Attitudes of UK doctors to intimate examinations

Medical culture has portrayed intimate examinations as important in maintaining the sexual and reproductive health of patients. Intimate examinations have also been at the centre of high-profile scandals. Existing literature suggests there is considerable heterogeneity in the use of intimate examinations, as influenced by underlying attitudes. This study sought to ask how doctors make decisions to perform intimate examinations and negotiate the emotional aspects. In-depth interviews were conducted with 38 doctors of different grades and from different areas of clinical practice in the South East of England. Data were analysed thematically using NVivo 9, adopting a constructivist approach. Findings indicate that doctors' emotional constructions of intimate examinations coalesce around feelings of embarrassment, fear and anxiety, and vulnerability. Understandings of gender, sex and power also influence emotional constructions. Doctors utilise varying methods to negotiate emotions, some of which may be detrimental to patient care. These emotional constructions lead doctors to attribute values to intimate examinations and to chaperones that extend beyond responding to indications or following guidelines for examination. Doctors who resolve their own feelings of embarrassment, anxiety and vulnerability may be more likely to perform intimate examinations when indicated, to use chaperones appropriately and to offer the best standards of patient care.