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	<title>Comments on: Sexual Assault in the ED</title>
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	<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/</link>
	<description>A blog from inside the emergency department</description>
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		<title>By: Mirjam</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-17465</link>
		<dc:creator>Mirjam</dc:creator>
		<pubDate>Sun, 28 Feb 2010 05:24:37 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-17465</guid>
		<description><![CDATA[First off, I&#039;m not a medical professional, just very interested in all this stuff. 

I live in Canada and I don&#039;t think it&#039;s the law here to have a chaperone present when having a pelvic exam done, however...I&#039;ve always had a female nurse present whenever I needed a pelvic exam done. 
Not because I request it, but because they just do it that way. I don&#039;t mind, might as well and I just figure that these people are professionals and see vagina&#039;s more than I&#039;ll ever do (and want ;)). 

Taping it would be a little over the top for me too...you might as well take all my personal information as well and distribute that across the globe. Haha, what if women would be indentified by their vagina...oh my gosh!!]]></description>
		<content:encoded><![CDATA[<p>First off, I&#8217;m not a medical professional, just very interested in all this stuff. </p>
<p>I live in Canada and I don&#8217;t think it&#8217;s the law here to have a chaperone present when having a pelvic exam done, however&#8230;I&#8217;ve always had a female nurse present whenever I needed a pelvic exam done.<br />
Not because I request it, but because they just do it that way. I don&#8217;t mind, might as well and I just figure that these people are professionals and see vagina&#8217;s more than I&#8217;ll ever do (and want <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> ). </p>
<p>Taping it would be a little over the top for me too&#8230;you might as well take all my personal information as well and distribute that across the globe. Haha, what if women would be indentified by their vagina&#8230;oh my gosh!!</p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16243</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Mon, 11 Jan 2010 03:11:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16243</guid>
		<description><![CDATA[Hi All - I missed the replies here. Thank you for explaining the breast part. Interesting.

&quot;pendulous breasts or post-menopausal breasts&quot;  ..words not in my vocabulary. ;)

Why unhook the bra though?

WC - Ha ha! Yeah ..I think I have a corner on that... considering no one else uses the word.  :)

Oh and what is that dossier link on me? That&#039;s weird... and a little unnerving at 1st. Funny ..I clicked on one Bajingoland link and it was for shoes and the message in the show site is &quot;We can find any Bajingoland products at this time. Please try refining your search&quot; LOL!! :)

I think you might be the next one in line for use of the word ..then Scalpel. Where is he anyway?? Come out ..come out where ever you arrrre ..Scalpel.  ;) (I miss his posts!) 

ERP&#039;s post on the biting mouse was HILARIOUS!! :)]]></description>
		<content:encoded><![CDATA[<p>Hi All &#8211; I missed the replies here. Thank you for explaining the breast part. Interesting.</p>
<p>&#8220;pendulous breasts or post-menopausal breasts&#8221;  ..words not in my vocabulary. <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> </p>
<p>Why unhook the bra though?</p>
<p>WC &#8211; Ha ha! Yeah ..I think I have a corner on that&#8230; considering no one else uses the word.  <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
<p>Oh and what is that dossier link on me? That&#8217;s weird&#8230; and a little unnerving at 1st. Funny ..I clicked on one Bajingoland link and it was for shoes and the message in the show site is &#8220;We can find any Bajingoland products at this time. Please try refining your search&#8221; LOL!! <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
<p>I think you might be the next one in line for use of the word ..then Scalpel. Where is he anyway?? Come out ..come out where ever you arrrre ..Scalpel.  <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' />  (I miss his posts!) </p>
<p>ERP&#8217;s post on the biting mouse was HILARIOUS!! <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16180</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Sat, 09 Jan 2010 19:25:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16180</guid>
		<description><![CDATA[But Matt ..what about patient privacy?]]></description>
		<content:encoded><![CDATA[<p>But Matt ..what about patient privacy?</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16179</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Sat, 09 Jan 2010 18:59:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16179</guid>
		<description><![CDATA[Physicians should welcome videotaping of procedures and exams.  It would alleviate many of their complaints about subsequent review by medical boards and juries.]]></description>
		<content:encoded><![CDATA[<p>Physicians should welcome videotaping of procedures and exams.  It would alleviate many of their complaints about subsequent review by medical boards and juries.</p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16176</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Sat, 09 Jan 2010 18:51:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16176</guid>
		<description><![CDATA[Correction: I meant to say ..I am going to ask my gyne doc why he gives the option for chaperones the next time I go in.]]></description>
		<content:encoded><![CDATA[<p>Correction: I meant to say ..I am going to ask my gyne doc why he gives the option for chaperones the next time I go in.</p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16174</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Sat, 09 Jan 2010 18:50:08 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16174</guid>
		<description><![CDATA[Hi William - I don&#039;t have a problem with witnesses at all and am totally on board with the necessity of that.

I personally prefer they weren&#039;t necessary and am glad my gyne docs give the option... but fully appreciate the necessity of having someone in with the doc ..100% appreciate why it is necessary. I am going to gyne doc the next time I go in for an exam. Come to think of it None of my OB docs (last pregnancy 1988) ever had a nurse in the room when they did the pelvics during entire pregnancy... or breast exams. I was new to that doc then and his partner gives me the option now.

I am very used to the uro staff and enjoy the chatting or joking we do. It&#039;s almost a party! ;)

Not the exam of course ..(post idea though ;) but I mean because I get along and am so comfortable with the staff. (I&#039;m JOKING about the party part -it&#039;s all *dignified and professional* ..but I do have fun with them and that puts me at ease as much as one can be even though they are ... familiar,professional and friendly.

BUT .. even if the exam were with them ..if I knew they were video taping.. I can&#039;t help it.. it would bother me. Okay..*maybe* ..I could handle the routine exam ..but if it involved pain and my reactions to it sometimes ..that would just be so embarrassing.

What would happen to these videos? who reviews them? are they ever destroyed? It&#039;s too creepy knowing it existed. How do you know some off hours matinee wouldn&#039;t be up on display for all to watch and be amused by?? or got out to You-tube. I know that is extreme.. but that is the creepiness it evokes. You absolutely could NOT identify the person&#039;s face on Tape!

Okay ..this may also come down to a *control* issue for me.

I know you all are looking at it (no pun intended) clinically and from a legal perspective and you should.

But as the woman in the body that is about to get nekkid and feel awkward, embarrAssed and vulnerable in the Bajingoland position (stirrups)..it is a *big* deal. With trust in the staff ..you are surrendering your privacy, exposing your most personal body parts ..BUT.. your conscious and aware of the events in the room. However... you DON&#039;T have *control* over that video!

Seriously...how would it be shot? Would the patient&#039;s face *have* to be in the picture? I&#039;d want a Do OVER if I didn&#039;t look good! ;)

Seriously ..there would have to be controls on how it was done, stored, destroyed. 

You med professionals see thousands of patients during your career. For you ..it is your job to do these things. To quote Dr Elliot Reed on Scrubs, &quot;We must&#039;ve looked at a hundred bajingoes today... bajingo,bajingo,bajingo.&quot; (She was tired and nonplussed with all the bajingo exams.. it&#039;s her job.)

But for the patients .. well .. it&#039;s *our* bodies and we see just you. So, where we patients just fall into the mix of all the others for you..for us ..the patient ..we don&#039;t blend in with anyone and it feels like our naked bodies are calling attention to us as if a bright neon sign were flashing... waving everyone in.

Chaperone ..Yes.
Tape ..NO.

But..I understand that there are time constraints in the *ED* and witnesses not readily available.
Where I worked ..they have cameras in place on all entrances to the hospital, corridors, etc. The tape holds 6 months or a year of info. ? I have watched it. You can zoom in, replay..etc.

It&#039;s a good ethics question.]]></description>
		<content:encoded><![CDATA[<p>Hi William &#8211; I don&#8217;t have a problem with witnesses at all and am totally on board with the necessity of that.</p>
<p>I personally prefer they weren&#8217;t necessary and am glad my gyne docs give the option&#8230; but fully appreciate the necessity of having someone in with the doc ..100% appreciate why it is necessary. I am going to gyne doc the next time I go in for an exam. Come to think of it None of my OB docs (last pregnancy 1988) ever had a nurse in the room when they did the pelvics during entire pregnancy&#8230; or breast exams. I was new to that doc then and his partner gives me the option now.</p>
<p>I am very used to the uro staff and enjoy the chatting or joking we do. It&#8217;s almost a party! <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> </p>
<p>Not the exam of course ..(post idea though <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' />  but I mean because I get along and am so comfortable with the staff. (I&#8217;m JOKING about the party part -it&#8217;s all *dignified and professional* ..but I do have fun with them and that puts me at ease as much as one can be even though they are &#8230; familiar,professional and friendly.</p>
<p>BUT .. even if the exam were with them ..if I knew they were video taping.. I can&#8217;t help it.. it would bother me. Okay..*maybe* ..I could handle the routine exam ..but if it involved pain and my reactions to it sometimes ..that would just be so embarrassing.</p>
<p>What would happen to these videos? who reviews them? are they ever destroyed? It&#8217;s too creepy knowing it existed. How do you know some off hours matinee wouldn&#8217;t be up on display for all to watch and be amused by?? or got out to You-tube. I know that is extreme.. but that is the creepiness it evokes. You absolutely could NOT identify the person&#8217;s face on Tape!</p>
<p>Okay ..this may also come down to a *control* issue for me.</p>
<p>I know you all are looking at it (no pun intended) clinically and from a legal perspective and you should.</p>
<p>But as the woman in the body that is about to get nekkid and feel awkward, embarrAssed and vulnerable in the Bajingoland position (stirrups)..it is a *big* deal. With trust in the staff ..you are surrendering your privacy, exposing your most personal body parts ..BUT.. your conscious and aware of the events in the room. However&#8230; you DON&#8217;T have *control* over that video!</p>
<p>Seriously&#8230;how would it be shot? Would the patient&#8217;s face *have* to be in the picture? I&#8217;d want a Do OVER if I didn&#8217;t look good! <img src='http://www.epmonthly.com/whitecoat/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> </p>
<p>Seriously ..there would have to be controls on how it was done, stored, destroyed. </p>
<p>You med professionals see thousands of patients during your career. For you ..it is your job to do these things. To quote Dr Elliot Reed on Scrubs, &#8220;We must&#8217;ve looked at a hundred bajingoes today&#8230; bajingo,bajingo,bajingo.&#8221; (She was tired and nonplussed with all the bajingo exams.. it&#8217;s her job.)</p>
<p>But for the patients .. well .. it&#8217;s *our* bodies and we see just you. So, where we patients just fall into the mix of all the others for you..for us ..the patient ..we don&#8217;t blend in with anyone and it feels like our naked bodies are calling attention to us as if a bright neon sign were flashing&#8230; waving everyone in.</p>
<p>Chaperone ..Yes.<br />
Tape ..NO.</p>
<p>But..I understand that there are time constraints in the *ED* and witnesses not readily available.<br />
Where I worked ..they have cameras in place on all entrances to the hospital, corridors, etc. The tape holds 6 months or a year of info. ? I have watched it. You can zoom in, replay..etc.</p>
<p>It&#8217;s a good ethics question.</p>
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		<title>By: Bill Alexander</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16170</link>
		<dc:creator>Bill Alexander</dc:creator>
		<pubDate>Sat, 09 Jan 2010 18:25:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16170</guid>
		<description><![CDATA[William, from your screen name I would think you never, never, never see a live female patient.]]></description>
		<content:encoded><![CDATA[<p>William, from your screen name I would think you never, never, never see a live female patient.</p>
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		<title>By: William the coroner</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16159</link>
		<dc:creator>William the coroner</dc:creator>
		<pubDate>Sat, 09 Jan 2010 02:51:20 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16159</guid>
		<description><![CDATA[Seaspray-

I understand your concerns.  The physical exam is private, the genital exam even more so.  I think there also is a cultural difference, men being naked in groups in the military, on sports teams, etc. 

It stands, though, that the punishment for a false allegation of abuse is minimal, the consequences of a false allegation for the doctor are extreme, the chance that the alligator will get away with it are high.  If you do the risk-reward calculus, it makes sense for docs to tape pelvic exams.  

Now, to be perfectly blunt, if this keeps patients away from getting the exams, and they die because of it, that&#039;s on them.  Failure to tape/chaperone will cost the doctor big time. I would never, never, never see an undressed female patient without a witness.]]></description>
		<content:encoded><![CDATA[<p>Seaspray-</p>
<p>I understand your concerns.  The physical exam is private, the genital exam even more so.  I think there also is a cultural difference, men being naked in groups in the military, on sports teams, etc. </p>
<p>It stands, though, that the punishment for a false allegation of abuse is minimal, the consequences of a false allegation for the doctor are extreme, the chance that the alligator will get away with it are high.  If you do the risk-reward calculus, it makes sense for docs to tape pelvic exams.  </p>
<p>Now, to be perfectly blunt, if this keeps patients away from getting the exams, and they die because of it, that&#8217;s on them.  Failure to tape/chaperone will cost the doctor big time. I would never, never, never see an undressed female patient without a witness.</p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16124</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Thu, 07 Jan 2010 18:46:26 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16124</guid>
		<description><![CDATA[ERDOC - &quot;I cried like a baby when I got home that day&quot;

That is so sad and so wrong that you were brought to that.  My heart went out to you when I read your words.

I still stand by the need for patient privacy regarding video during an exam ...but to be accused of a sexual crime when you are a decent human being and especially when you are dedicated in helping people ..even those awful lowlifes is just so very wrong.

It&#039;s one of the worst things a person could be accused of.  And being a man ... (which isn&#039;t fair because a crime is a crime) it must be even worse because society will come down harder and had it been publicized ..there could always be an element of the population reading/hearing the news that don&#039;t know you and thus will just assume you did it or vaguely remember &quot;That doctor who did the crime&quot;.

I am sorry about the minefields providers have to walk through and settle in ..just to take care of a patient. It is sad ..that this can hinder in anyway the interactions between med providers and their patients... that fear or distrust could be in the mix.

And I still stand by my opinion that any patient ..anyone ...who would wrongfully accuse an innocent person should be severely punished.  I&#039;m not talking life imprisonment ..but something that would cause them to *regret* their actions and also be a deterrent for others that would attempt to do the same. And they should have to do community service.]]></description>
		<content:encoded><![CDATA[<p>ERDOC &#8211; &#8220;I cried like a baby when I got home that day&#8221;</p>
<p>That is so sad and so wrong that you were brought to that.  My heart went out to you when I read your words.</p>
<p>I still stand by the need for patient privacy regarding video during an exam &#8230;but to be accused of a sexual crime when you are a decent human being and especially when you are dedicated in helping people ..even those awful lowlifes is just so very wrong.</p>
<p>It&#8217;s one of the worst things a person could be accused of.  And being a man &#8230; (which isn&#8217;t fair because a crime is a crime) it must be even worse because society will come down harder and had it been publicized ..there could always be an element of the population reading/hearing the news that don&#8217;t know you and thus will just assume you did it or vaguely remember &#8220;That doctor who did the crime&#8221;.</p>
<p>I am sorry about the minefields providers have to walk through and settle in ..just to take care of a patient. It is sad ..that this can hinder in anyway the interactions between med providers and their patients&#8230; that fear or distrust could be in the mix.</p>
<p>And I still stand by my opinion that any patient ..anyone &#8230;who would wrongfully accuse an innocent person should be severely punished.  I&#8217;m not talking life imprisonment ..but something that would cause them to *regret* their actions and also be a deterrent for others that would attempt to do the same. And they should have to do community service.</p>
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		<title>By: ERDoc</title>
		<link>http://www.epmonthly.com/whitecoat/2010/01/sexual-assault-in-the-ed/#comment-16108</link>
		<dc:creator>ERDoc</dc:creator>
		<pubDate>Wed, 06 Jan 2010 20:58:30 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4118#comment-16108</guid>
		<description><![CDATA[I once had a patient accuse me of being inappropriate.  It was a false charge and I cried like a baby when I got home that day.  This patient did not even disrobe.  She had a rash that covered most of her chest, abdomen, and back.  I was still relatively inexperienced with rashes, and examined her at length.  Nothing inappropriate intended, but somehow she thought I was being that way.
Lesson learned: chaperone is sometimes necessary for patients of the opposite sex, even if they are NOT having a sensitive area examined.  There is no excuse for EVER doing a rectal, pelvic, or breast exam unchaperoned.  These exams can always wait a minute or two until you can track someone down.
But now if there is a young female who needs an exam anywhere near these areas (ie, proximal thigh even if covered up/clothed) or if I get a weird vibe from them at all, I get a chaperone regardless.....]]></description>
		<content:encoded><![CDATA[<p>I once had a patient accuse me of being inappropriate.  It was a false charge and I cried like a baby when I got home that day.  This patient did not even disrobe.  She had a rash that covered most of her chest, abdomen, and back.  I was still relatively inexperienced with rashes, and examined her at length.  Nothing inappropriate intended, but somehow she thought I was being that way.<br />
Lesson learned: chaperone is sometimes necessary for patients of the opposite sex, even if they are NOT having a sensitive area examined.  There is no excuse for EVER doing a rectal, pelvic, or breast exam unchaperoned.  These exams can always wait a minute or two until you can track someone down.<br />
But now if there is a young female who needs an exam anywhere near these areas (ie, proximal thigh even if covered up/clothed) or if I get a weird vibe from them at all, I get a chaperone regardless&#8230;..</p>
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