Medical Chaperones for Sensitive Exams and Procedures: Frequently Asked Questions
CHAPERONES FAQs
We understand that certain medical exams and procedures are more sensitive than others and we want to make sure you are as comfortable as possible. Our trained chaperones help ensure that sensitive exams and procedures are safe, comfortable and considerate.
What is considered a “sensitive” exam or procedure?
A sensitive exam or procedure involves a physical examination of the chest, genitalia or rectum. Examples include chest, vaginal, penile, scrotal or rectal exams.
What does the chaperone do?
The chaperone is a specially trained member of the clinical team who enhances the patient’s and provider’s comfort, safety, privacy, security and dignity during sensitive exams or procedures. The chaperone is trained to observe for signs of pain or discomfort, answer questions during the exam, and assists as needed.
Can I decline to have a chaperone present during my exam or procedure?
Adults who are able to make their own medical decisions have the right to decline having a chaperone present during their exams or procedures. You can decline a chaperone at anytime during your appointment. In an effort to protect patients, providers, and staff from sexual abuse or allegations of abuse, our providers will not perform any sensitive exams or procedures without a chaperone present. In this case, alternate care options will be discussed.
SENSITIVE EXAMS FAQ
When might I have a pelvic exam or Pap test?
Patients typically have their first pelvic exam upon experiencing symptoms such as discharge or pain, or at the age of 21.
What can I expect during a pelvic exam or Pap test?
External exam: The provider makes a visual examination using a gloved hand to check for lumps or bumps in and around your vagina. You will lie on an exam table with paper or cloth covering over the lower half of your body and with your feet in foot rests (stirrups) or placed at the end of the exam table.
Speculum exam: The provider will gently insert a duck bill-shaped instrument into your vagina to see the vaginal canal and cervix. If you are over age 21, the provider may also conduct a Pap test by using a thin plastic brush to collect cells from your cervix. Additionally, they may collect a swab to test for infections or check vaginal discharge.
Bimanual exam: The provider may perform a bimanual exam if you are experiencing pain or other symptoms in your lower abdomen and reproductive organs. They will insert one or two gloved fingers into your vagina while using the other hand to gently apply pressure and push on the lower part of your belly to check the size and placement of your ovaries and uterus. The provider may gently move your cervix from side-to-side with their fingers to check for signs of infection. The provider may also use one finger to check pelvic floor muscles for tenderness due to muscle spasm.
When might I have a rectal exam?
Providers may perform rectal exams if you have pain in the lower abdomen and reproductive organs, blood in the stool, or other gastrointestinal or rectal symptoms. Rectal exams also test for sexually transmitted infections of the rectum. During a rectal exam, you will lie on your side, lie down with your feet in foot rests (stirrups), or kneel on the examination table.
Some patients may feel sensations similar to an urge to urinate or defecate during the rectal exam. This usually passes quickly, but patients should ask the provider to stop the exam if the urge is strong.
What types of rectal exams are there?
External exam: The provider visually examines the anus and surrounding area to look for sores, rashes and bumps, sometimes using a light to see better. The provider may collect tests for sexually transmitted infections by placing a cotton swab approximately 1 inch into the rectum, then gently rotating and removing the swab.
Digital exam: The provider inserts one gloved, lubricated finger into the rectum, to check for lumps or abnormalities.
Anoscope exam: The provider uses a hollow tube-like instrument, 3-5 inches long, to examine the anus and rectum closely. The lubricated anoscope is gently inserted into the rectum and slowly withdrawn as the provider examines the rectal canal. To ease the placement of the anoscope, the provider may ask the patient to tense and relax internal muscles (as if having a bowel movement) during insertion. The provider may position a light or ask a medical assistant to hold a light during the procedure.
When might I have a chest exam?
You may receive a chest exam for chest issues such as pain or lumps. If you are over age 25, providers may also offer you a screening chest exam based on your personal and family risk assessment.
What can I expect during a chest exam?
Visual exam: You will raise your arms above your head so the provider can check for differences in size or shape, as well as signs of rash, dimpling, etc. You may be in a seated position or lying on an exam table.
Manual exam: For this exam, your provider may or may not use gloves. The provider uses the pads of the fingers to press on your entire chest, underarm, and collarbone area to check for lumps or abnormalities. Providers also check for enlarged lymph nodes under your armpit. The provider might also gently squeeze the nipples to check for expressed fluid.
When might I have a urogenital exam?
You may have a urogenital exam to check for hernia if you are experiencing pain, swelling or discharge, or if you have sores or other unusual symptoms.
What types of genital exams are there?
Pubic/groin region and hernia exam: the provider visually examines and palpates the groin, scrotum, hip crease, inner upper thigh crease, and lower abdomen to check for abnormalities, especially along the lymph nodes of the hip area, testicles, and the spermatic cord connected to the testes inside the scrotum. This is performed by the provider placing fingers through the patient's scrotum while the patient is standing.
Penile/scrotal exam: the provider visually and manually examines the penis, including the skin, fore skin, glans, and urethra to check for pain, sores, or other unusual symptoms.
Note: Some patients develop erections during examination. This is completely normal as erections can result from anxiety, temperature changes or a reflex to touch (in addition to sexual arousal). Providers may ask uncircumcised patients to retract the foreskin back in order to examine all surfaces of the penis for sores and lesions and may palpate the area for irregularities. The provider may also examine the opening of the penis (urethra) and may use a swab to collect a lab sample, possibly pressing along the shaft to express potential fluid. Patient may swab the area themselves if they are comfortable and prefer to do so. Providers may on occasion check for scarring (Peyronie's disease) by squeezing the muscle of the penis.
