Family, Internal Medicine, General Medical Questions/Clinical Touching

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Question
I was wondering who in medical training determines the way doctors are allowed to touch patients? I'm sure there are a number of correct ways to determine breast or testicular lumps, but where does that "clinical feel" come from whereby a patient feels it is minimally invasive, yet without assumingly losing affectiveness? Maybe a psychologist helps determine what is appropriate touch? I was just curious if there was training for that type of thing?

Answer
that is a good question.... there is an excellent section on this in the book "Better" by Atul Guwande.... I agree with his position that the correct ways are cultural and societal.... we tend to have chaperones when examining sensitive areas on patients of the opposite sex, but the big question is whether the chaperone is there to make the patient feel more comfortable  (I don't think so) or for the health care provider's protection against a patient making some type of allegation.

There are no set rules, some loose quidelines....

You would hope that there would be a professional repoire that minimizes the awkwardness in the situation, but even with repoire, some patients becomes very anxious.  

In our culture, it is not an absolute, but usually there will be  a chaperone and an attempt to minimize the time the patient has to disrobe and be examined......

Family, Internal Medicine, General Medical Questions

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Robert Borucki

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I am trained and boarded in Family Medicine and have also worked extensively in emergency medicine for over 10 years.

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