Guidance on chaperones hard to implement in general practice

December 02, 2004

Guidance about the use of chaperones for intimate examinations is difficult to implement fully in general practice, according to a study published on bmj.com today.

The conduct of intimate examinations in medical settings has been a subject of controversy for many years. As such, the medical royal colleges, the General Medical Council, and the defence organisations now recommend that these examinations are not done by unaccompanied doctors.

Researchers surveyed over 1,200 general practitioners in England about the use of chaperones during intimate examinations.

A total of 517 (68%) male GPs and 24 (5%) female GPs usually or always offered a chaperone, while 410 (54%) males and 9 (2%) females usually or always used a chaperone. Only 60 males (8%) never used one compared to 344 (70%) females.

Use of chaperones was correlated with increasing age, belonging to a non-white ethnic group, and working in a smaller practice.

Practice nurses were the most common chaperones, but a non-clinical member of the practice staff, a student or GP registrar, or another doctor, were alternatives.

Use of chaperones by male doctors has substantially increased since the 1980s and '90s, but use by female doctors remains low, despite one third of practices having a policy, say the authors.

Record keeping about the offer and use of chaperones is poor, and significant barriers, such as confidentiality and time constraints, still exist. The recommendations of the royal colleges and other bodies are, therefore, difficult to implement fully.

More flexible guidance is needed for general practice as well as further research into patients' views and wishes on the use of chaperones, they conclude.
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BMJ

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