American Academy of Pediatrics recommends shared decision on chaperones during exams

Having a chaperone present during the physical examination of a pediatric patient should be a shared decision between the patient and the pediatrician, according to an American Academy of Pediatrics (AAP) policy statement.

The AAP recommends that the physician always explain the scope and nature of the examination to parents as well as to the patient if he or she is old enough to understand. The physician should review the findings with them on completion of the examination.

If any part of the examination may be physically or psychologically uncomfortable, every effort should be made to alleviate discomfort.

If the examination of an adolescent or young adult will include inspection or palpation of the anorectal or genital areas or the female breast, a chaperone-preferably a nurse or medical assistant-is recommended. The sex of the chaperone should depend on the patient's preference.

When deciding on the use of a chaperone, the patient's preference should be given the highest priority. If the patient declines a chaperone, the pediatrician should document this in the medical record and suggest alternatives, such as seeking care elsewhere.

Pediatricians should develop and follow policy for use of chaperones in the office or clinic and should document instances in which they cannot adhere to the policy.

In some states, the use of a chaperone during pediatric physical examination is mandated by medical board regulations.

American Academy of Pediatrics. Committee on Practice and Ambulatory Medicine. Policy statement-use of chaperones during the physical examination of the pediatric patient. Pediatrics. 2011. Epub ahead of print.