Use and offering of chaperones by general practitioners: postal questi
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《英国医生杂志》
1 The Surgery, Hingham, Norfolk NR9 4JG, 2 Population Health Group, School of Medicine Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ
Correspondence to: S Conway Shaun.Conway@nhs.net
Introduction
In the past 10 years offering of chaperones by general practitioners has increased. The proportion of male general practitioners never or rarely offering chaperones when examining female patients has fallen from 65% to 23%. Norfolk is more rural than much of the United Kingdom, but these temporal changes may reasonably be extrapolated.
We found high rates for offering of chaperones. The Tyneside study indicates that patients want to be offered a chaperone, so general practitioners may be responding to societal demand.4 Merely offering a chaperone does not protect either the patient or the doctor. Stern said that even when a qualified nurse chaperone is present the patient is not protected.5 Given that in most cases (58%) the final decision as to whether or not to have a chaperone rests with the doctor it seems that ultimately the chaperone is there for the protection of the doctor rather than the patient.
What is already known on this topic
A survey 10 years ago showed that most general practitioners did not offer and use chaperones for intimate examinations
What this study adds
Offering of chaperones has increased in the past decade, but use of chaperones shows less change
This article was posted on bmj.com on 16 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38320.472986.8F
We thank the doctors who completed the questionnaires, Jon Cooke, Sheila Ward, and Sheila Hawkins.
Contributiors: SC had the original idea for this study, which was to follow up Speelman's work 10 years on, ran the project, and wrote the bulk of the report. IH commented on the design, analysis, and write up and is guarantor.
Funding: Eastern Region NHS R&D department via an enterprise award to SC.
Competing interests: None declared.
Ethical approval: Norwich Local Research Ethics Committee.
References
Speelman A, Savage J, Verburgh M. Use of chaperones by general practitioners. BMJ 1993;307: 986.
General Medical Council. Intimate examinations. In: Duties of a doctor 2002. London: GMC, 2002. www.gmc-uk.org/standards/intimate.htm (accessed 2 Dec 2004).
Royal College of Obstetricians and Gynaecologists. Gynaecological examinations: guidelines for specialist practice. London: RCOG, 2002. www.rcog.org.uk/resources/public/WP_GynaeExams4.pdf (accessed 2 Dec 2004).
Whitford DL, Karim M, Thompson G. Attitudes of patients towards the use of chaperones in primary care. Br J Gen Pract 2001;51: 381-3.
Stern V. Gynaecological examinations post-Ledward: a private matter. Lancet 2001;358: 1896-8.
((Shaun Conway, general practitioner1, Ian)
Correspondence to: S Conway Shaun.Conway@nhs.net
Introduction
In the past 10 years offering of chaperones by general practitioners has increased. The proportion of male general practitioners never or rarely offering chaperones when examining female patients has fallen from 65% to 23%. Norfolk is more rural than much of the United Kingdom, but these temporal changes may reasonably be extrapolated.
We found high rates for offering of chaperones. The Tyneside study indicates that patients want to be offered a chaperone, so general practitioners may be responding to societal demand.4 Merely offering a chaperone does not protect either the patient or the doctor. Stern said that even when a qualified nurse chaperone is present the patient is not protected.5 Given that in most cases (58%) the final decision as to whether or not to have a chaperone rests with the doctor it seems that ultimately the chaperone is there for the protection of the doctor rather than the patient.
What is already known on this topic
A survey 10 years ago showed that most general practitioners did not offer and use chaperones for intimate examinations
What this study adds
Offering of chaperones has increased in the past decade, but use of chaperones shows less change
This article was posted on bmj.com on 16 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38320.472986.8F
We thank the doctors who completed the questionnaires, Jon Cooke, Sheila Ward, and Sheila Hawkins.
Contributiors: SC had the original idea for this study, which was to follow up Speelman's work 10 years on, ran the project, and wrote the bulk of the report. IH commented on the design, analysis, and write up and is guarantor.
Funding: Eastern Region NHS R&D department via an enterprise award to SC.
Competing interests: None declared.
Ethical approval: Norwich Local Research Ethics Committee.
References
Speelman A, Savage J, Verburgh M. Use of chaperones by general practitioners. BMJ 1993;307: 986.
General Medical Council. Intimate examinations. In: Duties of a doctor 2002. London: GMC, 2002. www.gmc-uk.org/standards/intimate.htm (accessed 2 Dec 2004).
Royal College of Obstetricians and Gynaecologists. Gynaecological examinations: guidelines for specialist practice. London: RCOG, 2002. www.rcog.org.uk/resources/public/WP_GynaeExams4.pdf (accessed 2 Dec 2004).
Whitford DL, Karim M, Thompson G. Attitudes of patients towards the use of chaperones in primary care. Br J Gen Pract 2001;51: 381-3.
Stern V. Gynaecological examinations post-Ledward: a private matter. Lancet 2001;358: 1896-8.
((Shaun Conway, general practitioner1, Ian)