Medical Students/Residents Being More Sensitive to Patient Modesty

Patient modesty needs to be a high priority during all medical procedures. Medical students and residents are often so busy focusing on their training for procedures and protecting a patient’s dignity and modesty gets sidelined, especially in surgeries, the ER, and other busy departments.

Many patients care about their modesty in medical settings and their wishes for modesty should be honored. Most patients welcome medical professionals of either sex for procedures and exams which do not expose their private parts. Intimate procedures are another story. Many patients prefer same sex intimate medical care. For example, many women prefer a female gynecologist and most men prefer a male urologist.

Patients often seek doctors who are sensitive to their needs. When they find a doctor willing to accommodate them these same patients will return for care and recommend the doctor to family members and friends. Doctors sensitive to patient modesty are in demand. Many men seek male urologists that employ male nurses. It is strongly recommended that you check out patient modesty friendly doctors and follow their example as you train to become a doctor.

Medical students and residents can be useful in honoring patients’ wishes for an all-same sex medical team. For example, many male medical students and residents could assist male urologists with procedures for male patients who do not want any females. For example, one male urologist who does not have any male nurses said that he could have a male resident assisting him in an urological procedure on a male patient who wanted an all-male medical team.

Medical schools need to reduce the number of intimate procedures such as pelvic exams, rectal exams, and pap smears required by students in order to graduate, especially if they are planning on specializing in areas that do not perform these intimate procedures. Many medical students have chosen their specialty early on. Cardiologists, neurologists, radiologists, podiatrists, optometrists, otolaryngologists, and orthopedic surgeons do not perform gynecological or urological procedures. Medical schools have the ability to exempt students from doing these intimate procedures. There is no reason for a female medical student, who is planning on becoming a gynecologist, to be required to learn how to do urological procedures on male patients. Look at how a stressed medical student who had planned on becoming a neurologist or pathologist at http://patientprivacyreview.blogspot.com/2011/07/medical-education-modesty-concerns.html had to quit medical school because she saw no value in doing unnecessary intimate exams on patients due to the specialty she was going into. This is sad because this lady would have made an excellent doctor.

*All medical students and residents are encouraged to watch the videos, Problems with Medicine Being Gender Neutral and Surgery and Your Modesty.

Here are two examples of surgeons sensitive to patient modesty:

1) One Illinois orthopedic surgeon, Dr. Scott Trenhaile, invented a special ‘Modesty Bra’ for female shoulder surgery patients after he received concerns from his female employee who felt uncomfortable letting him operate on her shoulder with her breasts exposed. The Modesty Bra can be used for many other surgeries.

2) An orthopedic surgeon, Dr. Bruce Levy who performs hip replacement surgeries at Mayo Clinic in Rochester, Minnesota grew weary of seeing patients unnecessarily exposed for the surgery and it inspired him to invent Covr Medical garments. Patients who undergo hip surgery, cardiac catheterizations in the groin, cardiac bypass surgery, and other surgeries that require access to the groin, hip, or part of the back can use the Covr Medical garments which cover the genitals. These garments have helped save embarrassment for so many patients. Realistically, many patients are more anxious about how they will be exposed for procedures than the actual procedure itself. One man who needed heart valve replacement said the garments helped to save embarrassment.

We need more doctors like Dr. Trenhaile and Dr. Levy who went the extra mile in helping to protect patient dignity and modesty. Medical students and residents should follow those doctors’ example in protecting patient modesty and dignity.

We encourage all medical students / residents to work on being more sensitive to patients. Below are some tips to use as a guide.

Tips For Medical Students/Residents

1) Never do pelvic, rectal, and genital exams on patients under anesthesia without their consent under any circumstances. This is unethical! The truth is many pelvic, rectal, and genital exams are unnecessary anyway. Check out this article, Truth about Pelvic Exams.

2) Stand up to your medical school about unnecessary intimate procedures. Refuse to perform them. If you already know what specialty you are going into and it will not require intimate procedures, encourage your medical school to exempt you from learning how to do intimate procedures on patients.

3) Never try to convince a patient to accept opposite sex medical professionals for intimate procedures. Don’t use arguments such as “they are professionals”, “they’ve seen it all”, and “they are very skilled and have done this procedure many times”.

4) Always introduce yourself to the patient and explain your role. Never pressure the patient to accept you to do intimate procedures on them because you need the training. The patient’s wishes should always be the priority. If they decline to participate, honor their wishes.

5) Ask for permission before you touch certain areas of any patient’s body. Explain in precise details what you will be doing, especially if the procedure involves private parts. Explain tests that are ordered and their results. This shows patient-centered care. Always respect a patient’s wishes if he/she says “No” to something.

6) Advocate for the patient to wear their street clothes as much as possible. Many procedures and tests, including blood tests, blood pressure tests, stethoscope heart exam, eye, ear, nose, and throat examinations, as well as throat cultures can be done fully clothed.

Check out the articles about patients wearing their own clothes: Hidden Beneath the Hospital Gown and Keep Your Pants, and Your Dignity, at the Hospital.

7) Always strive to give patients maximum dignity and respect. Do not unnecessarily expose them. For many surgical procedures that do not involve the genitals, hips, and groin, patients can wear 100% cotton underwear or disposable underwear/shorts as long as they do not contain metals. Check out Unnecessary Underwear Removal for Surgeries. Encourage your attending physician or professor to utilize special garments such as Covr Medical Garments for procedures that require access to the groin, hip, and part of the back (ex: kidney procedure) and the Modesty Bra for women. If a rectal exam or colonoscopy is required, patient should have the option of wearing boxer shorts backwards or specialized colonoscopy shorts that only expose their buttocks.

8) Encourage your attending physician or professor to suggest other facilities/doctors if that facility cannot accommodate a patient’s wishes for a same sex team, or schedule that procedure when a same sex medical team can be accommodated.

9) During general anesthesia patients continue to expect dignified care. For patients who require surgery that involves exposure of their private parts commit to helping them get a same-sex surgical team if that is their preference. Be open to using local or regional anesthesia if that is the preference of the patient. This allows the patient to remain awake and alert during a procedure and gives many patients peace of mind. Also, patients should have the option of having a personal advocate such as their spouse present for surgeries and procedures. Check out this article, Why You Should Have a Personal Advocate?

10) Treat compromised patients and those who suffer with dementia and Alzheimer’s with dignity and respect for their privacy. Always assume that a patient wants to be treated by a medical team of the same sex if the patient is unable to communicate her/his preference. One female car accident patient was traumatized when she witnessed a male nurse removing her tampon while she was semi-conscious.

11) If any colleagues including your attending physician make derogatory comments about patient’s private parts, report them to the administration. Do not tolerate this behavior.