A hospital recently paid out over $1 billion (that is 1000 million $) because there was no enforced chaperone policy and an ObGyn abused patient.
The hospital announced, with appropriate solemnity, the formation of the Interdisciplinary Task Force on Sensitive Clinical Encounters.
This was considered a major victory for patient safety because until then the hospital had only protected patients using mission statements, laminated posters, and a mandatory online module titled Respect Starts With You.
The task force met once a month for eighteen months.
There were representatives from Risk Management, Human Resources, Medical Staff Affairs, Patient Experience, Legal Compliance, Diversity Equity and Inclusion, Graduate Medical Education, and one actual physician who accidentally entered the wrong conference room while looking for coffee.
The proposal under discussion was radical:
Should hospitals require trained chaperones during sensitive examinations?
The room fell silent.
Not because anyone opposed patient safety. Everyone supported patient safety. The hospital had issued seventeen press releases proving this. The concern was operational complexity.
“What exactly,” asked Legal, “is the definition of ‘sensitive’?”
Gynecology suggested pelvic exams.
Urology suggested genital exams.
A surgeon suggested rectal exams.
Dermatology became nervous.
Orthopedics quietly removed itself from the discussion entirely.
Risk Management then raised an important point. If the hospital officially required chaperones, and one was not present, plaintiffs’ attorneys might later argue the standard had not been followed.
This was considered dangerous.
It was therefore proposed that chaperones remain “strongly encouraged,” “recommended whenever feasible,” and “left to professional judgment.”
This language was praised for its flexibility, which in hospital administration means everyone is protected except the patient and the clinician standing alone in the room.
The physician in the corner asked whether requiring chaperones might also protect doctors from false accusations.
The committee agreed this was true but warned that making the policy mandatory could imply the hospital believed accusations occasionally occur.
This was considered even more dangerous.
Patient Experience proposed a compromise. Instead of requiring chaperones, the hospital could create a brochure explaining that patients “may request the presence of a support person or trained staff member.”
The brochure was printed on glossy paper at considerable expense.
No one checked whether frightened patients in vulnerable situations actually felt comfortable requesting one.
The professional organizations then entered the discussion. They released a beautifully worded statement affirming dignity, trust, communication, trauma-informed care, equity, compassion, shared decision-making, and the importance of listening.
The word “required” did not appear.
One committee member finally asked the forbidden question.
“If chaperones improve safety, reduce misunderstandings, protect patients, and protect clinicians, why not simply require them?”
The room became tense.
Because medicine loves recommendations. Recommendations are elegant. Recommendations generate consensus statements, webinars, and continuing education credits.
Requirements generate staffing costs. And they create, well, requirements.
And so the hospital reached a courageous compromise.
A mandatory committee was created to discuss why mandatory chaperones should remain optional.