite nice to have the extra set of hands to pass you the swabs, brush, etc.… Read more »

Maz

Proceed to the exam