Chaperone policy in accident and emergency departments: a national survey.
BACKGROUND
Medico-legal societies and the General Medical Council have been urging a greater use of chaperones during intimate examinations. However, research into the use of chaperones has been limited only to general practice. The objectives of this national survey were to find out: (1) whether formal chaperone policy exists in accident and emergency (A&E) departments; (2) the frequency of chaperone use; and (3) clinical applications.


METHODS
A simple questionnaire was submitted to the lead clinicians/clinical directors of 460 A&E departments in the UK. The departments were identified through the British Association of Accident and Emergency Medicine Directory. The completed questionnaires were either posted or faxed back to our department.


RESULTS
In total, 270 of 460 forms were returned (58.7%), of which only 246 were useable. Although 81.71% of A&E lead clinicians/clinical directors believe that formal policies are needed, only 3.65% of the departments have a formal policy. The highest percentage of chaperone use was observed for male doctors examining female patients (91.46%), while the lowest percentage was observed for male doctors examining male patients (7.32%). Worryingly, 25.61% reported incidents of complaints regarding inappropriate examination by doctors.


CONCLUSIONS
We have demonstrated deficiencies in chaperone use and have identified specific factors that render A&E departments particularly vulnerable to allegations of inappropriate practice. We believe that policies should be designed and implemented focusing on the specific needs of A&E departments to counteract the rising numbers of medico-legal cases, thus safeguarding patient care and protecting the health providers.
Loizides
Sofronis
S
Foundation Year One Doctor, Royal Free Hospital, London, UK. loizides@doctors.net.uk
Kallis
Andreas
A
Oswal
Ashwini
A
Georgiou
Panayiotis
P
Kallis
George
G
Gavalas
Manolis
M
D003675:Defensive Medicine; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008318:Malpractice; D016134:Organizational Policy; D010808:Physical Examination; D010817:Physician-Patient Relations; D012737:Sex Factors; D012742:Sex Offenses / Q000517:prevention & control*; D006113:United Kingdom