The use of a chaperone during a physical examination of a pediatric patient should be a shared decision between the patient and pediatrician.
In the revised AAP policy statement, “Use of Chaperones During the Physical Examination of the Pediatric Patient,” in the May 2011 issue of Pediatrics (published online April 25), issues of patient comfort, privacy and confidentiality are discussed.
If the patient is old enough to understand, the purpose and content of the examination should be communicated clearly to the patient and parent in advance. If any part of the exam is physically or psychologically uncomfortable, every effort should be made to alleviate the discomfort, which may include using gowns or drapes to protect privacy.
A chaperone is recommended during female breast, genital, or anorectal exams and should preferably be a nurse or medical assistant, not a friend or family member. However, offices are not required to have a chaperone. In certain situations, a chaperone may not be present because of patient choice or a chaperone from the office is not available.
Pediatricians should develop their own office policy on the use of chaperones in the office, and they should document it in the patient’s medical record if and why they are unable to follow it.