In the context of increasingly complex and expensive malpractice litigation, it is as important as ever that doctors practicing in New Jersey be aware of their state’s Chaperone Policy. The policy, part of New Jersey Administrative Code, requires that in all office settings patients be advised of their right to have a chaperone present during an intimate exam. Intimate exams include breast and pelvic examinations of females, and genitalia and rectal examinations of both males and females.
To stay compliant with the Chaperone Policy, we recommend the following measures:
- Written Notice: Give written notice to all patients in all office settings of the right to have a chaperone present in any interaction with a healthcare professional. According to the Code, providers need to post notices in the waiting room and all exam rooms.
- Patient Acknowledgement: Have the patient acknowledge written receipt of chaperone policy notification prior to any care, treatment, or evaluation.
- Alternative Notice: If a patient is unable to understand his/her right to have a chaperone present during an examination based on the written notice, the healthcare professional must use another means to ensure that the person being examined understands his or her right to have a chaperone present.
- Permission: Honor a patient’s request to have a chaperone present. There should be an authorized member of the health care team available to serve as a chaperone.
- Documentation: Document if the patient declines a chaperone. If the patient accepts a chaperone, the name of the chaperone and what portion of the discussion or examination took place when the chaperone was present should be documented. Chart in the electronic medical record that the provider has offered a chaperone, using language such as the following:
- “Chaperone policy has been discussed. The patient has been informed that s/he can have a chaperone present at any time during consultation, evaluation, treatment or follow-up. The patient has been informed that if the patient desires a chaperone at any later time during consultation, evaluation, treatment, or follow-up, the patient will inform the staff or healthcare professional of that desire.”
- Accommodation of Relatives and Companions: Identify any relatives or companions in the medical record. Confirm that the patient is agreeable to the provider sharing whatever medical information needs to be discussed. (Documentation of that agreement should be made contemporaneously.) Offer a chaperone even if a relative or companion is present.
Chaperone requests are not just for the patient. Providers too have the right to request a chaperone in the room if they feel uncomfortable with their patient interaction. In addition, physicians are not obligated to provide further care for the immediate medical problem if they cannot provide a requested chaperone acceptable to the patient or if the patient refuses to have a chaperone present. If care is not provided due to the lack of a chaperone, the physician needs to discuss the risks of not receiving further care with the patient.
All New Jersey physicians and practices should take note of this Administrative Code and, if needed, change their internal processes to reflect its guidance.
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