Chaperones and intimate physical examinations: consultant practice and views on chaperones

Purpose - The purpose of this paper is to determine if recommendations from the General Medical Council (GMC), Royal College of Obstetricians and Gynaecologists (RCOG) and Ayling Inquiry with regard to chaperoning are observed in the hospital setting by consultants performing intimate physical examinations, and to ascertain consultants' views on the availability, nature and role of chaperones.Design methodology approach - A quantitative postal questionnaire was carried out based on the GMC and RCOG recommendations, and point 2.58 of the Ayling Inquiry. Participants were all consultants specialising in obstetrics and gynaecology, colorectal surgery, breast surgery, urology, genito-urinary medicine, and paediatrics in York and West Yorkshire Hospitals. The questionnaire covered consultant practice and views on the role of chaperones for intimate physical examinations.Findings - A response rate of 70 per cent was achieved. All gynaecologists, paediatricians, urologists, colorectal surgeons and genito-urinary physicians request a chaperone when performing female intimate examinations. A total 90 per cent of genito-urinary physicians request a chaperone compared to only 39 per cent of colorectal surgeons and 28 per cent of urologists for male intimate examinations. Of the consultants 97 per cent reported that a chaperone was "always" or "usually" available. A total 94 per cent considered health-care professionals to be appropriate chaperones. Cited roles of a chaperone include doctor protection (93 per cent), patient protection (84 per cent), patient comfort (73 per cent), and medico-legality (72 per cent). Only 20 per cent of consultants stated they document the presence of a chaperone.Originality value - The paper reveals that consultants use a chaperone for all female genital examinations, but inter-speciality differences exist for male intimate examinations in spite of national recommendations. A minority of consultants document the presence of a chaperone for intimate examinations. Consultants consider health-care professionals to be the most appropriate chaperones, and believe chaperones add to patient comfort and protect both doctor and patient.