During a full body exam at the dermatologist, has anyone had to ask the scribe to turn her back during the genital portion of the exam? It seems to me that the dermatologist would have told her scribe to turn her back for this part of the exam.
Privacy at the dermatologist. - Sensitive Issues ...
Privacy at the dermatologist.
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P51mustang
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33 Replies
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No. Patients need to know that dermatologists now routinely bring in a female scribe with a telecommunication device to record notes and take skin photos.
If you are uncomfortable with her seeing some part of your skin, particularly genitals, take or wear gym shorts and refuse any request or effort to remove them. If that doesn’t work tell them you consent only to an above the waist exam.
If you have an extremely rare skin problem in the genital area, only go to a same gender doctor and politely ask the opposite gender audience to leave or turn around. There is no medical reason for them to act like an unnecessary voyeur.
I see my dermatologist yearly for a full body exam. My doctor is female and I’m male. In fact the last 3 dermatologists I’ve had were female with female assistants.
I get a little embarrassed mostly because I am a small guy,
Each visit with I’ve had with any of the dermatologists I’ve had has been 100% professional and they have never made me feel uncomfortable.
Does your dermatologist have her scribe turn her head when she examines your genital area?
No, and I’ve never asked. One or two have been kind of young, but I’ve had the same in the hospital with the patient care techs. They have helped me dress after surgery and have seen me nude. I’ve also had male nurses and PCTs and it really doesn’t feel any better or worse with either gender.
When I had my kidney transplant a doctor came around with students to see me during recovery and proceeded to show them my incision and healing progress and every one in the room saw my genitals.
I had a biopsy twice on my transplanted kidney and both times they exposed me. The ultrasound tech, a female, was very considerate and at least covered my genitals. The surgeon didn’t care if I was exposed or not.
I still get embarrassed because when they examine me down there I sometimes start to get a little hard but never fully.
They all have been absolutely amazing about it.
Was this in the U.K.? I ve had three exams and declined them all. Each dermatologist was a woman - with a female student. There seems to be a shortage of male dermatologists.
Patient Bill of Rights (in the US) guarantees that you will be treated with dignity. If asking an extra voyeur in the room to step out or turn their backs during ANY part of the exam preserves YOUR dignity, then that is your RIGHT to do so.
As a survivor of repeated medical abuse with PTSD as a result, I have further protections to do so under the Americans with Disabilities Act.
Hi Arch.
That Patient Bill of Rights (in the US) isn't worth the paper its printed on.
Most female healthcare workers don't give a damn about male dignity & privacy.
It's up to the male to take control of any mtg. with american healthcare personnel from the start so things don't get out of hand & the patient leaves totally humiliated & embarrassed.
Men have to speak up before the system starts listening.
When you get in that situation that a scribe is in the room with the dermatologist, you can do what I did at a recent appointment. We had completed the stand up portion of the exam with my boxers on, and I needed the dermatologist to check something in my genital area. I directly asked the scribe to turn her back and she did. You are in control of what happens with the exam, and you can request having some privacy!! You are the one paying for this!!
When men start standing up, and speaking out against the system, maybe things will change.
Sometimes that works. If they are in the room solely as a scribe, they tend to just turn around & stay within your site the entire time. If they are there in a dual role as scribe/chaperone. They you get told they're there for your protection therefore that have to watch what the doctors does.
For me that's an appointment stopper right then & there.
I'm also trying to figure out how I can use the Americans with Disabilities Act to my favor.
When enough of us do & our wives, mothers, & girlfriends add their voices to ours, they will have to back down & come to the table like they did in the mid 60's when women went after them.
I still like tying patient dignity & privacy to Medicare/Medicaid pmts. Then for sure they'd listen.
If the chaperone states that she is there for my protection, I tell her I don’t need any protection, and I would like some privacy during the intimate portion of this exam, so please turn your back. With the doctor wanting to get to the next patient without delay, he, or she will probably not object at that point.
I personally don't care why they are there. If I had to go into any surgery while awake I would have the same issue. and the surgery would not be done. the doctors feelings on the issue and the feeling of the scribe or chaperone are COMPLETELY immaterial. I have several spots that are suspicious even now and I have never been able to work up the courage to see the dermatologist, just because a full body exam couldn't happen in the way it happens now. I have had this argument so many times with nurses telling me how comfortable THEY are with seeing my body. the whole argument makes no sense. this is NOT about them. and they cause ME to feel ashamed for feeling ashamed. I cant do that any more.
Their attitude and approach are totally misguided. It leads me to the conclusion they are trying to discourage especially men from having preventive care. Dermatologists are oblivious to the harm this attitude causes.
I have refused to even go to the dermatologist for these reasons. they fail to realize that for many it is a bit embarrassing, or awkward. but for some of us it is a deal breaker. I cannot and will not go. I have had surgeries as well in which I had to be examined and have a catheter removed etc those are hated times but they are times at which there is one and only one care giver. that is more than bad enough.
I have contacted various doctors offices about this very issue and I cant even get an answer about their office policies. I would not think that an answer to a simple Question" does your office require chaperones/scribes... would not be too hard. but they seem unable to answer.
The standard response I get is please make an appointment your health is important to us and so on because of PTSD I freeze once I am in that position. I cant find a voice to tell them I am freaking out inside. I cannot take the chance of going and finding out then.
When you get in that situation that a scribe is in the room with the dermatologist, you can do what I did at a recent appointment. We had completed the stand up portion of the exam with my boxers on, and I needed the dermatologist to check something in my genital area. I directly asked the scribe to turn her back and she did. You are in control of what happens with the exam, and you can request having some privacy!! You are the one paying for this!!Below is something I saw on another blog:
All you simply have to say is "I am a survivor of abuse with PTSD and under the Americans with Disabilities Act, I request the reasonable accommodation (accommodation provision) that you (the doc) are the only person in the room for the exam."
You are under no obligation to disclose what your disability is (PTSD, anxiety, depression, phobias, etc.). It is illegal for them to ask what it is. And you do not have to prove you are disabled. All you have to do is ask for it. Once you request a reasonable accommodation, it creates a legal obligation that the provider MUST accommodate or you have legal recourse against the provider and the facility.
The ADA is a very powerful means to protect patients. Under federal ADA, you are under no obligation to disclose your disability (in your case, mine, and those harmed it is PTSD), it is illegal for the one that you are requesting accommodations from to ask what it is, and you do not have to prove that you are disabled. All you have to do is ask for it.
You can now tell your providers that you a survivor of abuse and request accommodations under the Americans with Disabilities Act (and by federal law they must accommodate you).
Unnecessary exposure is a traumatic experience and can leave the victims with PTSD.
I hope this helps!
You can decline to have genital area done. Most females dermatologist will only have you undress to underwear unless you specifically have issues in the genital areas. I had to actually ask my derm to check that area because of rashes otherwise she just checks around opening of underwear. Now I just take everything off and cover the penis. She takes it off anyways for the checkup. As for the scribe and student i let them do whatever. They need the knowledge they learn if they become dermatologists The way I look at it no big deal. I'm not a shower either. Her and I know what we expect from each other. If I have a problem there I want it addressed. They probably seen hundreds of penises so its probably not a big deal to them. I.had 3 females in.the room once. Doc, nurse and student nurse and we just talk when I'm getting dressed. I tryst them and they trust me.. Also my regular doctor I had are good friends. That wasn't a big deal to us either.
• in reply to
I read your response again from 10 months ago in regards to your comfort with being naked in front of 3 women inspecting your entire body and wondered why you could feel so comfortable with that and for me it would be unbearably humiliating. I guess it is a matter of perspective. I can not separate being naked in front of women in a medical setting from being naked in any other setting where I am being treated by a woman in any manner that doesn’t elevate my manhood when it comes to sharing the most sacred part of what makes me a man and I am only willing to share that with a woman who in return is also sharing with me her most sacred parts because it puts you on a level playing field when you both surrender yourselves in an intimate way. But what most of us here are talking about are acts that bring shame and humiliation to many men and women because of the cavalier attitude that many in the healthcare industry have taken towards patient nudity. They would all have you believe that they don’t look at your penis in anyway sexually but that is not true
Let me tell you a story about my wife’s best friend who is a sono tech. one day she was delivering some results to an urology office that was in her same building. When she arrived the doctor was not there but all the girls in the office were all huddled together laughing and making a big ruckus and my wife’s friend asked what all the laughter was about and they told her they had just seen the biggest penis that had ever been in that office and they were holding a paper where they had been recording all the men’s penis sizes that entered that office and this was being done for sport not for medical reasons.
I have to add I had been a patient at that office before 😤
That is a first hand story but if you dig around there are a lot of documented stories of sexual violations and no one knows how many go unreported or unknown and no one knows how many voyeurs and sexual predators are in the system ,where they are or who they are
So my suggestion is not assume they are all the professionals they claim to be and if you are comfortable being stripped of all your dignity in front of a bunch of women that may or may not talk about you in a professional manner once you have left than I wish you all the best but that is absolutely not something I will tolerate
• in reply to
If they had said something in front of me then I would take offense to it. In fairness one was a student dermotologist, another was the nurse (derm always has a nurse with them to scribe), and the dermotologist themselves. No I didnt give permission for the student, but they have to learn somehow. I figure if everyone turn the student then how do they learn? Practice makes perfect. What they say behind my back, I don't give a hoot.Recently I was at a urologist office for the first time seeing the female doctor and her assistant came in and asked the questions. So being a urologist assistant she had to have someone in room with her. I couldn't believe it a great looking blonde came back in with her. Told myself " be cool". They left after the checkup the urologist came in and did her teaching and findings, comparing her notes to what her assistant found. The student never touched me, just observed. It's just skin, everyone has it. No biggie. No pun intended.
• in reply to
Also, what is your take on a gay nurse or doctor? Would you go to guys that are gay? What if they talk about you when you've left the building?
xsevenx• in reply to
it would make no difference to me if the nurse/doctor is gay, or indeed any part of the LBQT+ community.
• in reply toxsevenx
Me either
• in reply to
the point in this is professionalism and for any gender to speak about a patient in an unprofessional manner is a violation of that patient and the Hippocratic oath. If you feel that it is just skin why do laws prevent you from revealing certain parts of your skin in public without being charged with indecent exposure
And yes if a male provider was to openly declare to me that he is gay I would have a problem with that because I would need to question his motives for that in a medical setting
• in reply to
I've had nothing but professionalism from females. In fact I've been verbally and sexually assaulted by an urologist. He made me want to do myself in. So I got flipped to another urologist who just happened to be a woman. Best thing that happened to me. Also I have had 3 other encounters of male urologists who cut me down and verbally abused me. The females have all been nothing but good to me. Once you get assaulted by a male provider, you'll be embarrassed and shamed. I never want that feeling again.
• in reply to
being made to feel like that regardless of the sex is completely inexcusable and is a major reason to patients suffering emotional trauma and in my case it ultimately developed into PTSD
I am truly sorry that happened to you
• in reply to
Thank you. Everybody have their own preferences. I have just reasons why I feel like the way I do.
Everyone's sensitivities are different - it's not really about one's presenting conditions. Also, the original poster's complaint had to do with the presence of medically unnecessary witnesses, not actual caregivers.
• in reply tomodestguy
Dermotologists always have scrolls in the room. Some sit with their backes to you and don't even look. But IF a procedure has to be done, a second pair of hands are needed. Would people rather them go chase a person down (open the door, no privacy then) or have someone that is close by and have the privacy? I had one appt with a urologist and he needed an assistant and one wasn't in room, so door wide open with people going by with pants to ankles. No thanks, give me 2 people in room and keep door closed. If a third person is there to observe/learn, I don't care. As long as door is closed. Not everyone is going to see me then. Besides the urology and dermatology rooms are so small anyways, you're lucky 4 or 5 people can be in there but be in each other's way. Most I've had was 3 females at one time. But the door stayed closed.
I suspect this is really a U.S. based issue.
I no longer ask, I tell them anyone not DIRECTLY involved get out or I get out
• in reply tojloptout
what still baffles me and always will is why do they think it is appropriate for for three females to ambush a man in that kind of setting but you would never hear of three men observing the naked body of a female patient. The double standards are unbelievable and when you say something you are treated as the problem
jloptout• in reply to
well ladies if you think I'm the problem you aint seen noting yet
Females in medical settings essentially shame and mock men for refusing the same type of treatment of women for which there are formal policies to prevent- the hypocrisy is ASTOUNDING as is the loss of trust
I recently wrote this letter to the large Dermatology practice I go to. It goes into detail about how men feel about how they are currently being treated with regard to their privacy and dignity during medical examinations. I wrote it specifically to dermatologists but it could be easily adapted for any Specialty.
Please feel free to copy and paste any, or all, of it and send it to your doctor's practice. I sent one to each doctor in the practice and the practice manager.
I think this letter should go a long way in helping doctors and staff in understanding the truth about male modesty and how to make small changes in the way they conduct exams thereby make the examinations more dignified.
Name of Dermatology Clinic
ATTN: Dr. XXXXXXXXX
Date XX/XX/XXX
Dear Dr. xxxxxxxxx,
As a concerned patient, I want to make you aware of what men are saying, on multiple blogs, concerning their visits to the dermatologist. The consensus among these men agrees with the experiences I have had regarding my privacy. Although this is not widely appreciated, most men are just as modest as women! Just like women would never tolerate having a male assistant looking on during her pelvic exam, most men find it humiliating to have a female assistant staring at them unnecessarily when they have to expose their genitalia. Men expect to receive the same dignity and privacy afforded women. Unfortunately, many men feel ambushed by a female assistant and most men feel too intimidated and embarrassed to speak-up. They state that it is very demeaning for them to be completely naked while the scribe stares at them. When this happens, they feel violated and many vow to never come back for further exams. Some even report needing therapy for PTSD-like trauma! This disregard for a man’s emotional trauma results in him not following-up on possible life-threatening conditions (i.e. Melanoma) and that likely contributes to the shorter life span of men. Women are tired of losing their fathers, brothers, sons and husbands sooner than they should. This does not mean that male assistants have to be provided. If a female assistant is needed to take down physician’s notes, then she should be TAUGHT TO REPECT THE PATIENT’S DIGNITY BY TURNING AWAY during the genital/perianal portion of the exam. This should occur without the assistant having to be told by the doctor or the patient! The doctor can dictate his findings while she has her back turned. If an assistant is needed to perform a procedure (i.e. Biopsy) then the patient should be covered except for the lesion that needs to be biopsied.
The comfort of the patient is paramount, so much so, that Congress passed the “Patient’s Bill of Rights”, legally guaranteeing the patient’s Privacy and Dignity.
Men are saying that they are fed up with this type of disrespect and invasion of their privacy. They believe that many medical professionals, particularly nurses and assistants, are indifferent to male modesty and routinely dismiss men with bullying and shaming practices, unbeknownst to the physician. “We’ve seen it all!” is of no consolation to the man being exposed unnecessarily. Some are even considering litigation.
I hope you will be willing to make these minor changes to make it more comfortable for your male patients. I believe most men would greatly appreciate this consideration.
Most sincerely,
Current Male Patient
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