One of the most serious complaints a doctor can receive is that they inappropriately touched or examined a patient. Worse still is an allegation of sexual assault.
These types of complaints are not uncommon and if examinations of an intimate nature are not approached in the right way, a patient may complain to the GMC, or even the police, with potentially catastrophic consequences for the doctor’s career.
There are a number of measures doctors can take to help avoid such accusations. It is crucial to follow GMC guidance Maintaining boundaries – guidance for doctors, with one key element of this being to 'offer the patient the security of having an impartial observer (a ‘chaperone’) present during an intimate examination.'
The role of the chaperone
The role of the chaperone is to reassure patients and offer emotional support as intimate examinations can be embarrassing or uncomfortable. Also, by having a chaperone present, a doctor can reduce the risk of complaints or allegations during intimate examinations.
It is recommended that even where the doctor and patient are of the same gender, the offer of a chaperone is still made.
The chaperone does not have to be medically qualified but should have received appropriate training and must be sensitive and respectful of the patient’s dignity and confidentiality. He or she should be prepared to reassure the patient if they show signs of distress or discomfort and be familiar with the procedures involved in a routine intimate examination.
The chaperone must be prepared to raise concerns about a doctor’s behaviour where necessary. Any discussion about a chaperone should be noted in the medical record, including the chaperone’s name.
If the patient does not want a chaperone and the doctor is happy to proceed, then it should be noted that a chaperone was offered and declined.
When no chaperone is available
Should no chaperone be available and the doctor or patient is unwilling to proceed without one, the patient should be given the option of delaying the examination to a later date. If either party is uncomfortable with the choice of chaperone then the examination can be delayed until a suitable replacement is found.
Any decision that is made should take into account the patient’s best interest. It is worth remembering the use of a chaperone can prevent any unfounded allegation of inappropriate behaviour during intimate examinations. Therefore, chaperones not only benefit the patient, but the doctor too.
- Dr Anthea Martin is senior medical adviser with the UK-wide medical and dental defence organisation MDDUS