The Defense Health Agency has clarified the U.S. military’s policy regarding chaperones during medical exams following several prominent cases of Army doctors taking indecent liberties with patients behind closed doors.
In a memo sent last month to military health system leadership, including military hospitals and dental facilities and support offices, acting DHA Director David Smith said patients have always had a right to a chaperone, but physicians now must offer them for sensitive medical exams or procedures.
Signage will inform patients that they have a right to a chaperone regardless of treatment, according to the memo, but in gynecological, breast or pelvic exams, they must be offered one.
“Having chaperones available is a crucial part of patient-centered care,” said Dr. Paul Cordts, DHA’s chief medical officer, in a statement released Thursday. “Chaperones can help protect both patients and health care staff.”
Last January, former Army physician Maj. Michael Stockin was sentenced to nearly 14 years in prison for sexually abusing patients at Madigan Army Medical Center, Joint Base Lewis-McChord, Washington.
Stockin had pleaded guilty to 41 violations of the Uniform Code of Military Justice, to include abusive sexual contact and indecent viewing with male patients under the auspices of medical exams.
In November, patients of Army Maj. Blaine McGraw, an OB-GYN at Carl R. Darnall Army Medical Center in Texas, filed a lawsuit against him alleging that he had secretly recorded and sexually exploited them during breast and pelvic exams.
McGraw was charged in December with 54 counts of indecent visual recording, five counts of conduct unbecoming an officer and other charges. He is in pre-trial confinement awaiting court proceedings.
The American Medical Association recommends that physicians ensure that their patients are aware that chaperones are available on request and that doctors should always honor a patient’s request to have a chaperone — one that is an authorized member of the health care team.
Having a chaperone present, especially during sensitive exams, provides reassurance to the patients and “demonstrates an attention to the patients’ well-being,” according to the association’s code of ethics.
It also is helpful for the “more pragmatic goal of legal protection for the physician,” according to association guidance.
Under the new DOD policy, chaperones are available to serve as a safeguard for patients and staff and are members of the medical team who will maintain privacy but also would report any suspected inappropriate conduct.
The guidelines call for staff to try to provide a chaperone of a certain sex if requested and if one is not available, the exam can be rescheduled. If a patient declines a chaperone, the medical staff must document the request but also can decline to conduct an exam if it is sensitive in nature.
Personnel who may serve as chaperones include physicians, dentists, physician assistants, psychologists, social workers, nurses, medics and corpsmen, medical technicians and support assistants, medical residences and hospital volunteers.
Non-medical personnel such as sexual assault response coordinators, victim advocates or family advocacy personnel may be in a room at the request of a patient in the event of a violence-related exam but they will not count as chaperones, according to the new policy.
Regarding pediatric care, a chaperone is not required for normal checkups for children if a parent or guardian is in the room, but health care staff must offer a chaperone if an exam or procedure is beyond routine.
For adolescents ages 11-17, the policy will follow the guidance for adult chaperones.
“This system-wide chaperone policy is just one part of DHA’s broader commitment to protect all patients and maintain the highest standards of professionalism,” officials said regarding the new policy.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.