The University of Alabama, Office for Academic Affairs

CCHS - Sensitive Physical Examination Policy

Unit:  University Medical Center
Contact: Dr. Thomas J. Weida; Dr. Todd B. West
Title:  UMC Chief Medical Officer; SHC Medical Director
Effective Date: 9/1/2019
Revision Date: 04/20/2022


 
 

Purpose

This policy is designed to provide a consistent and safe care environment for members of The University of Alabama’s (UA) campus community as well as those that receive care from University medical care providers. This policy will respect the patient’s rights, dignity, and confidentiality concerns while providing safeguards to protect the professional nature of the examination.

Policy

Use of Chaperones

  1. Except as noted herein, a chaperone must be present for all sensitive examinations. A chaperone may assist the provider with the examination.
  2. A family member or patient guest may be present during a sensitive examination if it is the expressed desire for the patient but should not serve as a chaperone for purposes of this policy. For vulnerable adult patients, an accompanying caregiver, social worker, or group home escort can be present to alleviate potential stress to the patient.
  3. If a chaperone is not available, the provider will notify the patient and make arrangements for the patient to return for the sensitive examination when a chaperone is available or refer the patient to another medical facility.
  4. If the patient does not want to have a chaperone present for a sensitive examination, a record, acknowledged by the patient, should be made noting the patient has declined to have a chaperone present. The patient may, however, stop the examination at any time to request that a chaperone be brought into the room for the remainder of the examination. The provider retains the final decision whether to proceed without a chaperone.
  5. Patients under the age of eighteen cannot decline to have a chaperone present for sensitive examinations.
  6. When discussing important health issues or concerns, the patient should be provided the opportunity, either before or after the examination, to speak privately with the provider. Patient privacy and discretion should be used when conversing with the patient in the presence of the chaperone.
  7. Any of the parties present during a sensitive examination have the ability to stop the examination if they feel the behavior of anyone in the room is inappropriate or unacceptable. If this occurs, any conduct that potentially violates this policy should be reported as noted herein.

Chaperone Duties

  1. Chaperone shall uphold professional standards of privacy and confidentiality, be sensitive and respect patient dignity and confidentiality, reassure the patient if they show signs of distress or discomfort, and be familiar with the procedures involved in a routine sensitive examination.
  2. Chaperone must stand or sit in a location where they are able to assist as appropriate and observe the examination, procedure, or care.
  3. Chaperone must stay for the entire sensitive examination.
  4. Chaperone must report any good faith concerns regarding the provider’s actions or behavior.

Exceptions

Unless the patient or provider requests a chaperone, one is not required in the following situations:

  1. Standard patient care protocols, such as listening to the heart or lungs or placing EKG leads.
  2. Breast radiological procedures including mammography, ultrasound, interventional, and MRI. A physical female breast exam during mammography or other care does require a chaperone, subject to the provisions above.

Additional Requirements

Individual UA departments or areas may develop additional requirements beyond this policy related to the presence of chaperones in medical examinations. Any such requirements, however, may not negate this policy and, to the extent such requirements conflict with this policy, the terms of this policy shall govern.

Emergency Situations

Emergency care should never be impeded by this policy

Reporting

  1. Any concerns about potential misconduct arising from or connected with a provider’s sensitive examination of patients under 18 years of age should be reported to The University of Alabama Police Department pursuant to UA’s Child Abuse Reporting Policy and Procedures.
  2. All other concerns about a potential violation of this policy or possible misconduct arising from or connected with sensitive examinations should be reported to the UA Title IX Office.
  3. An individual may not delegate the duty to report a concern under this policy.
  4. This policy should not be viewed as limiting any legal, ethical, and/or professional reporting obligations any individual may have separate and apart from this policy. If an individual is subject to additional reporting obligations, that individual should comply with those obligations as well as this policy.
  5. Any person who makes a good faith report of a potential violation of this policy or misconduct arising from or connected with sensitive examinations shall not be subject to retaliation.

Definitions

Chaperone: An individual who acts as a witness for a patient and provider during a sensitive examination. A chaperone should be a properly trained UA employee or representative, not a family member or guest of the patient.

Patient: An individual receiving medical care directly from either UA or an entity that has contracted to provide care to individuals in a UA facility.

Provider: An individual appropriately trained to provide the medical care for which they are assigned, including, but not limited to a physician, nurse, technician, physical therapist, resident, athletic trainer, massage therapist, advanced practice provider, physician’s assistant, or other medical assistant.

Sensitive Examination: A sensitive examination includes the physical examination of or a procedure involving potential contact with the genitalia (regardless of gender), rectum (regardless of gender), or breast (for patients who are female or identify as female).

Scope

This policy applies to all providers employed by UA or providing a sensitive examination in a UA facility.

 
 

Office of the Provost

Approved by Dr. Lesley Reid, Associate Provost, 04/20/2022