MPS issues guidance on the use of chaperones

The Medical Protection Society (MPS) has issued best practice guidelines for the use of chaperones during medical examinations.

If a doctor is accused of sexual misconduct their reputation may be irreparably damaged. Such allegations can lead to criminal charges or to regulatory sanctions which limit or deny a doctor the right to practise.

In most countries it is left to the individual practitioner and the patient to judge whether a chaperone is appropriate. But whatever the local protocol, MPS advises doctors to follow some basic advice to ensure there is no scope for their actions to be misinterpreted by a patient.

MPS 10 best practice points for the use of chaperones

1. Chaperones should be offered for intimate examinations. Doctors should consider what defines ‘intimate’ and should judge this from the patient’s perspective. 
2. Doctors should not assume that a chaperone is not needed just because they are the same sex as the patient. 
3. Doctors must be aware of and respect cultural differences. Religious beliefs may also have a bearing on the patient’s decision over whether to have a chaperone present. 
4. The most appropriate person to have act as a chaperone would be a member of the clinical team. 
5. The patient should be introduced to the chaperone before the examination can proceed. 
6. Doctors should record the name and position of the chaperone in the patient’s notes. 
7. If the offer of a chaperone is declined by the patient, doctors must document this. 
8. Doctors should never force a chaperone on an unwilling patient. 
9. If a doctor does not wish to proceed in the absence of a chaperone, they should explain this to the patient and the reasons why. The patient might then reconsider or agree to see a different doctor on another occasion. 
10. Using a chaperone every time you examine a patient is impractical – doctors should use their judgment about individual situations to decide when a chaperone is appropriate.

MPS also emphasises the importance of good communication, as the real risk lies in patients mistaking a doctor’s intentions. Doctors need to think about and interpret what patients tell them, and respond to body language and other cues.

Director of Education and Communications at MPS, Dr Stephanie Bown, said

“Intimate examinations can cause patients to feel vulnerable, and this can easily lead to misinterpretations of a doctor’s actions. It therefore makes sense to do whatever possible to make the patient feel comfortable and in control. “Respect for the patient’s opinions and feelings, and being able to communicate this respect effectively, is important.

“A doctor must always explain prior to the examination what he or she is going to do. When explaining what will happen, the doctor should consider the patient’s expectations of what will be involved.”

It is also important to understand that the presence of a chaperone can help to make a medical professional feel comfortable. Doctors have the right to the presence of a chaperone and should not feel obligated to continue an examination without one.

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For further information please contact Ciara Brannigan, MPS Media and Policy Manager, on +44 (0)207 399 1406 or +44 (0)7841 560741.

Notes to editors

Examples of non-intimate cases with the potential for misunderstandings and where it may be prudent to offer a chaperone:

(a) Patients don’t always understand why it is necessary to examine a particular part of their body when their symptoms are felt somewhere else. Potential misunderstandings can be avoided by simply telling the patient the reasons for examining a certain area. In the event of a patient presenting with symptoms of glandular fever, the doctor must explain that there are glands elsewhere on the body apart from the throat which may be affected, before examining under the arms and at the tops of the legs.

(b) If a patient presents with headaches and the doctor wishes to perform an examination of the backs of the eyes, he or she must explain to the patient what is going to happen before he or she turns out the lights and comes very close to the patient’s face. This can avoid misunderstandings about the encroachment of personal space.