Peter Glover wrote
> A GP colleague of mine (yes-really,I'm not involved!) has recently
>recieved a complaint the crux of which is the fact that,suspecting
>appendicitis,he performed a PR on a 19 year old girl without a
>chaperone.Oddly the complaint at this stage seems to be from her elder
>sister and not the patient.Puting to one side for the moment the wisdom
>of doing a PR under these circumstances(damned if you do,damned if you
>don't),how many of us actually make it a habit-that is for maale GPs-to
>haave a chaperone each time we do a PR or VE on our female patients?
>Logistics can be very difficult and I'd be very interested in a cross-
>section of opinions.
>Peter Glover
>
I don't make routine use of a chaperone and IMHO the
offering or suggestion of one might lead the patient to
think she _needs_ one!
I've no doubt I'll get shot down in flames here but I do
sometimes question why we do some things like the one
illustrated in this unfortunate case. Surely if one
suspects appendicitis from the history and abdominal
examination then why do a PR? What do you expect to find
which could possibly alter the management, i.e. admit to
Hospital where she'll probably get another two, from
houseman then registrar.
A similar argument might be applied to urinalysis in this
situation, i.e. if abnormal does not exclude appendicitis.
Do we do this so we can report our findings to the
admitting Doctor in the fear of feeling inadequate if
we've neglected to go by the book?
I know that some advocate using chaperones at all times but
where on earth does one draw the line, e.g. auscultating
the heart, groin lumps, breast checks? Also how does one
cope when on an unattended home visit?
Regards
Peter
Dr Peter Wilson The Mockett's Wood Surgery
Medical Manager Hopeville Avenue, St. Peter's
East Kent Doctors On-Call Broadstairs, Kent, CT10 2TR
Kent International Airport Telephone 01843 862179
Manston, Kent, CT12 5BP Fax 01843 823046
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