Use of medical chaperones by colon and rectal surgeons in outpatient practice

The purpose of this study is to determine the frequency and motivations for medical chaperone use during anorectal exams by colon and rectal surgeons in the outpatient setting.

This cross-sectional study examined factors impacting chaperone use via an anonymous online survey distributed via the American Society of Colon and Rectal Surgeons email list. Routine chaperone use was defined as ≥ 90%.

Of 1,380 emailed board-certified colon and rectal surgeons, 402 (29.1%) completed the survey in November 2019. Median years in practice was 14, and 72.3% were male. Overall, 65.2% reported routine use of chaperones during anorectal exams. Over half (56.3%) felt chaperones should be mandatory and were more likely to report routine use than those who did not (85.7 vs. 39.1%; p < 0.001). Only 23.7% reported that their institutions had formal chaperone policies. The most common reason for use was medicolegal (91.8%), and the most common barrier was chaperone availability (56.7%). When chaperones were used, 42% did not document use in the medical record. On multivariable analysis, increased odds of routine chaperone use were independently associated with: being ≤ 10 years in practice, routine chaperone use during fellowship, and chaperones being routinely available.

Half of surgeons felt that chaperones should be mandatory, suggesting lack of consensus among the cohort. Despite expressing legal concerns, one-third did not use chaperones and nearly half who used chaperones did not document their use. Efforts to improve chaperone availability, documentation of chaperone use, and knowledge of policies are necessary.