At first, the chaperone is standoffish and wary of Louise’s crazy and reckless spirit. Seeing Norma’s character development throughout the film is enjoyable. The dance scenes in particular are some of my favorite parts, with Louise twirling and dancing around. The movie’s Jane Austen-esque ambiance is beautiful, with its pastel dresses and light piano music. Her working parents can’t leave Wichita, so Norma Carlisle, a middle-aged woman not content in her marriage, volunteers to accompany her. Louise gets accepted to study at an elite dance school, but her parents won’t let her attend without a chaperone. With Downton Abbey star Elizabeth McGovern leading, I had high hopes for the flapper-era, coming-of-age movie.īased on a true story, the movie begins in 1922 Wichita, Kansas, where a young dancer, Louise Brooks, wants to chase her dreams of performing. These guidelines could allow you to defer the exam to another day or to another physician or chaperone, and should reassure the patient that this is standard practice.ĭo not allow the process of ensuring that an exam is chaperoned to interfere with appropriate and timely patient care and clinical judgment.ĭocument all encounters involving chaperones in the electronic health record, including names, time, and date.As a huge fan of basically every Masterpiece drama PBS airs ( Downton Abbey, Sherlock, Poldark), I was excited to see the network’s newest project - The Chaperone. If your practice consensus is to require a chaperone for certain types of examination, apply this requirement to both male and female physicians.ĭevelop chaperone selection criteria that consider issues such as gender and training.ĭevelop practice guidelines that support both the physician and the patient in cases where a patient declines a chaperone but the physician still feels uncomfortable. Provide information explaining chaperones and chaperoned exams when a patient first seeks care at your practice.ĭocument in every patient's chart his or her preference regarding chaperones front-desk staff could ask about this during check-in to make the process more standardized. Offer a medical chaperone to any patient undergoing genital, rectal, breast, or full-body skin exams. The American College of Physicians Ethics Manual says, in part, that “in general, the more intimate the examination, the more the physician is encouraged to offer the presence of a chaperone.” 13 The American Academy of Family Physicians has not published recommendations on the use of chaperones. 12 The exam of an infant, toddler, or child should always be performed in the presence of a parent or guardian, according to the AAP policy. 11 The American Academy of Pediatrics (AAP) explicitly recommends having a chaperone attend genital, rectal, and breast exams of adolescent patients but also recommends using shared decision making if the patient is old enough. 3 The American College of Obstetricians and Gynecologists recommends, in part, accommodating patient requests for a chaperone, regardless of the physician's gender. The AMA Code of Ethics recommends, in part, notifying patients about chaperone guidelines and always honoring a patient's request to have a chaperone. In any event, it appears the intended use was to protect the interests of both patients and physicians.Īlthough a number of associations and government bodies have attempted to centralize recommendations on this topic, these guidelines are often ambiguous and conflicting. 3 The addition of medical chaperones to the patient encounter coincided with increasing rates of medical litigation in the United States, 4 although it is unclear that this was the catalyst. 1, 2 Currently, the American Medical Association (AMA) says any authorized member of the health care team can serve as a medical chaperone as long as there are clear expectations to uphold professional standards of privacy and confidentiality. References to medical chaperones began to appear in the literature in the 1970s and 1980s, with varying connotations and differing role descriptions. In family medicine, we are taught to be sensitive to patient modesty when providing a thorough physical exam, but best practices for chaperoned exams are unclear at best. I have been in medical practice for only a few years, but I have already lost count of how many times I've asked that question of my nursing staff.
0 Comments
Leave a Reply. |