Chaperoning Doctors' Visits: A Good Idea?

By Tula Karras
WebMD Answers to Questions

Question:

Should a nurse be present during a gynecological exam?

Answer:

There's no legal requirement that a chaperone, or a third party, be present, but most experts say it's the right thing to do, for both the patient and the doctor.

"I always trained my doctors to use a chaperone," says Kenneth J. Ryan, M.D., former head of the departments of gynecology at Harvard Medical School, Case Western Reserve University in Cleveland and San Diego School of Medicine. "A pelvic exam is an intimate exam and a chaperone can serve as a support for the patient," explains Ryan, who often had nurses assisting him during procedures and had the nurse double as a chaperone.

While chaperones often do provide emotional support for a sensitive or young patient during a procedure, their primary function is to protect both the patient and the doctor from sexual harassment or any misconstrued or inappropriate actions.

The American College of Obstetricians and Gynecology (ACOG), the medical association that sets guidelines for obstetrics and gynecologists across the country, issued a Committee Opinion on the subject in 1994, stating that "Chaperones can provide reassurance to the patient about the professional context and content of the exam and intention of the physician and offer witness to the actual events taking place should there be any misunderstanding."

Despite ACOG's stance -- and the insistence of doctors like Ryan -- a good number of physicians choose not to use chaperones: The results of a survey of ob-gyns published in the March 1994 issue of OBG Management, an industry publication, revealed that just 56 percent of ob-gyns had a chaperone present during a pelvic exam and only 38 percent had a chaperone present during a breast exam. One reason cited for the lack of compliance: Doctors reported that some patients feel uncomfortable with a third party in the room.

ACOG acknowledges that a third person in the room can be embarrassing for some patients and may actually keep them from asking questions and discussing important health issues for fear of risking confidentiality. Because of this real and valid concern, an ob-gyn should always provide an opportunity -- either before or after the examination -- to speak in private.

The same survey found that 42 percent of ob-gyns thought it was important for female ob-gyns to use a chaperone as well. The chaperone can be of either gender, says ACOG. The chaperone should not, however, be a family member, advises the organization, unless the patient specifically requests a relative. This is of particular concern to adolescents, who may be less likely to speak openly if a parent is in the room.

Don't feel that you're offending the doctor by requesting a chaperone. A good doctor will honor your request. "If I were a patient, I would want a chaperone," Ryan says.

*Name has been changed to protect privacy.

WebMD Answers to Questions