Legal Update: Why Your Practice Needs a Medical Chaperone Policy
By Joshua J. Owen, J.D.
Sturgill, Turner, Barker & Moloney, PLLC
If your medical practice does not currently have a medical chaperone policy, now is the time to consider implementing one. A well-crafted chaperone policy not only enhances patient comfort and trust—it also serves as a critical safeguard against allegations of sexual misconduct, which can lead to costly litigation and reputational damage.
Why Chaperones Matter
Medical chaperones promote a sense of safety and comfort during sensitive examinations. Their presence can deter inappropriate behavior and provide an objective witness if concerns arise. Recent high-profile cases, such as the $750 million settlement paid by Columbia University and New York-Presbyterian Hospital to resolve sexual abuse claims brought by 576 women against a prominent OBGYN, are a reminder of the importance to help reduce risks for potential misconduct claims.
Legal and Regulatory Context in Kentucky
While Kentucky’s Medical Practice Act does not require a chaperone for sensitive exams, it strictly prohibits inappropriate sexual conduct or communication with patients. Violations can result in disciplinary action, including license restrictions. For example, a Kentucky physician was recently barred from conducting sensitive exams without a chaperone due to concerns about interactions with female patients. A broader investigation by The Atlanta Journal-Constitution found that over 3,000 physicians nationwide were sanctioned for sexual misconduct between 1999 and 2015. (1)
Guidance from the Kentucky Board of Medical Licensure
The Kentucky Board of Medical Licensure issued a board opinion (March 2009) outlining standards of acceptable and prevailing medical practice relating to physical examinations by physicians. Key takeaways include:
- A chaperone should be readily available during all physical exams.
- A chaperone should be present during exams involving sexual/reproductive organs or the rectum—regardless of physician or patient gender.
- Physicians must inform patients of their right to request a chaperone.
- Chaperones are not typically required during history-taking or non-sensitive exams.
Documentation is essential. Physicians should record whether a chaperone was present, the identity of the chaperone, and any patient preferences or refusals.
The Kentucky Board’s guidance aligns closely with the AMA Code of Medical Ethics, Opinion 1.2.4, which recommends using chaperones even when a trusted companion is present.
Best Practices for Policy Implementation
To protect your practice and patients, consider the following when developing a chaperone policy:
- Communicate clearly: Display notices and preferably discuss the policy through a conversation initiated by the intake nurse or the physician.
- Honor patient requests: Always provide a chaperone when requested.
- Use trained professionals: Chaperones should be professional, approachable, and aware of their confidentiality obligations. They should be a trained health professional, such as a nurse or medical assistant—not administrative staff.
- Consider gender: While not required, assigning a chaperone of the same gender as the patient may reduce discomfort and risk.
- Ensure confidentiality: Chaperones must understand and uphold patient privacy.
- Allow private conversations: Patients should have a separate opportunity to speak privately with their physician, even when a chaperone is provided.
- Establish discharge protocols: If a patient refuses a chaperone and the physician feels uncomfortable proceeding, the policy should outline appropriate steps for discontinuing care.
Implementing a medical chaperone policy is a proactive step toward fostering a safe, respectful clinical environment. It protects your staff, your patients, and your practice from legal exposure—and reinforces your commitment to ethical care.
(1) Teegardin, Carrie and Robbins, Danny. “Still forgiven.” Atlanta Journal-Constitution, April 26, 2018.
