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Chaperone Use by Family Physicians During the Collection of a Pap Smear

¹ Department of Family Medicine, University of Michigan, Ann Arbor, Mich
² Department of Family Medicine, Medical University of South Carolina, Charleston, SC

CORRESPONDING AUTHOR Mack T. Ruffin IV, MD, MPH, Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI 48109-0708, mruffin{at}umich.edu

BACKGROUND We wanted to determine whether variations exist in use of a chaperone during the performance of a pelvic examination by family physicians.

METHODS A self-administered questionnaire was mailed to 5,000 randomly selected active members of the American Academy of Family Physicians.

RESULTS There were 3,551 survey responses (71% response rate) and 2,748 useable questionnaires. Most respondents (75.4%) reported routinely using a chaperone in the room during the collection of a Papanicolaou (Pap) smear. Significantly (P < .00001) more male physicians (84.1%) than female physicians (31.4%) reported using a chaperone. Physicians reporting routine use of a chaperone were significantly younger (P = .01) and did fewer Pap smears per month (P < .00001). Regional reporting of chaperone use varied significantly (P < .00001), with 71.6% reporting use in the Northeast, 89.0% in the South, 65.7% in the Midwest, and 72.4% in the West.

CONCLUSION Family physicians vary considerably in the reported use of a chaperone during the collection of a Pap smear. The variation could reflect different regional or local norms, efficiency or resource issues in high-volume clinical settings, or other interpersonal factors. These issues need to be explored in more depth.

Key Words: Cervical intraepithelial neoplasia • professional practice • vaginal smears

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