Illustrations by Richard Watkins / AJC

Staying safe in exam rooms

For patients: What should you expect during doctor examinations

Whether it’s chilly exam rooms, uncomfortable paper gowns or stark presentation of our half-naked bodies, there’s no question: Visiting a doctor can be intimidating.

Patients’ lack of knowledge about what’s proper in an exam can leave them more vulnerable.

A groundbreaking investigation by The Atlanta Journal-Constitution has found thousands of doctors over the past 16 years raped, molested, humiliated or sexually exploited patients, sometimes under the guise of conducting medical exams.

Yet many of the violators never come to the attention of patients or the public.

“Only vigilance guarantees our safety.”

David Clohessy, Sexual abuse survivor

Here’s what you need to know about what to expect from doctors during exams:

Out of respect for patients’ privacy, doctors should not watch you dress or undress. If you are unable to disrobe without help, the doctor or an aide may assist with your permission. The doctor also should make sure a gown is available, and during exams the doctor should use drapes to avoid unnecessarily exposing your body.

Regardless of your gender, the doctor should have a chaperone consistently available for  intimate exams, according to the American Medical Association Code of Medical Ethics.

Doctors should not examine or touch the genital areas without wearing gloves. In addition, doctors are not to conduct intimate exams without justification or to perform them in unusual ways, such as ordering a patient to assume positions to expose the genital or rectal areas, without medical justification.

The doctor should not make sexualized or sexually demeaning comments to a patient or request details of a patient’s sexual history or sexual likes or dislikes when that isn’t tied to the type of examination or consultation. Nor should the doctor initiate a conversation about his or her own sexual problems, preferences or fantasies. And when the doctor conducts an intimate exam, the patient should be told the reason for doing it, what will be done and why.

Repeatedly, the AJC found doctors violating these safeguards. Some preyed on patients’ lack of knowledge, requiring monthly pelvic exams (the standard for healthy women is yearly, and a 2014 panel from the American College of Physicians said even that often may not be necessary) or pressuring patients to engage in degrading, and unnecessary, acts.

Although doctors are often some of the most respected members of a community, that doesn’t mean patients should be submissive, sexual abuse survivor David Clohessy told the AJC.

Ryon Horne/AJC

Video: The impact of sexual abuse on victims.

“It doesn’t matter how many degrees, how much prestige, (or) what kind of reputation they have,” said Clohessy, executive director of the survivors group SNAP. “All of those positive attributes, they do not guarantee our safety. Only vigilance guarantees our safety.”