Thread by @DrOlufunmilayo

In the following tweets I will address an issue which I’ve heard two similar stories about and I have had to apologise to the people involved and also offer a form of ‘explanation’ on behalf of the doctors involved.

Please read this story and hopefully we all learn.
#Chaperone

Case 1: A man in his 40s went to a hospital and saw a young female doctor because he’s been having more frequent urination and waking up at night a lot to urinate.

The lady asked to check his prostate by putting her fingers in his anus, and he felt very awkward.
#Chaperone

He claimed (may not be true) the lady basically just told him “You need to pull your trousers and I need to check your prostate by putting my finger in your anus” and didn’t offer him any form of witness to make the procedure comfortable for him.
But he had it done.

#Chaperone

He basically said he didn’t ask for a #chaperone because he didn’t want to upset the female doctor and his symptoms of frequent urination and waking up almost every hour at night to use the toilet was becoming too worrisome. So he consented to the examination anyway.

Case 2: A 23 year old lady said she noticed some lumps in her breast and then went to the hospital to see a doctor. He asked to examine her and simply said “Okay. Get on the couch there and let me see what the lumps look like. I need to examine your breasts”

#Chaperone

According to her, he didn’t offer any witness or anyone else to be in the same room so as to prevent any possibility of foul play.

She said she didn’t feel comfortable and told him she wants to quickly use the toilet and she just went home from there.

#Chaperone

I noticed that in both cases there’s something missing- a misunderstanding or a wrong understanding of what a #chaperone is, especially from the perspective of the patient.

I believe the doctors already know about it, however we will remind each other in this post about it.

So who is a #Chaperone?

A chaperone is an adult (usually a trained healthcare professional) who is present in an “intimate physical examination” of a patient, so as to serve as a witness that the whole examination was done in a totally professional manner.

What’s an “intimate physical examination”?

Generally, an intimate physical examination will include, but maybe not limited to, examination of the breasts, vagina, penis, rectum, anus; or any examination of any part of the body that a patient may consider “private”.

#Chaperone

What’s the purpose of a #Chaperone?

A chaperone’s role is to provide reassurance for a patient undergoing a procedure they may find embarrassing or uncomfortable such as intimate examinations or examinations under dim lights or where the doctor may need to get very close.

Who can serve as a #Chaperone?

Usually a chaperone is a health professional who will have had sufficient training to serve as an independent non-biased witness to an intimate medical examination of a patient. Sometimes it can be nurses or health care assistants.

Can a partner/relative/friend act as #chaperone?

You can choose to hav your partner, relative or friend with you during your examination. But you need to think whether they will feel comfortable about this.

But if you, them and the doctor is happy to proceed, this may be okay.

Now as an important question, to assess the awareness of #Chaperone, please kindly take this little poll before I continue.

Whenever you go to hospital, and a doctor is about to carry out an intimate examination on you, were you always offered the option of a #chaperone?

To the patient:

It is your right to be offered and to request for a #chaperone if a doctor is performing an intimate physical examination on you.

There’s no excuse for you not to be offered.
Or for you not to request.
Please let’s be clear on that.

Infact IF you want the doctor and/or the #chaperone to be a particular gender. It’s absolutely within your rights to request.

However, please be aware that this request will be considered within the capacity of the hospital to provide it. And as such it’s not 100% guaranteed.

If the examination is to be done on a child, an adult #chaperone must be present at all times. This may be a parent or carer, although there may be some circumstances (like in abuse) where this is not appropriate.

Children cannot be chaperones for themselves or for adults.

Can I decline the offer of a #chaperone?
Yes you can.

However, if your doctor feels a chaperone should be present (possibly for legal reasons or just to be comfortable) and the offer of a chaperone is declined, the doctor has a right not to continue with the examination.

However while the doctor has the right not to continue the examination should you decline the offer of a #chaperone which he thinks is ideal to preserve the professional nature of the examination, he can then refer you to another doctor who may be willing to do it on your terms.

However in all of this, in a life saving situation, or in a situation where a doctor needs to do a quick examination to save a patient’s life, a doctor may not necessarily delay the examination, investigation & treatment of a patient whose life is in imminent danger.

Let’s note.

And back to the previous post, as a doctor, you MUST offer a patient a #chaperone BEFORE performing an intimate physical examination.

This is for your own protection and for the patient’s reassurance that the whole procedure will be strictly professional.

You must realise as a doctor, that IF a patient sues for sexual assault or harassment based on a physical intimate examination carried out on them by a doctor, the patient will win the case IF there’s NO offer/presence of a chaperone, and NO record of such in the medical notes.

To those whose FIRST response is to give excuses, let’s be clear about something. As a doctor, you should make the offer of a #chaperone at least, and IF the patient turns it down, and you feel comfortable with that situation then you can go ahead.

And all this must be recorded.

And to those who think getting a #chaperone is such a huge deal, it is not. Any other health professional who is less busy can do the job. It could be a nurse, a health assistant or another doctor.

We must inculcate the habit of TRYING to do what is right. Rather than excuses.

So BEFORE a doctor carries out any intimate physical examination on you, these are the things that should be done:

-explain to you WHY an examination is necessary and give you an opportunity to ask questions.

-explain WHAT the examination will involve, in a way you understand.

-You must be told if there will be any pain or discomfort, and be given an idea of the degree and what will be done about it IF it will be significantly distressful.

-Your permission should be gotten BEFORE the examination and the doctor should record your consent or refusal

-Should you refuse to give consent for the examination, the consequences should be clearly explained to you.

-You should be OFFERED a chaperone EVEN IF the hospital does not have the personnel. You have the choice to either go ahead or not.
But it’s your choice to make.

And if it is a child or young person who can understand enough to give independent consent for such an examination, then their consent must be sought.
Otherwise their parent/guardian should give consent.

A doctor should not examine a child’s private organs with NO consent.

On a final note, for both doctors and patients alike, the presence of a #chaperone during an intimate physical examination provides assurance for the patient, protection for the doctor and a professional environment where everyone is happy, safe and fulfilled.

Thank you.