Is a Chaperone in the Exam Room Enough?

3 thoughts on “Is a Chaperone in the Exam Room Enough?”

1. 1)This insanity is why fewer people are willing to go to medical school and residency.
   2)There is no presumption of innocence until proven innocent.
   3)The chaperone is there to prevent any improper contact from occurring. If the patient is alleging that that occurred with a chaperone present, then they are more likely in need of psychiatric care.
   4)The fact that a DA is alleging that because a chaperone could not remember the individual details of an exam 5 years earlier is ludicrous. The chaperone was present for many exams over their 5 year period when no improper contact occurred. Therefore the pattern of behavior of the physician is proper. What is the DA’s reason for the physician to depart from their normal routine. The burden of proof needs to be on the patient. The physician must be innocent until proven guilty.
   5)More documentation on the part of the chaperone? The chaperone could just be office staff.
   It is in many offices where there is not a nurse. Normally the office staff never enter anything in the medical record. So now even with this form, the DA will allege that the chaperone was not trained to “supervise” the medical exam. More paperwork will not solve this problem.
   6)Saying that one has to ask permission of the patient to examine them, is ludicrous. Why else would they be in the physician’s office. Why else would they have disrobed and put on a paper gown? They could have not shown up, not disrobed. The consent is already implied.
   More paperwork is not going to help this either.

   We need to stop agreeing to do just a little more documentation, because it is just not helping.
   7)EHRs were supposed to eliminate malpractice due to poor record keeping. But instead they have added even more causes for litigation because of lost or buried information.
   8)The plaintiff’s bar is going to continue to come up with ever more absurd causes of torts.
   More documentation is not going to help this. I bought into all of the added documentation when I was in practice. Now that I am retired and obtaining medical care at a university hospital system, I see how far ahead of the curve I was in terms of discussion, explanation of risk, consents, etc.
   9)In the end since the plaintiff’s bar is motivated by greed, there is going to be a never ending stream of new theories of torts. At the same time the patient population seems to be crazier and crazier. People imagine things that do not happen. I would ask if the patient has ever used drugs because it seems like a larger and larger percentage of patients have with unknown effects on their perceptions.
   10)Have doctors gotten dramatically worse, or inappropriate? I doubt it. If so, please show us some actual documentation studies of physician malfeasance.
   11)Solutions to this problem start with the plaintiff’s bar, by cutting their share of reimbursement to 5% of the settlement. That would discourage all but the most egregious claims. Then make sure that before a malpractice case can be filed, it must be reviewed by a three physician panel in that specialty, with unanimous agreement that a tort occurred and the case should proceed. Without that assent, the case should never be subject to a board of medical licensure action against the licensee.
   We have at least 5 times the number of attorneys per capita in the US compared to Japan. We need to start making the practice environment attractive for physicians again, so that they are willing to devote the first third of their lives in training.

2. We just (correctly) make the assumption that the plaintiff’s bar is opportunistic and greedy and that they will destroy anyone for a settlement.

   But in my opinion this goes far deeper than greed. The genesis is in the increasing hatred and marginalization of men and boys.

   I assume the vast majority of these complaints are against male doctors. It just stands to reason.

   Very few men are now seeking marriage, going to college, having children or are “participating” in society. Why should they participate in a society that detests them?

   Michael M. Rosenblatt, DPM

3. Isn’t there a statute of limitations? How long after an examination does a patient get to imagine that she was abused? The more extreme, the less credible.

   I had a patient I treated in Florida for an AVM. It was a simple procedure–small lesion, easily accessible–and everything went smoothly. Some time later, I was informed that she and her family were planning to sue me for malpractice, that she had had a cardiac arrest during the procedure and only through heroic means did she survive, etc. All this was news to me, especially since she went home the following morning. The matter evaporated shortly thereafter. But the fact that someone made such wild claims was unsettling to me, to say the least.

   Was she digging for gold–it was Florida in the bad old days, after all? Or was she simply schizophrenic? I didn’t do routine psychiatric exams on patients before treating them. But of the other radiologist who did the case with me, as well as the techs and nurses, everyone seemed to miss the cardiac arrest in the patient who was conscious and unseated the whole time.

   Who knew?

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