Bioethics Discussion Blog: Patient Modesty: Volume 53





Monday, February 25, 2013

Patient Modesty: Volume 53


The matter of how patients can get their physical modesty issues known, acknowledged and satisfied by the medical system seems to be a repetitive consideration on this blog thread and continues with no final conclusion. With regard to this issue, I thought to add to the conversation or perhaps even throwing in a "monkey wrench", so to speak, by putting up the graphic for this Volume which displays a known expression  thought to be a solution but then, on second thought, it might not be considered acceptable by some of my visitors. Instead they may say "we must change what we can get!" Ah! That will make the solution more complex. So what is the answer? Continue the discussion and maybe an answer will find consensus. ..Maurice.

p.s.- For those visitors who would like to access the recent conversation of my thread on this issue,
click on this link to Volume 52.

Graphic: Created by me with ArtRage and Picasa 3.



At Monday, February 25, 2013 3:52:00 PM, Anonymous Anonymous said...


I agree with you and your points are well taken
and certainly I hope press ganey will respond to my
request and visit this blogspot. I don't believe they will
but they should and if they don't, we will know the reason why. That reason I believe is that they just pay hospitals lip service. For our readers who are interested and want to know whom and what press ganey does do a google search "press ganey" or visit their site at this web at


At Tuesday, February 26, 2013 11:05:00 AM, Blogger Joel Sherman MD said...

We have published a new article, a book review of a highly unusual book concerning modesty concerns of hospitalized teenage girls.
Please take a look.

At Tuesday, February 26, 2013 11:29:00 AM, Blogger Doug Capra said...

We just posted a new article on our blog. I think you'll all find it quite interesting. The post is a review of a new book. "Hospital Gowns and Other Embarrassments by Michael W. Perry -- A Book Review by Doug Capra and Joel Sherman, M.D.

You can find it here:

At Wednesday, February 27, 2013 10:45:00 AM, Anonymous Anonymous said...

Here is a perfect example of what I have been talking
about. The Fem-Nazi instituting their own agenda
repeatedly, discriminating against male patients and
male healthcare workers. As I have said previously,
nurses don't write laws.

It is unlawful gender discrimination in employment
for a healthcare employer to have a hard and fast policy
saying that female patients automatically get only
female caregivers, while both males and females are
assigned to care for male patients.

This is exactly what happened at a facility in New
Jersey, the male caregiver sued and won.



At Friday, March 01, 2013 4:44:00 PM, Anonymous Anonymous said...

PT, This is the same website that I shared last blog and you would not open it. What am I missing?

At Friday, March 01, 2013 7:48:00 PM, Anonymous Anonymous said...


It is not the same website!


At Saturday, March 02, 2013 5:49:00 AM, Anonymous Anonymous said...

Regarding Belinda's article, what if a patient just doesn't like all opposite gender hospital workers because they are allowed to do what they do? I personally think any kind of patient "care" involving nudity and opposite gender workers is extremely unethical. Even if my care doesn't involve nudity I know that every female worker in the facility does unethical things to other male patients, very often without the consent or knowledge of the patient. Because of that I can't stand the sight of any of them. It makes me sick to think that the woman checking my blood pressure was earlier inserting a man's foley. Is that considered discrimination, refusing care from a woman who was in my opinion unethically abusing other patients?

At Saturday, March 02, 2013 12:35:00 PM, Anonymous Anonymous said...

PT, Here's the url for that article. It's from, just like yours.

At Saturday, March 02, 2013 12:43:00 PM, Anonymous Anonymous said...

Maurice, It occurred to me reading many of these postings and comments from you and other doctors that the medical community is lumping everything to do with the naked body as "modesty issues".

In order to confront this issue, abuse, sexual misconduct and cruel and degrading treatment must be taken out of the equation.

Once this has happened, the medical community can look at this issue from the viewpoint of a patient and decide this grey area of "cruel and degrading" treatment as the other two are unacceptable to everyone including the medical community.

Eliminating this element may be as simple of informing the patient ahead of time of what is expected.

Here's the main issue. Do you think that this would be an issue if patients were treated properly in the first place? I think not, coming from a place where I had none of these issues until I was treated in an horrible way.

As for previous victims of sexual assault or abuse a little talk could instill protocols that would make these patients happy. So simple and yet so difficult.

Finally, the medical community's refusal to acknowledge the problem is the biggest problem.

At Saturday, March 02, 2013 11:34:00 PM, Anonymous Anonymous said...

Belinda and others who may be interested, here is the link to a Canadian news site that is searching for personal stories of hospital experiences:

At Sunday, March 03, 2013 9:35:00 PM, Blogger Maurice Bernstein, M.D. said...

Belinda and others: Until proven otherwise (with unequivocal statistical evidence), I cannot imagine, of all the patient-healthcare provider interactions minute after minute, hour after hour, day after day and year after year within the United States as an example that sexual assault or even "cruel and degrading treatment" is any more than some extreme statistical outlier. Of course, one can say that these acts may be what has become the conclusion of the beholder ( the "victim") and that some objective analysis would find these conclusions to be unreasonable. If these events are, indeed shown to be routine, common and not outliers then I worry that my medical profession is in a sad, degraded state and whatever any clinical benefit exists with regard to treating disease that would appear to be overwhelmed by the harm to the patient. And I would be embarrassed to continue to participate in this profession. If my impression is statistically correct, I still would not ignore the outlier misbehavior or worse and encourage attention and prevention. ..Maurice.

At Monday, March 04, 2013 5:09:00 AM, Anonymous Anonymous said...

Maurice, It is well known that institutional abuse occurs in prisons, mental health facilities, prisons, and yes, in hospitals.

The reason that this information is not readily accessible is because the medical community has hidden it much like the Catholic Church.

The culture is to protect the guilty, fear of consequences to whistle blowers, and hide this behavior.

I will say, though, that cruel and degrading is in the eye of the beholder and while one might feel comfortable being stripped in the OR or ER, someone else would consider this cruel and degrading because of the audience of unnecessary others who often hang around.

Just the idea of patients having intimate things done to them without the respect of informing them, is enough.

So, while every episode doesn't have to have sexual abuse and deviance at it's core, from the eye of that patient, who is not informed and then suddenly loses their autonomy along with their clothes, is humiliated, feels degraded.

However, there are thousands of real reports of completely unacceptable activity. What do you say to the perceptions of those people? Would you trust strangers again in the same environment?

At Monday, March 04, 2013 9:00:00 AM, Blogger Maurice Bernstein, M.D. said...

And, Belinda, how about the other way around: "unacceptable and disruptive behavior" on the part of the patient. Again.. "in the eye of the beholder" and also a statistical outlier? Here are some forms, I found, which are suggested to send to the patient in event of this behavior.

My opinion is that most of all patients and most of all healthcare providers are attempting to work together to accomplish the needed goal. And with respect to the malignant outliers, whether patients or providers, don't ignore or accept them but deal with them in the most ethical and legal ways to join the behavior of the majority. Any argument about that? ..Maurice.

At Monday, March 04, 2013 3:51:00 PM, Anonymous Anonymous said...

Maurice, none from me. We all owe each other mutual respect, follow the rules most of the time.

However, medical workers may come home from work absolutely frustrated by abusive behavior from patients (we have all seen them) but because of the power differential in the medical setting, the damage from issues of violating someone's autonomy and dignity cause problems that were not deserved and may damage someone for life.

Additionally, if someone working in healthcare finds the atmosphere to be intolerable, they can get a new job in a different field. What do we do?

At Monday, March 04, 2013 5:34:00 PM, Anonymous Anonymous said...


I couldn't care less about blogs,articles and
points of interest regarding respectful care for female
patients. I mean after all, with 95% of all nurses being
female and other support staff, how could there be a
problem for you. Since we are on the subject of websites here is one I found, www.I-can'
This privacy healthcare thing, why are some
women complaining about this now, it apparently wasn't
a problem in 1970, when only 2 or 3 % of all nurses
were men, so why now? Nothing at all has changed
in the last 43 years. Still no males in L&D, no male
mammographers, no males in post-op gyn floors, the
vast majority of hospital directors are still female. One
thing has slowly changed and that is there is more an
abundance of CEO's who have nursing backgrounds
versus business people. That is again a positive for
female patients.
Recently, a male nurse sued and made an EEOC
complaint against a hospital that refused to hire him for
a position in the operating room. Their excuse, females
have always traditionally worked in that operating room,
and with all the negatives I read and continue to read
regarding negatives toward male patients, I fail to see
why women have concerns.
It's suggestive, there has always been descension on the other side when discrimination is at
it's greatest. I'm guessing this is a large part of the
problem or perhaps some women complain simply
because of a lack of attention directed toward them when in fact, no one is looking at them anyway.


At Tuesday, March 05, 2013 6:13:00 AM, Anonymous Anonymous said...

PT, I understand your concerns and agree that they are justified. The article I posted said that they cannot discriminate against men with regard to gender selection, had you chosen to read it. It supported you and your agenda but you were so bent on your refusal to read it that there is nothing else to be said on this issue. What I can't understand is why as it came from the same website as your article.

Your passion, concern, and validated arguments would serve you well to start an advocacy male website to support your agenda instead of tireless rants that just say the same thing over and over again.

PT, I'm not against you or anyone on this blog, just the opposite. However you are not a woman, you are not a woman who has been victimized with sexual intent and you have no right to say that my needs are any less important than yours; nor do you have the right to say that one gender's needs are more paramount. Women may have it easier when it comes to nurses, however, once you leave the hospital bed and need any type of test, procedure, or operation, we're all in the same boat.

At Tuesday, March 05, 2013 6:14:00 AM, Anonymous Anonymous said...

I think maybe the truth lies somewhere in the middle. I don't think that the majority of medical professionals are assaulting patients. But, I think things that make patients feel degraded may happen more often than many medical professionals think.
I've personally witnessed a male resident staring at a naked female patient who had requested that he not do so. He wasn't providing care, he just wanted to listen to what the attending was saying. It took quite an argument, until the attending noticed and removed him. And I had to cover up the patient. She did not have good experience there.
And his justification - as he was standing at her feet staring up her body "I'm a doctor, I've seen them before". Medical staff focus on how it feels to them, not how the patient feels. It's everyday to them, so it shouldn't be a problem.
As psych studies have proven, power corrupts, absolute power corrupts absolutely. In the case of a hospitalized patient, medical staff has a lot of power. I have personally never seen such a problem with attending physicians, it's been residents and nurses.
I think the smaller things occur more often than many may think.

At Tuesday, March 05, 2013 8:50:00 AM, Anonymous Anonymous said...


Why do female patients recieve substantially
more privacy and respectful care? Why are most facilities
geared to the needs of female patients in terms of staffing.

Women have this notion that they are celebrities,property,real estate and traded like a commodity on the stock exchange and/or something special, I tend to disagree. All men are created equal and thus this paradigm that has worked for you is shall I say starting to crumble.

There is a movement to start drafting women,
and I should be thanked for this since for the last several years I have been a proponent for this, writing
to several congressmen. Since 1970, the number of
males in nursing have tripled, marriages are at an all
time low. I personally am tired of these special
privileges people get in healthcare.

Female nurses are not the sharpest set of
pencils in the box and for the most part they have been
derelict in their responsibilities to provide privacy to
ALL patients. To be an advocate for all patients they are
not. It was they who insured only female mammographers, exclusive females in L&D, and post-op gyn. All one needs to do is look at the logistics of
any facility to see this.
Furthermore, playing the sexual victim carries no
clout with me. State nursing board disciplinary records
show many females reprimanded for sexual assault on
male patients, they hold the record among the genders
on boundary violations.


At Thursday, March 07, 2013 4:23:00 AM, Anonymous Anonymous said...

Tam's experience is probably very common, but I wondor what would have been done if it was a female resident and a male patient. Probably nothing, or the male patient might have been called a sissy and ridiculed.

At Thursday, March 07, 2013 4:34:00 AM, Anonymous Anonymous said...

I think this question is relevant to the blog. When a patient is given a conscious sedative such as Versed does it effect how a person thinks? If a patient is determined not to allow the opposite gender to see them undressed Versed won't change that, will it? From what I understand, you are often awake during the procedure but you later forget what happened. To me that just seems like it benefits the medical staff and not the patient.

Should I be able to trust my actions when under the influence of Versed and not worry about allowing something to happen that I ordinarily wouldn't allow? L

At Thursday, March 07, 2013 7:11:00 AM, Anonymous Anonymous said...

There is a new article on Kevin MD about students (both college and high school) shadowing doctors, basically to get exposure to the medical field as a possible career. Although the author questions it's value and ethical nature to patients, it's interesting to note some of the comments justifying the practice even without proper consent from the patient. In other words, it's more important for the "education" of the shadower than the patient's comfort or acceptance. Some of you here may be interested in reading it and possibly commenting. Maybe we can move this discussion to a new area as it seems to be stuck. I feel like the redundancy of the last volume or so has turned off some readers and limited the conversation and audience.

At Thursday, March 07, 2013 10:26:00 AM, Anonymous Anonymous said...

Sounds like "StayingFit" has never been a victim of abuse. Try lowering your nose and noting what other people have gone through before condemning them from your soapbox.

At Thursday, March 07, 2013 1:52:00 PM, Anonymous StayingFit said...

@Anon Regarding your post from March 07, at 10:26 AM. Perhaps I should, and perhaps I should not. It's really hard to know, given that you didn't bother to include a reference to the comment of mine that seems to have disturbed you so.

If you would care to rectify that, I would be happy to respond.

At Friday, March 08, 2013 8:44:00 PM, Blogger Maurice Bernstein, M.D. said...

Anonymous wrote the following comment today to Patient Modesty Volume 28 which, of course, has long been closed for further comments. ..Maurice.

Am I the only one that finds it offensive to hear a female nurse, female ultrasound tech,or any female in the medical profession tell a male patient "ITS NO BIG DEAL WE SEE IT ALL THE TIME" SO I ASK HER IF SHE WOULD LET A MALE DO A TRANSVAGINAL U/S ON HER, SHE TURNED RED AND SAID NO. They make every effort to make sure no male nurse or male ultrasound tech, ever is left alone with a female patient or even allowed to tend to a female patient. I recently was scheduled for an scrotal ultrasound so I called ahead to make sure that a male tech would do the procedure, only to be told "we dont even hire males as sonagraphers". I cancled my appointment and have been looking for a male tech to do the procedure. The condecending attitude of these people really upset me. When will the humilation and double standard for men stop?

At Saturday, March 09, 2013 3:26:00 AM, Anonymous Anonymous said...

Couldn't have said it better myself anon from 8:44:00 PM.

The only Gastroenterology clinic in my town actually has one male nurse to assist with procedures if you make arrangements ahead of time but no male equipment technicians. That means either traveling or dying from health problems. Naturally nobody there wants to talk about it. L

At Monday, March 11, 2013 3:19:00 PM, Blogger Maurice Bernstein, M.D. said...

Just to let my visitors know that the Care2 petitionsite request which I started a while back to advocate the patient modesty issues described here, garnered only 49 signatures and the issue is now officially closed.

I had hoped some of my visitors here would start their own advocacy argument there or elsewhere perhaps expressing a bit more fervor then I did but I guess it hasn't happened yet. But why not??? ..Maurice.

At Tuesday, March 12, 2013 6:58:00 PM, Anonymous Anonymous said...

I believe Misty has started a site and from what I have seen has done a lot of work with it. I personally am impressed. And then there are all the things we are doing individually That may not show up here but start chipping away. I have a medical scholarship that targets males in nursing, I also funded putting books in elementary schools called "My Daddy the Nurse", maybe not a game changer but progress

At Tuesday, March 12, 2013 7:31:00 PM, Blogger Maurice Bernstein, M.D. said...

Anonymous (from today), WOW! That's great! These actions, even beginning on a limited scale, meet my criteria for the needed advocacy behavior. I think what you write about is much better, I think, than just moaning and groaning about the issues on blogs like mine.

Anonymous, I wonder if you can identify yourself with some pseudonym. Furthering my "wondering" is whether advocacy of issues might be enhanced by going beyond pseudonyms but by the advocate identifying themselves with their own real name. It would add a degree of openness for others interpreting the issue, demonstrating that the proposer is not trying to hide anything and will give the proposer's view more clout. As you all have seen here, it has only been myself, Doug Capra and Dr. Joel Sherman MD who have been open in this regard. (I apologize, if I missed another visitor.) I am not asking nor do I approve, in general, regarding naming names of others in the postings without their permission particularly when discussing personal matters. I just mean te identification of those expressing some advocacy view. (We have never commented here previously about this matter but I think it is an important aspect of making advocacy effective.) What do you think? ..Maurice.

At Tuesday, March 12, 2013 9:23:00 PM, Anonymous Anonymous said...

Maurice.I agree with people using their real name instead of some cute,made up name.It has more credibility.These last few volumes have been nothing more that which gender has it worse.We all should be working together to bring change.Fighting amoung ourselves does nothing to bring about change.You need to give idea's to the new visitor's on what to expect and how to bring about change for ALL.I REPEAT.ALL.It can't be about only one gender.It needs to be about both.You need to inform the new visitor's to call ahead and ask if they can accommodate.If they say no,you need to tell them your sorry you won't be using them for your health care and tell them why.If you can't find help on this blog where will people find help.Most people i know say what are you going to do ? It's up to us to tell them where and what to do. Thanks to all who try. AL

At Tuesday, March 12, 2013 9:44:00 PM, Blogger Maurice Bernstein, M.D. said...

You know, I am looking forward for some visitor here or elsewhere end up on the cover of Time Magazine as Sheryl Sandberg has in the current issue (March 18 2013) championing her advocacy to change the attitudes of women who work outside the home so that they can attain higher positions and the pay they deserve. How about getting one of our visitors up on the Time cover advocating not just about women but about equal patient-determined gender selection of healthcare providers regardless of the patient' gender? ..Maurice.

(p.s.- to accomplish that feat of reaching a Time cover, you probably will need to identify yourself by using your real name. Huh?)

At Wednesday, March 13, 2013 12:01:00 PM, Blogger Doug Capra said...

I think we also need to understand how this "modesty" issue fits into the bigger picture, which is:
1. Why is healthcare so expensive in this country? Of course, the answer is that we've developed a system whose main goal is neither making people more healthy nor caring for them. The main goal is making money. It's the Medical Industrial Complex made up of the drug companies, the insurance companies, the manufacturers of medical equipment and a significant number of doctors themselves. Systemically, it's all about making money. That is not to say that doctors, nurses and other caregivers don't care -- but they're caught up in this huge, power, money-making system.
2. What does this mean in terms of the modesty issue? Among other things it means that money talks. There's much competition and it's getting even more fierce. So -- if you're not getting the services you need, let them know. Go somewhere else. If you're insured, let the company know they're not getting their money's worth, and you're not satisfied with the care. As someone said above, if you can't get the gender care you need, let the providers know that they won't get your money because of that and you'll go somewhere else.
Having said all that -- I am not against same gender intimate care as some on this blog are. For me, it's about being treated with respect and dignity -- and about full disclosure, full informed consent. If I'm not fully informed as to what will happen and who will do it -- I consider that poor communication that verges on lack of respect. But, patients need to make clear what their expectations are. And they need to work with, negotiate with, and cooperate with their caregivers within that context. Doctors and nurses are not your enemies. Most are caring individuals caught up in a broken system who most often want to the best for you but often are blocked by many situations beyond your control. How can those situations be changed?
Money talks. Follow the money. And take your money where you will get what you consider respectful and dignified treatment.

At Thursday, March 14, 2013 5:08:00 AM, Anonymous Anonymous said...

I'm new here and hope it's acceptable to comment on my recent experiences in radiation therapy for breast cancer. I agree with comments that dignity and respect are important issues in healthcare and patients need to seek the care they feel they deserve.

I might prefer female caregivers but I actually have had better luck with many male nurses and techs since getting cancer.

I have changed radiation centers for follow up care. This is because the one which treated me didn't respect my needs.

1. Some of the techs refused to cover the untreated breast during treatment. One female tech in particular repeadedly yelled at me saying that I shouldn't be bothered by being uncovered since only professionals were viewing my face and breast pictures.

2. This center did not have a closed off room for monitoring patients. Pictures and patient information were transmitted into a wide area of a hallway where I sometimes saw non-medical people milling around and "shooting the bull" with the techs. The only impediment to viewing was a portable sign saying that passerbys should not look at the computer monitors.

3. The dressing cubicles were coed and some of the patients forgot to lock them when they changed which meant I accidentally looked in on a man pulling down his pants.

4. The inner waiting room was also coed which meant that I often saw men's backs and butt cracks.

5. Everyone was forced to wear hospital gowns in the hallways while going to and from visits with the nurse, doctor, social worker and nutritionist. I was mocked for bringing my own robe. I have large breasts and was embarrassed that the thin fabric showed everything. During my simulations, practice appointments and treatments I saw one person with two gowns for more coverage but I was never offered this option.

6. One reason for my embarrassment was that during the first simulation attempt the techs injured me causing a huge blood blister and bruise next to the nipple. This left a permanent blob which looks a little like a second nipple. It might seem silly but having everyone look at this slight deformity is humiliating to me.

7. During the second simulation since the first one was botched, the doctor came in with a tech and they were laughing at women who had to wear breast immobilization contraptions like the one that injured my nipple. The joke was that Madona should wear one since it was clear plastic with a cutout for the bare areola to protrude. This kind of talk would not have bothered me if I hadn't been injured by one of these "lascivious" devices.

Thank you for a chance to write this. It's helped me even if you decide you need to delete it from your site. Keep up the good work.


At Thursday, March 14, 2013 5:46:00 AM, Anonymous Anonymous said...

Well said Doug. However I do wonder about the competition thing: I have been reading lately that with the new health care law and with so many more insured people possibly seeking care many are predicting a shortage of doctors, especially primary care ones. This often seems puzzling to me since where I live there is constantly new hospitals, clinics, 24 hour emergency clinics, etc. being built and opened. There is also an increasing amount of advertisement (billboards, television, newspapers, internet, etc.) for individual doctors and hospitals (call us, we have appointments available). These things lead me to believe that there is, indeed, competiton for business but that is a disconnect from the other forebodings of doctor shortages. If some of the predictions about these shortages with longer waiting times and difficulties getting appointments turn out to be true I think that would not bode well for those of us with modesty concerns: it would just boil down to getting in to see someone and being grateful that you got that appointment. In other words, take what you can get and be glad about it. But if there is indeed more competiton for the patient dollar that would help those with modesty concerns find and/or negotiate for the care they want. In other words, money is the ultimate trump card. Jean

At Thursday, March 14, 2013 7:44:00 AM, Anonymous Anonymous said...

Cheryl, I'm sorry you had to go through such indignities. You don't have to wear anything that you don't want as long as it doesn't interfere with your treatment.

You could come in with a shirt that opens down the front using velcro, and wearing a bra with plastic front closures so that in a matter of seconds you could be ready for your radiation treatment.

I never wear a hospital gown even for colonoscopy, endoscopy, CT scan or mammography. If they try to force you, tell them you'll go elsewhere. I have never had a problem and have just said no.

It's important that you are as comfortable as possible going through a difficult time.

Hope this helps

At Thursday, March 14, 2013 3:33:00 PM, Blogger Doug Capra said...

Competition and doctor shortages are a regional issue. Lack of competition and shortages are more typical in rural areas. The real talk of shortages is in terms of the future with more people having access.
As it is today in most urban areas there is tremendous competition, not only among hospitals, but also among private clinics and practitioners. If you live in a rural area with little competition, but close to a city -- do some research and see what's available. Savvy rural clinics realize their competition may be only an hour or two drive away in a big city -- so they may be willing, if they have the staff, to make accommodations. Both rural and urban areas know that sometimes it may be cheaper for locals to just hop on a plane and fly to another state or even country. The capitalist nature of health care in our society has driven up the cost of health care -- but it has also created more competition for that money. Generally, it really has become a buyers market in many areas.
But it's not just a matter of going somewhere else. One should also let them know you're going somewhere else and why. And the "them" is those looking out for the financial end of the clinic of hospital. And the PR people. Individual patients often have much more power than they think they have.

At Thursday, March 14, 2013 3:35:00 PM, Blogger Doug Capra said...

I suggest you copy what you've written here and send it to the CEO of the hospital, and to the hospital's Board of Directors, each member -- and to the Joint Commission. They all need to understand that this kind of behavior will neither be ignored nor tolerated.

At Saturday, March 16, 2013 7:28:00 PM, Blogger Maurice Bernstein, M.D. said...

In case I haven't published it here previously, here is the American Medical Association's Code of Medical Ethics with regard to chaperones during a physical exam of a patient. By the way, I couldn't find in the Code anything about gender selection of healthcare providers in general. ..Maurice.

Opinion 8.21 - Use of Chaperones During Physical Exams

From the standpoint of ethics and prudence, the protocol of having chaperones available on a consistent basis for patient examinations is recommended. Physicians aim to respect the patient’s dignity and to make a positive effort to secure a comfortable and considerate atmosphere for the patient; such actions include the provision of appropriate gowns, private facilities for undressing, sensitive use of draping, and clear explanations on various components of the physical examination. A policy that patients are free to make a request for a chaperone should be established in each health care setting. This policy should be communicated to patients, either by means of a well-displayed notice or preferably through a conversation initiated by the intake nurse or the physician. The request by a patient to have a chaperone should be honored.

An authorized health professional should serve as a chaperone whenever possible. In their practices, physicians should establish clear expectations about respecting patient privacy and confidentiality to which chaperones must adhere. If a chaperone is to be provided, a separate opportunity for private conversation between the patient and the physician should be allowed. The physician should keep inquiries and history-taking, especially those of a sensitive nature, to a minimum during the course of the chaperoned examination. (I, IV)

Issued December 1998 based on the report "Use of Chaperones During Physical Exams,"

At Saturday, March 16, 2013 7:35:00 PM, Anonymous Anonymous said...

Sorry, I usually use my middle name, Alan, to post. My given name is Don Good and I posted the efforts on scholarships for males in nursing and putting My Daddy the Nurse in schools. I think there is a lot that can be done by individuals. I do still have hopes for a larger, co-ordinated effort but quite frankly just do not have the time. I have been blessed with a certain amount of success in business which allows me to finance certain intatives. I just connected with an organization called AHEC, they are an agency that works with education in medical careers. By providing rather modest contributions to them I can lever what they already have in place to target my portion to males in nursing etc. There are ways we can accomplish things if we try. From as simple as calling your local hospital to find out if they can provide same gender and then writing a letter to the CEO and paticularly the Board of Directors telling them you would like to patronize them forming an advocate group. While this thread was the motivator, letting it end here is a waste of energy. You can accept what is, you can morn what isn't, or you can do something,,anything and change at least that. Dr. Sherman had a guy named Art Stump who wrote about a hospital in my area who let a HS girl observe his treatment for prostate cancer. I checked, guess what, they now offer same gender for the proceedure, I am no longer in the shadows, I no longer feel the need to, Don

At Saturday, March 16, 2013 7:56:00 PM, Blogger Maurice Bernstein, M.D. said...

Don, again, congratulations for your efforts toward advocacy and even more accomplishments than just "speaking" and also for coming out from anonymity. ..Maurice.

At Sunday, March 17, 2013 5:52:00 AM, Anonymous Anonymous said...

Don, thanks for the update and congrats on using your real name as I.

Maurice, medical modesty ethics are great and we all wouldn't be here if they were followed. They are not and violations are not only abundant but unreasonable, ridiculous and a violation of patient rights. So it's great to write what should be and quite another to practice it.

Patients come in for surgery the same day. Long gone is the overnight stay where patients are prepped in private and knocked out before draping begins.

Salesman for equipment are sometimes present as well as cleaning personnel, etc. The patient is not informed that they will be completely uncovered while prepping takes place for most surgeries. How is this dignified care when you are subjected to a public stripping in front of everyone? Wouldn't it be nice to tell the patient what's going to happen to them. This is standard of practice not an isolated incident.

It is not uncommon to ask for same gender care for a procedure. They accommodate making the nurses, doctor same gender and then send in a male tech. It boggles my mind the amount of stupidity from otherwise intelligent individuals not to understand that dignity, autonomy are the foundation of all that is human and what happens when that is violated.

At Sunday, March 17, 2013 10:17:00 AM, Anonymous Anonymous said...

Good Afternoon,
I need some advice from the group. My husband is going to have some shoulder surgery in the near future and we will be requesting that his shorts and underwear remain on throughout as the OR field is nowhere near the "nether regions"! Short of my being present for the entire procedure, is there some way to guarentee that our wishes will be respected and that no over zealous OR nurse or tech will take it upon themselves to thwart our request? We plan on telling the doctor and the pre-admin staff as well as writing our request on the OR consent forms, but I still have a sneaky suspicion that once he gets to the prep area, our requests may go right out the window and the underthings will be removed under the guise of "we have to for patient safety"--which we all know is BS. So what can we do to ensure that doesn't happen? If he doesn't have any general anesthesia then he can continue to advocate for himself. But if he has even light GA, he'll be at the mercy of the OR staff.
What more can we do? I guess if the our only option is for me to be there throughout, then I guess that's how it will be and if they don't like it, off the table he goes to find some place more amenable. I don't want to come across as being adversarial, but I also want our wishes respected.
Thanks for any input you can provide.

At Sunday, March 17, 2013 2:38:00 PM, Anonymous Anonymous said...


Send your doctor the letter. Have him acknowledge receipt by initialing, bringing an extra signed copy with you on the day of surgery. Write in the letter that by initialing your copy, the doctor understands and agrees with your request and that your consent is revoked if your request isn't agreed to.

Next...bring that letter that your doctor signed to the hospital the day of the procedure and when you sign the request forms, add that you agree only if underwear stays on. Have the nurse print her name and initial same to make this part of the consent. You should intial where you wrote as well. Printing of the nurses full name is essential so that if legal action were to ensue you know who she is. Name and position.

Then, if your husband awakens without his underwear, you have a lawsuit. You could have him put them on with a little superglue so that if an attempt is made to remove them, you will know it.

You never know if they remove them and put them back on but that seems a little ridiculous. It would probably be that an unknowing part of the staff might remove them because that's part of the standard procedure. Good luck!

They probably will not let you attend the procedure but you might be able to hire a private duty who is on staff at the hospital to act as a personal advocate as well.

At Monday, March 18, 2013 10:07:00 AM, Anonymous Anonymous said...

Thanks for the input Belinda. I am definitely going to get everything in wriitng, initialed and verified!
I might be allowed to attend the procedure as I am a nurse (not on staff) but could approach it from the standpoint of an interesting learning experience. We'll see what happens.
I also told my husband that duct taping his clothing on was another option (super glue just doesn't seem to work very well any more!!). He seemed amenable to that.
Thanks again.

At Monday, March 18, 2013 7:37:00 PM, Anonymous PJL said...

I was thinking the same as Chris, if I was your husband, I would want you to watch the surgery from the scrub room window.
In 2009, I was having severe groin pain; I figured I sat down way to fast, as working in the hospital is fast paced. I checked my parts & found lumps on both sides. I rushed to my PCP, & he ordered STAT ultrasounds. I had to fight for a male tech, they told me they don’t have any male techs, & that I must get over it & allow a female tech to do the test. I told them I would die first. They played games with me, telling me that I had an appointment with a male tech, all the way across town during the rush hour. I drove out there, paid the co-pay, & everyone was nice, & then they said “She will be out in a moment for your test” & immediately I asked “She will take me to the male tech that was promised?” They said “NO, she is doing your test.” I told them “hell no” so they tried to get me to consent, saying how I was already there etc…. They refunded my co-pay, & eventually I got a male tech, when I went in for the test I told him all the BS I was put through… He told me that he didn’t work for the company, & that he was a contractor, & there every Friday, at the location closest to my home as well!
My urologist, a very kind & caring doctor, said the removal of the cysts is the next step to cure the pain. He told me that when/ if I chose to go ahead with the surgery, I would have to go to my PCP to clear me for surgery. Due to work vacation & medical leave rules, I scheduled surgery 6 months out. I did the pre-op with my PCP, was cleared to go. On the next visit to my urologist, I brought a list of questions so I would have all my concerns addressed before the day of surgery. The only two points that were to be covered, was no cath, & he agreed to the no-cath. The other was harder for him to answer, the question obviously was an all-MALE team, he said since it was scheduled so far out that it should be no problem just let all the surgery schedulers for his office, & the schedulers for the facility to know so they can plan for it. I did this every time I had to call them & when they all called me during the 6 months. Everyone agreed.

At Monday, March 18, 2013 7:39:00 PM, Anonymous PJL said...

The day of surgery I had been called back to a mean nasty female nurse, then when I asked for my nurse, she said she was my nurse; I stated I was promised an all-male nurse team. This set her off, YELLING at me that any female nurse is better than any male, & that I would just have to deal with the female nurse that was in charge. This nurse thought the charge nurse would yell or degrade me, she didn’t, she apologized for the mix up & that she only learned of the male only team the Friday before surgery (surgery was on a Monday) & had no time to get replacement male nurses, since all the male nurses were on vacation. (I think it was BS but since she was nice I overlooked it) I was ready to cancel the surgery, in hindsight I should have canceled it, but stupidly I agreed to have a male nurse in the OR, (she switched the one male nurse from another operation) & female post-op, I stupidly agreed under the condition that I would be covered at all times. I got through surgery, & when I was with my post-op nurse, she tried to lift the blankets to place an ice pack; I instinctively hit the blanket down with my arm, & said no. The doctor came over to place it, and told the nurse to keep me covered & if she needed to do something there to call him over to do it.
3+Years post-op still have the same pain just worse, & I have needle like stabbing pain on the incision line. And I still have severe nightmares of the surgery, three or more nights a week, I wake up panicked…
Chris, for your husband, please watch from the scrub room, it would put to rest the “not knowing” part for him, IF I knew it was an option, I would have had my brother watch from the scrub room, & I probably wouldn’t have all the nightmares years after the surgery.
(My brother is my advance directive proxy, since he knows how to tell off any doctor)

At Tuesday, March 19, 2013 4:58:00 AM, Anonymous Anonymous said...

Maurice, these experiences where people are promised their same gender care and than a big switch occurs. It has happened to me multiple times.

All the medical community ends up doing is creating more distrust, anxiety, and another unpleasant visit for the patient. How do you this bodes for future visits? It doesn't.

Please address this issue and assume that this does happen to tell us why is it so difficult and why is the medical community, resistant, angry instead of telling us that you've never seen this in practice.

At Wednesday, March 20, 2013 4:40:00 AM, Anonymous Anonymous said...

Way to go PJL!!!

Chris, I've had it happen both ways with me. For two knee surgeries I was told beforehand to wear comfortable shorts. As far as I know nothing was removed.

For an adenoid extraction I was told to take everything off. I refused and prepared to cancel the surgery when the nurse returned and promised me I could wear scrub pants. I later learned that she had lied and I was stripped completely after I was unconscious and redressed afterwards. For a simple elective adenoid extraction! I've never trusted anyone in healthcare ever since. Watch out because promises mean nothing to many of them.


At Thursday, March 21, 2013 7:53:00 AM, Anonymous Anonymous said...

My husband's shoulder surgery is still upcoming and we haven't spoken to the MD or surgical center yet (but we absolutely will!); but I'm just curious how a few of you accomplished protecting your modesty in the OR. One person mentioned "marking their underwear"---how so? Another person mentioned using athletic tape to secure the undergarments--again, how so? I'm just trying to amass various ideas in case the OR staff can't be trusted to comply with my husband's wishes and we have to thwart their attempts at subversion.
Thanks again.

At Thursday, March 21, 2013 4:34:00 PM, Anonymous Anonymous said...

Chris.Be prepared for alot of attitude from everyone.Dig in your heels and always have a plan B.If they use the phrase we'll try,or were not sure, that's the same as telling you it's not going to happen.Long time readers of this blog will remember me as the guy who dismissed his wifes doctor and hospital,to seek urology care from a female at a different hospital.The next day she returned to continue chemo , but you could tell they were not happy about it.After that on the board by the nurses station they had the symbol for male in red and everyone else was in blue.Later they did a spinal tap and the male doctor in charge brought in two females to prep and do the tap.He told them to get her ready and excused himself while she was exposed.He told me to come and get him when they were ready.I did and on the way back , he told me his wife prefers female also.I think alot of people in the medical field have selective hearing.They hear only what they want.Be prepared to leave and seek care someplace else.Only when they realize you mean business will they actually listen to you.Good luck. al

At Sunday, March 24, 2013 1:09:00 PM, Blogger Hexanchus said...


General anesthesia or sedation is not needed for most, if any shoulder surgeries. There are other options.

I had a fairly complex surgery on my shoulder several years ago with only a local anesthetic - didn't even have an IV.

There are other options such as regional blocks (brachial plexus nerve block) that can also be used. There is no need for sedation unless that is what your husband would prefer.

You need to talk to both the surgeon and anesthesiologist and insist on what you want. Make any consent specific and conditional upon your preferences being honored.

If they are using electro-surgical tools, there bill be a bovie grounding pad attached. It is usually located over a large well vasculated muscle, typically the thigh, but upper arm is another option. If they prefer the thigh there is no reason he still can't wear shorts - been there, done that.

At Wednesday, March 27, 2013 6:21:00 AM, Anonymous Anonymous said...

What legally constitutes rape? Does sexual intercourse have to happen, or can fondling genitals against someone's expressed will be considered rape?

This isn't just a general legal question, it involves medical care.


At Wednesday, March 27, 2013 8:19:00 AM, Blogger Maurice Bernstein, M.D. said...

X, Pursuant to 42 USCS § 15609 [Title 42. The Public Health and Welfare; Chapter 147. Prison Rape Elimination], the term "sexual fondling" means the touching of the private body parts of another person (including the genitalia, anus, groin, breast, inner thigh, or buttocks) for the purpose of sexual gratification. Rather than considering rape, simply touching without "fondling" of any part of the patient's body without the patient's consent could be legally considered as the act of battery. No doctor or nurse or other medical provider or even medical student should touch a patient without the patient's consent. ..Maurice.

At Friday, March 29, 2013 7:36:00 AM, Blogger Maurice Bernstein, M.D. said...

I just wanted to let my visitors to this Patient Modesty thread to know that I just created a new thread that seems pertinent to the issue of the personal, individual autonomous right to gender selection as discussed here. The thread is titled "Same-Sex Marriage: Is It Ethical?"
I would like to read your comments about that issue but go to the thread itself to write. ..Maurice.

At Friday, March 29, 2013 1:24:00 PM, Anonymous Anonymous said...

Trisha Torrey does a blog on medical advocacy. Sometime back she made a comment along the line that men just need to suck it up and deal with the violation of modesty for medical care. It touched off a storm of responses that took her by surprise. She just posted another article about it. The thing I found interesting and as stated in the past I feel is at the root of the issue was a nurse's post. She started out by saying something like "Bottom line gender should not matter", but then went on to qualify it that while she admitted if she needed a procedure where she worked she preferred same gender but that was different becasue of the social/work line. She went on to explain she is a trained professional and if someone expresses concern she will acknowledge their concerns, assure them she is a professional, and do what she can. To me that is the biggest problem here, providers want to define what is right for the patient from their poiint of vew, not from the patients...until they are the patient. She obviously did not see the hypocracy in feeling she deserved same gender for her paticular view of modesty, but patients should be fine with what she (the provider) feels she should offer to accomodate She fails to see their concern, regardless of where comes from or why it is there is just as valid as her co-worker based concern. When someone posts that sentiment it is obviousl they don't see what is clear to the rest of us as being a double standard or they would not post it. I have seen this scenerio numerous times and believe it to be more widespread than a anomally. Don

At Saturday, March 30, 2013 8:17:00 AM, Anonymous Anonymous said...

I recently went to a large orthopedic practice in my area for the treatment of a shoulder injury. I looked at their website and I noticed that of nineteen physician's assistants, eleven were male. So even though the majority of exams they perform do not require intimate exposure, if that should be the case one would presumably have no difficulty in requesting a male PA to assist a physician if necessary.
Out of curiosity, I checked the websites of the two largest urological groups in the area and they employ a total of seven PA's, all of whom are women! If the orthopedic practice can manage to hire so many males, why can't the urologists hire at least one per practice? Are males just not interested in the field? Do male urologists simply not put in the extra effort to locate and hire male nurses and PA's? I would be interested in any insights readers of this site may have. I'm sure most would agree that if any field desperately needs male nurses and PA's, it is urology.

At Monday, April 01, 2013 5:35:00 AM, Anonymous Anonymous said...

I found a quote that many here may find useful or pertinent to the concerns here. "Change happens by listening and then starting a dialogue with the people who are doing something you don't believe is right." (Jane Goodall) I think that is a very useful way of approaching the medical modesty issue (if only there were more people willing to do it!).
Don: Can you provide a link to the latest Trish Torrey comments you referred to? Jean

At Monday, April 01, 2013 10:37:00 AM, Blogger Doug Capra said...

Dr. Sherman and I have posted a new article on our blog "Inappropriate Touching in the Doctor’s Office:
How Good Intentions Turn into Bad Actions by Peter A. Ubel, M.D. Among other issues, this article concerns informed consent, a topic about which Dr. Ubel often writes. You can find the article here:

At Tuesday, April 02, 2013 6:41:00 PM, Anonymous Anonymous said...

Jean I am sorry I am e-paired but if you google trisha torrey flipant remarks, it will bring the thread up. There is an interesting thread going on allnurses. The title is somehthing like I don't want a male nurse caption. It is a cartoon and responses about patient not wanting male nurses, couple of thoughts, they are a lot more understanding of patients not wanting male nurses and a lot less aggressive toward those expressing those thoughts. When it is about gender in general or female nurses the responses tend to take it personal and throught the nurse is a nurse etc out there with feeling. Don

At Friday, April 05, 2013 8:37:00 AM, Anonymous Anonymous said...

I just watched a disturbing episode of the show "House". I know it's just a fictional TV drama but I can imagine it happening in real life in the United States. There were 4 interns (or whatever they're called), 2 men and 2 women. There were only two positions available so two had to be fired. House decided to fire the two women but the hospital administrator (a woman) stepped in and wouldn't let him. At least one woman had to be hired.

Apparently choosing the two best doctors was out of the question. I wonder how true-to-life that is, and what would have happened if he chose to fire the two men? It's not like they were OBGYNs. That would be understandable.

Considering that most of those that do the hiring are women, men don't seem to have much of a chance, no matter how good they are. There doesn't appear to be a rule like that in the nursing world, or nearly every male nurse that applied would get the job.


At Saturday, April 06, 2013 12:02:00 PM, Anonymous Medical Patient Modesty said...

Medical Patient Modesty recently published two new articles about hysterectomy.

Concerns About Modesty During Hysterectomy

Why Are Hysterectomies Often Unnecessary?

We also have a video about why breast and genital exams are unnecessary for sports physical exams.


At Monday, April 08, 2013 8:23:00 AM, Blogger Maurice Bernstein, M.D. said...

Do you text and drive? I have a new thread on the ethics of that subject and you are invited to make some comments there. ..Maurice.

At Monday, April 08, 2013 8:54:00 PM, Anonymous Anonymous said...

This was said some time ago but when I came across it again, thought you might find it interesting that someone acknowledges that patients are not always treated with dignity and respect.


At Monday, April 08, 2013 9:28:00 PM, Blogger Maurice Bernstein, M.D. said...

Belinda, nonsense from politicians. Nothing that goes on in hospitals could be said to meet the behavior of those treating the prisoners in U.S. detention facilities (prison facility behavior descriptions based on published government documents. behavior see the Joint Commission surveys. It's one thing to stick a needle into a human as a form of torture to obtain secrets from the human for the govenment's benefit compared with sticking a needle into a human to administer a disease treatment for the human's benefit. ..Maurice.

At Tuesday, April 09, 2013 1:39:00 PM, Anonymous Anonymous said...

Maurice, I get your point but things do go on in hospitals that are cruel and degrading without any medical necessity what so ever. There are deviants and sadists who work in hospitals. The hospital employee population is a microcosm of society at large. While some may say these instances are rare, when you're the patient it's everything to you.

When it happen to you, you are dumbfounded, outraged and years later still can't believe that not only were you treated badly, but that the medical community did everything they could to invalidate the experience. Not only unethical, but harmful to the mental health of those who were victimized.

At Tuesday, April 09, 2013 2:40:00 PM, Anonymous Anonymous said...

I browsed through a number of pages of this blog with interest. I am a registered nurse of almost 25 years. I am a man and my clinical specialty was OB/GYN until I moved into quality improvement and executive management positions in 2004. My clinical experience was primarily in the Labor & Delivery area. I had less than 5 patients in all the years I worked labor & delivery who refused to have me care for them. In all cases the patient’s who preferred to not have me care for them had a history of sexual abuse perpetrated upon them by a male. Other patients confided in me after I had cared for them that when they first met me, and saw that I was a man, that they were somewhat hesitant to have me care for them; however, they stated that once they got to know me any concerns they had went away. I believe that a caregiver’s professionalism and demeanor is what patients evaluate to determine whether they consider the caregiver is competent.
As a patient myself I have had both male and female physicians. I have had physical exams by both, and each performed an exam of my genitalia for tumors and inguinal hernia. I was equally uncomfortable with that portion of the physical exam. My discomfort was mild as I tend to be comfortable with nudity in most situations.
I do find it interesting that male nurses are often prohibited from caring for women when the care may require evaluation of the breast of vaginal region, yet women routinely care for men and manipulate their genitals without a second thought.

At Tuesday, April 09, 2013 3:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Anonymous from 2:40pm today, I bet your experience of women accepting you, a male, as their nurse in OB/GYN is not at all some sort of statistical outlier despite what conclusions are written on this blog thread regarding gender selection.

I also think that many of the complaints suggesting widespread sexuality attention and actual sexual misbehavior by doctors or nursing staffs is unrealistic. What the patient suspects as sexual behavior by the healthcare providers is very likely an interpretation based in the "eye of the beholder". And, if that "eye" has seen and experienced, in the beholder's past life, sexual misbehavior or worse, I would say that the "eye" is understandably biased when considering current behaviors. Again, I am sure many of my visitors who write to this thread will disagree with me. But, think, this is a "discussion blog" and one of the necessary factors in a discussion is disagreement. So I am happy with what is being written here, even opposing my views. ..Maurice.

At Tuesday, April 09, 2013 5:50:00 PM, Blogger Maurice Bernstein, M.D. said...

By golly! One doesn't know what they are missing by just sticking to this one thread on my bioethics blog! Even I nee to be reminded what topics I started and have been responded to by a visitor currently writing to a thread from 2004. A great example of that and most likely of interest to those who are writing here is the one on medical student abuse and it's effect not only on the medical student him/herself but on others. You might find it interesting to go to the above link and read and then write about your views but also there. ..Maurice.

At Wednesday, April 10, 2013 6:10:00 AM, Anonymous Anonymous said...

Maurice, It may be unrealistic to think that misconduct or deviance exists in medicine. One would like to think that.

I am a person who had no previous history of sexual abuse anywhere.

I also went to any doctor recommended with a complete disregard to gender and never even thought to ask.

My experience did involve someone who was charged with sexual misconduct, as well as others. They were punished. Heads really did roll with the exception of support withheld from me from my own doctor.

It is interesting to note that he is not head of ob/gyn at a big hospital and there was recently an article written that he did not support a male doctor in his private practice as the women didn't want to see him with all the other women he did have in his practice.

So many times over the years I wondered if he ever learned anything from what happened to me.

I have letters and proof of my experience. What your other blogger said about people who refuse have a previous history, I tend to agree. My previous history started in the hospital and vowed then to never let anything like that happen again...and it hasn't.

Maurice, it only has to happen once and if the experience is bad enough, it changes the way you feel about the medical profession. Once you lose that relationship with your doctor and you are thrust to the care of strangers who previously mistreated you, its' shaky ground even for the most formidable patient.

At Wednesday, April 10, 2013 5:35:00 PM, Anonymous Anonymous said...

Dr. Berstein I agree whole heartedly with you that the issue of sexual abuse and focus by providers is a different conversation and very few providers are violators. However, you make a statement that is at the core of this issue, the eye of the beholder. Providers want to provide or accomodate modesty from their perspective, in the eye of the beholder patients should accept the things they provide (using proper terms, their actions and behavior) as being enough to address their concerns, should not the eye be that of the patient. That to me is one of the main issues that providers refuse to recognize. Don

At Thursday, April 11, 2013 5:02:00 AM, Anonymous Anonymous said...

Don, you make a viable point. Just the idea that this issue isn't really discussed with processes or procedure for "standard of care" for prepping prior to operations and tests, is a statement.

The article "Naked" talks about the lack of standardization of procedures so that patients know what to expect, what is procedure that also enables patients with what to expect.

It would seem to me that withholding information, not addressing a process that protects the patient's mental health and attitude is a statement.

Students may suffer abuse in their training. Who is going to stop that? Why haven't they stopped that? And...just because someone was subjected to abusive behavior does that give them the right to abuse others?

Patients are not prisoners. They are paying customers. How many times have you been to doctor and they don't listen to what you say.

It took me eight years to get someone to listen to me and when testing ensued, what a surprise. I was the one who knew what I was talking about. You would think that an adult would be able to communicate what a muscle spasm feels like. Why ignore? Just because it isn't the norm?

Medicine has come a long way. Doctors like Maurice help patients but there is a flaw in the way that disease is looked at. Tell them too much and they tell you you're "anal". Leave out something important and you're blamed for that.

Above all, listen to your inner self when it comes to an illness, your modesty, etc. and surround yourself with fine doctors who are out there; you just need to look a little harder sometimes.

At Thursday, April 11, 2013 6:28:00 AM, Anonymous Anonymous said...

It seems that much of this conversation about medical modesty has lately involved the possiblity of sexual abuse. Although this happens I think that originally a lot of bloggers here were mainly voicing a mere modesty/embarrassment (lack of dignity, etc.) concern when it came to opposite gender intimate care and not. I still think a lot of us have this as a core concern: it's not that we fear or suspect a sexual intention. I know that is how I feel. I have never been sexually abused but I still have a tremondous amount of anxiety when I think about having opposite gender medical care and I avoid it at all costs. I do not mind male doctors/nurses/assistants when the issue does not involve me disrobing. I also find it interesting that the anonymous male OB/GYN nurse only had a few patients refuse his care and that those few were victims of sexual abuse. Did he ask them the reason? Was he sure this was why they refused? I also think a lot of patients (both men and women) just accept the care provided because they do not feel that they can questions it or refuse. I know I was this way in the past. In other words, a lot of patients just "grin and bear it" so to speak. I do agree with Maurice: that most medical professionals are considerate and do not have sexual intentions but I also agree with Don that those same medical professionals want to determine what is provided in terms of modesty, etc. as it conveniences them and not as it may convenience or reassure the patient. Jean

At Thursday, April 11, 2013 9:49:00 AM, Anonymous Medical Patient Modesty said...

Jean makes some very interesting points. Many patients who have never been sexually abused do not want opposite sex intimate medical care. You can find a list of reasons why many women do not want a male gynecologist on our Tips For OB/GYN Patients page. One of the top reasons why a man does not feel comfortable with female doctors or nurses providing intimate medical are is the desire for their future wife or wife to be the only woman to see and touch his private parts and they want to protect their intimacy with their future wife or wife. A high number of patients do not want opposite sex intimate medical care have never been sexually abused.

I agree with Jean that many patients won’t speak up. Many patients feel so powerless. I bet that many of the male OB/GYN nurse’s patients felt very uncomfortable with him, but they did not feel they could speak up.

On another subject, I recently found a very interesting article that was written in 1974, Modesty And Your Physician” that was written in a Christian magazine. I found it very interesting that it was written in 1974 because female gynecologists were extremely hard to find in the 1970s. My mom did not have a choice in 1979 and 1983 when she had my sister and me. Things are changing today because medical schools are very receptive to women becoming doctors. That was not the case many years ago.


At Sunday, April 14, 2013 10:27:00 AM, Anonymous Anonymous said...


On Sunday, mar 3rd 09:35,of this thread
you said. " Until proven otherwise,I cannot imagine
of all the patient-healthcare provider interactions,
minute after minute,hour after hour,day after day and
year after year,within the United States as an example
that sexual assault or even "cruel and degrading"
treatment is any more than some extreme statistical

Now, Maurice before I get to the crux of responding to your comment I will first say that
the Rand corporation has been researching medical
mistakes for 40 years. It was not till the year 2000
that the prestigious medical institutes of health suggested that anywhere from 44,000 to 98,000
patients die each year in this country from medical
mistakes,furthermore 1.5 million patients are injured
each year from medical mistakes. There never has been
any sponsored program that requires hospitals to report
medical mistakes to anyone. Last year, the government
Is now asking patients to report their medical mistakes.

Now Maurice, is it any surprise that there exists no
statistical evidence to support sexual assault, let alone
cruel and degrading treatment towards patients when
we don't even document medical mistakes resulting in
injury and death.

Only recently are many hospitals being required to
report patient accusations of sexual assault to police
departments within 24 hours. As another example,
only last year are all new nurses required to get
finger prints prior to obtaining a nursing license in

Of course you won't find any statistical data, it's
called risk management.


At Monday, April 15, 2013 4:21:00 AM, Anonymous Anonymous said...


Here's a standard of care practice. Is it cruel and degrading.

A woman has been in labor for hours and things are just not working out so, the doctor comes in and says you can wait several more hours but I think it's beneficial for you to consider a "C" section.

She consents. She is given the epidural and then moved to the labor and delivery room.

The room is bustling with activity. There are numerous personnel, a pediatrician.

Nobody talks to the patient. She is put on an operating table and her arms are strapped down on either side. The patient is questioning what happens and at that time the nurse tells her it's for her own safety.

The next thing she knows her gown is removed. She's paralyzed, strapped down and completely naked.

They are busy for a few minutes with other things and that few minutes turns into five. The patient is feelings completely humiliated, traumatized and in her yeeyes, she feels she was treated in a cruel and degrading manner.

Wouldn't it have been better if they wheeled her into the room, spent a few minutes to advise what would happen to her and to complete the removal of her gown, "painting" and recovering in a matter of seconds?

It's the lack of preparing the patient, and the lack of urgency with regard to her state of undress, and the many people who are present. Many times while prepping the OR door is folded back and anyone in the hallway and just peek in.

Add a negative comment about her body from someone, you have a patient who is already sensitive about her body, who is not expecting to be publicly stripped, and is not able to fight nor to flee due to her strapping down and temporary paralysis.

One other note. There's a doctor at HUP in Phila. who wrote a paper together with an attorney about patient perceptions of sexual assault in the ICU. Many people take care of those too sick to take care of themselves. Because these pepeople are so sick, they lack the ability to accept or decline personal care.

Just because they can't object, doesn't mean that they consented. That's where the flaw is. It's the difference in perception between what's going on with the patient. One distraction and you're taking a normal procedure where the patient is surrounded by two nurses and cared for, next they leave her alone, strapped down on a table, stark naked. Sorry Maurice, the gawkers are always there.
Comments please.

At Tuesday, April 16, 2013 6:24:00 PM, Blogger Maurice Bernstein, M.D. said...

I don't understand why in all these Volumes what should be a discussion of patient physical modesty is described as "sexual assault" on the part of the healthcare providers. Modesty is the psychological or behavioral characteristic of certainly most patients to one degree or another. "Sexual assault" is clearly a behavioral act by another individual upon the patient. What is considered as "sexual temptation" or the thoughts of the healthcare provider is not sexual assault or any kind of assault if the provider does not act but only thinks. I bring this distinction up because in the discussion of patient modesty since conflation with only assumed provider's thoughts doesn't aid in understanding the resolution of the issues of patient modesty. ..Maurice.

At Wednesday, April 17, 2013 5:35:00 AM, Anonymous Anonymous said...

I don't consider medical providers' behaviors as sexual assault when it comes to my modesty issues. I do agree that some here have equated it with that because obviously that has been their experience and I do not mean to belittle that, because it obviously happens, but personally I think that issue goes deeper than just modesty. In other words, a sexual assault is a criminal act whether it is in a medical setting or not. If it is an overt act then it should be treated as a criminal matter. On the other hand, many here, myself included, have never equated the modesty issue with sexual misbehavior on the part of medical staff. It's merely a matter of comfort: a need to minimize the feeling of humiliation/embarrassment that comes with being exposed to, basically, strangers and sometimes numerous strangers. So I see it as 2 issues: one of possible criminal intent (sexual assault) and one of attention to patient preference/comfort. Perhaps it should warrant 2 different blogs. Sort of 2 different issues. Jean

At Wednesday, April 17, 2013 3:04:00 PM, Anonymous Anonymous said...

Maurice, are you intimating that the posting I made had something to do with a sexual assault?

What happened is standard of care prepping and draping for a C section.

What wasn't standard of care is that the patient wasn't informed of what to expect.

If you are intimating that it is a sexual assault in the context of standard of care; that's important.

There was no inappropriate physical contact between patient and providers. What there was, was a distraction that took the draping personnel away from there duties leaving the patient exposed.

If you are intimating that there is sexual impropriety in the scenario presented, what would be different that it wouldn't be?

And...if this is the case, how can you separate modesty issues from the scenario presented? Wasn't what happened in the scenario presented a gross modesty violation.

Please explain, this is important.
One last note, was not the treatment that this patient received in the context of the scenario cruel and degrading from the mindset of that patient?

At Wednesday, April 17, 2013 9:21:00 PM, Anonymous Anonymous said...

The events certainly describe a typical c-section
to me, the surgical area is prepped and draped. The
circulating nurse and the scrub tech are preparing the
surgical tray and other relevant supplies and paperwork.
Personally Belinda, I don't see what the issues are
here regarding this surgical case. If the physician was
male, that is the gender the patient chose, thus the patient was satisfied with the physician. Realize that virtually all L&D floors have their own surgical suite. This means that the nurses in those suites are about 99.9 percent female. I am sick, sick and tired of people stating on various forums that there are male nurses
working on L&D floors. Where, where are they? State
which hospitals they are working at, if there is one male
nurse for every 50 L&D suites then no,that dosen't count.
By the way, obese female nurses make snide
comments about obese female patients and just about
every thing else regarding odd body habitus they see
on other female patients. Sounds like a common female
nurse issue. I suggest you write the American nursing
association and see how "not" interested they are
regarding your concerns.


At Wednesday, April 17, 2013 11:50:00 PM, Anonymous Anonymous said...

Belinda has written:
"Nobody talks to the patient. She is put on an operating table and her arms are strapped down on either side. The patient is questioning what happens and at that time the nurse tells her it's for her own safety.

The next thing she knows her gown is removed. She's paralyzed, strapped down and completely naked.

They are busy for a few minutes with other things and that few minutes turns into five. The patient is feelings completely humiliated, traumatized and in her yeeyes, she feels she was treated in a cruel and degrading manner.

. . . Many times while prepping the OR door is folded back and anyone in the hallway and just peek in."

Belinda, this is clearly a case that could result in PTSD, or worse. The woman is powerless, she has been strapped down and paralyzed, has not been told what to expect, and is helpless to move her hands to cover her breasts and pubic hair from people's stares. It is dehumanizing and degrading treatment of a human being. This kind of treatment can have devastating effects. One woman committed suicide after similar treatment.

PT, your inability to see "what the issues are" is also shocking. I'm afraid I read PT's comments with no small amount of horror.

With all due respect to the moderator and all commenters - Belinda, if not for your comments on this site I would not still be reading here. I am appalled at how your comments are sometimes downplayed/ignored/ridiculed/attacked.


At Thursday, April 18, 2013 10:25:00 AM, Anonymous Anonymous said...

Anon, what I shared was only a small part of what happened to me when I had my first child. If you think it couldnt get any worse, it did.

You all will find out what happened as a result of cruel and degrading treatment when this book is finally published.

It's interesting that I asked Maurice for a comment as it seems he felt it might have been related to a sexual assault. The part of the story I told you was not, and yet, was it? Some would consider this kind of treatment torture in another setting.

What I was trying to say and PT, acknowledged so, is that this kind f treatment is "standard of care" and if it is, there is nothing legally that can be done, other to change the "standard of care" issues.

Patient mental health is every bit as important, or more, than physical health.

I consider the insensitvity of medical workers failing to see the damage that is done routinely, most of the time without any ill intent and the patients are left holding the bag.

It makes you wonder how ethical the medical profession really is when their assigned rsk departments of complaints of this nature more than any other.

My research into the psycho social aspects of medical care that are detrimental to mental health speaks volumes and may be part of the original book or into another that deals with patient advocacy and what patients can do for themselves.

Maurice, if one is not willing to look at the issues that causes patients the need to protect their modesty, then there is nothing to look at except the status quo.

Thanks Anon1 for your comments.

At Thursday, April 18, 2013 10:39:00 AM, Anonymous Anonymous said...

Amen Belinda!!

At Thursday, April 18, 2013 12:20:00 PM, Anonymous Anonymous said...

PT, there were about 8 people in the room and about half of them were male. Modesty issues did not exist for me at that time.

So, if I'm one example of someone who has issues based on previous hospital experience, look at the "monster" that the profession is creating of their own making.

If a survey were done, I would bet that most people have issues because of previous negative experience (that didn't necessarily have to be traumatic) vs. other reasons due to religious beliefs, etc.

At Thursday, April 18, 2013 2:48:00 PM, Anonymous Anonymous said...


Shocking and horror are words I look for in
a good scary movie. This surgical suite is on a L&D
floor and there is a good reason for that. The patients,
mother and child, do not have to be transported up or
down an elevator, via several floors. Nursery floors
are adjacent to L&D and for a real good reason,
security. All nursery floors are locked down,it seems
women love to steal babies. All newborns have an
electronic bracelet that trips an alarm if attempts are
made to remove the child from the floor. In fact, there
are protocols if the alarms go off, it's called a code
Once the alarm is announced hospital employees
man all exits to look for the baby. Now, getting back
to the original post. Among all the nursing units that
one can look at in a hospital setting, L&D units are
essentially 100 % female. The only males on those
units would be the OB physician and the
anesthesiologist. In most cases the patient can have
their choice of the physician as well as the gender
of the anesthesiologist, provided there is a female
anesthesiologist that has privileges at that facility.
And that is the important catch, provided they
have privileges at that facility. Now, remember that
"Your" female hospital brethren are the ones who
decided long long ago that only female nurses can
work on these kinds of floors. They made that
decision for you,not you. These discriminatory
practices have embraced female patients for
decades and quite honestly, I am ecstatic that this
backfired on you.


At Friday, April 19, 2013 1:09:00 PM, Anonymous Anonymous said...

Any medical worker who has the mindset and attitude shared by PT doesn't belong working in healthcare.

Medical workers should have the mindset of wanting to do no harm, caring and a positive attitude.

Anyone who wishes anyone ill or gloats from someone else's misfortune is not a nice person.

At Saturday, April 20, 2013 10:39:00 AM, Blogger Maurice Bernstein, M.D. said...

"Gloating" is often used to make a point in a discussion. Whether this is a good or bad literary tool, that is also up for discussion. In any event, let's keep this blog free from animosity especially of anonymous origin.

My view is that "sexual assault" is a criminal act and is not part of the practice of medicine. Yes, there are reports of physicians and other healthcare providers violating the profession and the law. But my point was also that what the patient suspects in going on in the mind of the healthcare provider is not "sexual assault" unless the provider acts. Finally, yes, I can understand a PTSD related to physical modesty in a medial situation, if a patient ever was inflicted with a true sexual assault in the past regardless of the circumstances. ..Maurice.

At Saturday, April 20, 2013 5:16:00 PM, Anonymous Anonymous said...


Thank you for your comments. Sexual assault may not be in the mind of the provider, however, if a patient isn't informed of what is going to happen to them and then they are what amount to as a forcible stripping against their will, while that in and of itself is not a sexual assault, the wonderings of the healthcare providers, leaving a patient, tied up and paralyzed is nothing less than sexual battery and cruel and degrading treatment.

Studies were done during the George Bush administration that said that phychological torture had worse outcomes for people than physical torture and...that would include forcible stripping against someone's will. You can develop PTSD from cruel and degrading treatment even if there was no
sexual assault.

Here is an article explaining psychological torture damage and the main issue is the loss of control.

There is no doubt that this patient was humiliated, that control was lost and the flight, fight or flee mechanism couldn't work and...while
this was only part of what happened and I speak now in the third person to generalize other people's experiences.

There are certain commonalities to PTSD: loss of control, unexpected circumstances, and a loss of the ability to cope with an overwhelming situation. Furthermore, other studies show that a strong support system helps people to recover.

While they may be uncommon, this modesty issues has all different kinds of variations and the feeling of humiliation and loss of control is enough. That's why this issue is so important. It touches the autonomy of what makes us human. One little mistake (leaving a door open, inviting others in the room, cleaning personnel in the room, etc. can take a normal experience to something else very quickly.

It is my strong feeling to never feel degraded again to insist on same gender care. You may not understand it, others may not, until one has lived it and many on this blog have.

Instead of arguing the point, why not listen to what's being said and provide programs for those who need them in the healthcare setting to understand, accommodate and one step further to ensure that patients who have PTSD (and avoidance of going back to the hospital is a symptom so many don't know there's a problem), get the same care that they need that a handicapped patients for another reason gets. One last thought, because this issue affects further experiences in healthcare, mental health, this issue is important regardless of the patient's reason. It's valid and it's real.

At Saturday, April 20, 2013 9:54:00 PM, Anonymous Anonymous said...

Hmmmm... so the medical community wants to take the term sexual out of sexual assult, based on the presumed notion that 6 million employees have the low factor of termed outlier.
I think it is just as dangerous to assume healthy motives of a mass of individuals as it is to assume unpure motives of a mass of individuals.

At Saturday, April 20, 2013 10:52:00 PM, Blogger Maurice Bernstein, M.D. said...

I think that the vast majority of healthcare providers have healthy motives for their behaviors toward the care of the patients they are attending. I do agree with Belinda that what is often at fault is the fact that the majority of healthcare providers assume that the patient is aware of the details of the provider's very routine procedures, which often the patient is not. Along with that is the general belief of the providers that the patients can and will tolerate some degree of indignities if the end result is for the betterment of their health. Obviously, both of these assumptions are false and this I think is the basis for a lot of the concerns written here. But I think that "sexual assault" is an overreach for an explanation. I have never found anything "sexual" in attending to a sick patient. Unless you are a doctor, you will never know the uncertainty and responsibility that goes along with the professional activity. ..Maurice.

At Sunday, April 21, 2013 7:18:00 AM, Anonymous Anonymous said...


I agree with you. It's not until there is some impropriety that there is a sexual violation and I will also agree with you that it doesn't happen all that often. But when it's a big problem.

Going to my private doctors with draping this and that, the door knock and conscience focus on patient comfort and dignity, it came as a complete shock to me, that such goings on are routine.

There is no reason for a patient to suffer indignities when there is no medical emergency, period.

Can we agree, Maurice, that it would help both physicians and patients if they were told what to expect. It might save some minor embarrassment, however, if treated properly, most would ignore it and focus on the important healthcare they are getting. Taking away the unexpected takes away the key element that develops into PTSD.

Dr. Vanderkolk wrote an excellent text on this issue. Every medical student should be reading it as well as any student that deals with draping procedures and this modesty issue.

Thanks, Maurice!

At Sunday, April 21, 2013 10:12:00 AM, Blogger Maurice Bernstein, M.D. said...

Belinda, I agree: the "unexpected" is a troublesome and perplexing (unknown what to "expect" next) experience both for doctors and for the patient. In the patient's case, if the "unexpected" can be turned into "expected" and "understood" through communication and thoughtful actions by the healthcare provider, I am sure much emotional trauma will be prevented.

And with regard to the doctors, well.. the "unexpected" is not infrequently part of the challenge of the profession and can't always be avoided. Education and experience may help but unfortunately not always! ..Maurice.

At Sunday, April 21, 2013 11:07:00 AM, Anonymous Anonymous said...

Without a physician's order, a nurse may not performan any nursing procedure with the exception of blood pressure,pulse and temperature checks. The nurse simply acts as a liaison between physician and patient. A nurse cannot make decisions for you regarding your medical care and should not even give you their opinion, yet they do.

They insured that females would staff all L&D
suites as well as mammography, post op gyn and
countless other nursing areas. This was their opinion,
they did this without asking you. Many even would
automatically schedule female patients with female
practitioners for intimate exams when many female
patients have openly expressed their desire for male
physicians. Their reasoning, male physicians are more
gentle and less judgmental.
Let the patient decide,no one should be making assumptions or opinions about what the patient
prefers and it states so in the nursing pledge as well
as the nurse practice act.
In conclusion, I want to make some comments about
ones experience in an L&D. First, you will never see
8 people in a c-section. There would be at most the
Ob-gyn,the anesthesiologist, a scrub tech and the nurse. The cost for a surgical team is about $350 a
minute as cost is an important factor and that cost
does not include the charge for the suite,nor the
supplies. Second, pediatricians do not stand in on
deliveries. That is not cost effective for them,besides
pediatricians not not care for newborns,neonatologists
do and they certainly don't wait around in the
L&D suite for a delivery. They make rounds in the
NICU or the nursery and then they leave to another
Finally, doors to operating rooms are never left open
for one reason,infection. They have laminar flow
ventilation to prevent operative and post-op infection.
The doors are either electric push button or saloon
type, but cannot be left open. There is no mechanism
to keep them open as they were deliberately designed
that way.


At Tuesday, April 23, 2013 11:42:00 AM, Anonymous Medical Patient Modesty said...

For people concerned about sexual abuse in medical settings, I strongly recommend that you read this article, Sexual abuse under guise of health care presents barriers.


At Tuesday, April 23, 2013 4:08:00 PM, Anonymous Anonymous said...

Sexual abuse in the health care setting involve male
patients as well. When this article appeared on the
Allnurses site, one female nurses commented,
" is this a joke".


At Tuesday, April 23, 2013 5:31:00 PM, Anonymous Anonymous said...

Surgical procedures differ from state to state. Not only did I have a pediatrician present at the birth of my son, there was also one at the birth of my daughter at a different hospital two and a half years later. Double doors were also at the end of the hall entering the labor and delivery area. The operating room in my case was just that. A room with a regular double sized single door (with a small window in it) that opened and closed like a regular door that was located on the other side of the hallway from the labor rooms.

Misty, great article!

At Tuesday, April 23, 2013 5:54:00 PM, Anonymous Anonymous said...

personally I still feel intentional abuse of patients is rare and a different subject then what we are addressing here, HOWEVER everytime I think I am getting more comfortable with providers, I see read something that sets me back. Go to all nurses and read comic relief, a nurse posts humor in a story about a male patient whom OD'd and had brain damage, was masturbating unaware, a nurse used his condition to play a joke on another nurse. That nurse posted it under the title Comic Relief. While some nurses condemned it, other thought it was funny and one discribed it as adorable and cute. Ok that gives me confidence while I am out. The other was several shows called NY ER or NY 911. Filmed in a ER, all the nurses are female, very attractive, and found humor in such stores as a man getting a foley and screeming in pain, a man with a bad reaction to ED drugs and an erection that would not go away, and an unpleasant patient whom the nurse had to put his testicles in a sling. Then there was the scence where a man was brought in shot in the groin while the nurses made jokes 8-10 female nurse laughed in the background just watching. While I understand the later is TV, consider what it says that the Hospital, and nurses, were all part of the program and process, what does that say about them that they would allow it? All in all Disturbing,...Don

At Tuesday, April 23, 2013 7:41:00 PM, Anonymous Anonymous said...

The joint commission has been around since the early
1950's although then called the JCAH. Surgical procedures
do not differ from state to state. A craniotomy performed
in New York will follow the same regimen if performed
on the moon.

Don, yes it is disturbing and as I have mentioned on
this subject matter before, these medical shows you
mentioned got their script from somewhere, and that
somewhere was from female nurses. Look at the credits
and the medical advisory panel.


At Tuesday, April 23, 2013 7:45:00 PM, Anonymous Anonymous said...

Interesting discussion - excellent site.

Couple of comments:

1. Belinda's experience speaks for itself - sad to see a physician step in to dispute/discount her lived experience rather than trying to learn from it - especially shocked and appalled by PT stating" These discriminatory
practices have embraced female patients for
decades and quite honestly, I am ecstatic that this
backfired on you".

WTF? Really, you were able to type this out and submit it and not recognize what it says about you?

2. I know a lot about PTSD and agree with Belinda's previous post. Trauma impact is not related to the "intent" of the natural disaster or the accident - it is related to the central features of the experience that the person goes through, and to the subsequent trauma-related symptoms. It doesn't matter if there was no ill intent (so let's just drop intent - ill or good from the debate) if the ACTIONS give rise to traumatic experiences and impacts. If "standard medical practices" do this, then they need to be changed - not defended. And a history of prior sexual abuse is not relevant to this discussion - a person with no history can experience trauma and PTSD symptoms if they go through some of what passes as "standard medical practice". If physicians don't get this then they are complicit in systemic abuse, no matter how lofty they might describe their intentions.

SD in reply to PT

At Tuesday, April 23, 2013 7:48:00 PM, Blogger Maurice Bernstein, M.D. said...

It appears that from HealthGrades Background Check Dr. Twana L. Sparks, "age 58" is still in practice with unrestricted license since November 11 2011, having been on "probation" beginning Nov. 23 2009.
The nature of the Complaint to the New Mexico Medical Board, as some of my visitors may recall was that "The physician allegedly performed genital exams on many of her ear, nose and throat patients while the patients were under anesthesia and without obtaining prior written informed consent and failed to document the examinations in the patients hospital records.

The physician also allegedly while performing ear, nose and throat surgeries at the Gila Regional Medical Center wrote messages and created artistic images on the bodies of many of her patients while they were under anesthesia without obtaining the patients prior written informed consent." The Interim Order "The physician shall only diagnose and or treat ear, nose and throat conditions of her patients.
The physician shall not perform any genital, rectal or breast exams for any reason.
The physician shall inform her patients that they need to be seen by other providers for any other condition.
The physician shall have a chaperone present for all interactions with patients over eighteen years of age" which led to the probationary license to practice subjected to, in addition, "It is further Ordered that the physician is placed on probation under the above conditions, and these additional terms and conditions:

The physician shall participate in the Resource Center for Health Professionals and comply with the requirements.
The physician hereby waives any right to confidentiality she may have with respect to information gathered by the RCHP.
The physician will participate in regular individual therapy sessions with a psychotherapist that is approved by RCHP.
The physician shall have the psychotherapist provide quarterly written reports to the Board.
The physician shall go to the PRC in Kansas for further therapy it that is recommended by RCHP and her treating psychotherapist.
The physician shall undergo polygraph examinations every 4 months that would specifically ask questions regarding similar conduct that is set forth in the NCA that may have occurred since the last polygraph evaluation.
The physician shall obtain a worksite monitor at each facility where she performs surgery.
All of the physician’s interactions with patients in an office setting will be done in the presence of a chaperone who is over 18 years old.
The physician shall appear before the Board on a quarterly basis or upon the Board’s request.
The physician shall submit quarterly reports to the Board attesting to her compliance with this stipulation.
The physician shall comply with all federal, state and local laws."

In a Google Search of the news, I couldn't find any current information about this doctor. I guess she hasn't been recently in the news. My own opinion is that she should have had her license to practice revoked. But that is my own personal opinion. ..Maurice.

At Tuesday, April 23, 2013 10:37:00 PM, Anonymous Anonymous said...


I certainly agree with you regarding Dr. Sparks,
her license should have been revoked. What is even
more telling about this case aside from the fact that
even the nursing staff knew she was fondling her male
patients, nursing staff were not reprimanded to my
knowledge and where was the New Mexico state
board of nursing when the dust settled.

I am in no position to cite state laws in regards
to this case, however, those patients were required to
be notified. To my knowledge only one patient was
alerted, yet this went on for years. For anyone who
disputes things such as this happens to male patients,
here it is.


At Wednesday, April 24, 2013 7:23:00 AM, Blogger amr said...


Re Dr. Sparks, it was an OR nurse who blew the whistle, and she was fired for doing so.


At Wednesday, April 24, 2013 8:55:00 AM, Anonymous Anonymous said...


But this behavior went on for years despite
the fact that finally one of the or nurses who as you
say blew the whistle. That her and Dr Sparks were
in a lesbian relationship and they had a falling out.


At Wednesday, April 24, 2013 4:47:00 PM, Anonymous Anonymous said...

I actually emailed the hospital and expressed my displeasure and told them what it said about the facility and the entire staff that she was retained. I got a response from the patient advocate asking if she could share the email with admin. I consented and heard nothing more. She went above exams, the final case that brought it all to light was when she uncovered a male patient who was there for sinus surgery, slapped his penis and said bad boy bad boy. During the investigation there was comment that in the hospital it was oh well just Dr. Sparks being herself she does it all the time. I am reasonably sure a male physician would have been toasted long before much less retained. These things cast a pall on the entire profession, which is unfortunate as the vast majority are really great people, even if they don't provide for modesty as I think they should, I don't think there is malintent, just malinformed and indoctrinated. don

At Wednesday, April 24, 2013 5:01:00 PM, Blogger amr said...


Could you provide links to back up this assertion regarding the love affair?


At Wednesday, April 24, 2013 7:00:00 PM, Anonymous Anonymous said...

I was curious about the same. I got involved in the local papers commontary on the issue and as I recall the nurse who reported it, was fired, filed a wrongful termination suit, was actually engaged to a Dr,. (male), So curious where the lesbian thing came from. I realize Dr. Sparks was lesbian but did not recall that about the nurse don

At Thursday, April 25, 2013 5:57:00 AM, Anonymous Anonymous said...

Has anyone here ever known somebody under the age of 19 that had a hernia? Every Jr high and high school athlete I've ever known had to have a hernia exam before they were allowed to play their sport, yet I've never known a single teenager that was diagnosed as having one.

As a teenager I never understood exactly how or why they were performed. All I knew was that all of my friends that played sports had to line up side by side, drop their pants and let the school nurse fondle their privates. For that reason I never tried out for a team. I understood it as more of a rite of passage.

The more research I do on it the more pointless it seems to be. They might as well test the young boys for lung cancer. And why is it that teenage girls don't seem to have to go through the same humiliation?


At Thursday, April 25, 2013 4:45:00 PM, Anonymous Medical Patient Modesty said...


I can certainly understand why you chose to not play sports. They should have given boys the option to skip the hernia exam. Take a look at our article about how hernia exams are not necessary for sports physical exams. You will notice that we have a link to Dr. Joel Sherman's article about sports physical. Dr. Sherman is a cardiologist. He confirmed that hernia exams are not necessary to ensure the safety of playing sports.


At Friday, April 26, 2013 8:34:00 AM, Anonymous Anonymous said...

I submitted a comment prior to the most recent ones that you approved. Interesting that it was not approved.

Granted, the opinions expressed were put in strong terms. However, I note that you approve similarly strong language when used by a male physician (you publicly defended his use of "gloating" as an acceptable rhetorical device, and did not comment on his denigrating comments - e.g., "obese female nurses").

If you disagree with my opinions or way of expressing them, fine. As moderator, you have the right to refuse to post my comment. I just think it unfortunate given that your blog is clearly inspired by very positive motives on your part, and I know of many who come to your blog because it represents a positive and constructive force. Seems a shame to detract from that simply because my post was phrased in strong and challenging terms.

Oh, and if you didn't post my comment because you thought it contained (a) a personal attack on PT, or (b) unfair generalizations about physicians, then I'd ask to consider whether this is a bit of a double standard that promotes a bias towards physician over patient voices. You posted comments by PT that were personal and which contained negative generalizations about nurses.

Perhaps you were simply delayed in being able to read and approve my earlier comment, and if so, my apologies if I have been inaccurate in my hypotheses.


At Friday, April 26, 2013 11:40:00 AM, Blogger Maurice Bernstein, M.D. said...

SD, your original posting on April 23 2013 at 7:45pm was posted at the time however if you had submitted a subsequent comment, did not make me aware of its presence for moderation. You may want to re-submit it, if you desire. I have almost never, as moderator, rejected a comment from posting unless it is spam and it is obvious that spam contributes absolutely nothing to the specific discussion.

SD, your apologies are accepted. ..Maurice.

At Friday, April 26, 2013 12:58:00 PM, Anonymous Anonymous said...

Dr. Bernstein,
Thank you for your quick reply and for the clarification. Good to know that it was simply an issue of my post not making it to you. Here - as best as I could reconstruct it - is my original post:

Belinda - you raised a very good topic for discussion, and thank you for sharing your experience.

Sorry to see that you appear to have encountered some responses that seem reflective of attitudes that perpetuate the type of situation that you described to begin with.

At best, some of the comments suggest a lack of awareness of gender issues related to women's experiences in health care (both as patients and providers), and at worst, they might be interpreted as paternalistic or misogynistic (these are strong terms - others can judge whether they apply to the repeated bashing of "female" nurses & the expressed ecstasy in a woman's misfortune).

Aside from the moderator's comments (which were helpful), there was a recurrent theme of other comments that don't do much to inspire confidence that women's concerns are going to be responded to in an empathetic and constructive manner.

It was especially disappointing to see the topic-shift that oriented the discussion towards a statistical "outlier" (i.e., female physician engaging in sexually inappropriate touching). There is no disputing that this type of action is wrong and requires disciplinary action. Males can be the subject of this type of abuse, as this case illustrates.

That said, highlighting this case in the context of the thread that contained multiple, sometimes subtle, sometimes overt criticisms of females was unfortunate.

That case is simply not a good representation of where the major concerns exist in terms of gender issues in medical misconduct in relation to sexual issues.

The evidence base indicates:

- Males commit the vast majority of sexual offenses (one statistic I found stated they commit 99% of rapes).
- 8% of the men admit committing acts that meet the legal definition of rape or attempted rape.
- 8 different studies examining disciplinary actions for sexual boundary violations reported the percentage of male vs. female perpetrators as being at 97.4%, 97.3%, 100% (2 studies), 93.2%, 96.3%, 85.7%, and 93.8%.

Men are far more likely to cause harms related to sexual misconduct. Male defensiveness and denial about this reality is part of the problem, not a part of the solution.

Protecting women's safety from medical system trauma requires a review of "standard practices" that cause harm based on women’s experiences and perspectives. Belinda's experience is one that should be viewed as something to prevent rather than justify or rationalize.

IMO, it would be good to stop using the term "modesty" in reference to the type of traumatic incident that Belinda described. Use of the term implies that the issue is with the patient (they have a modesty issue) when the reality is that modesty is likely the smallest part of a much bigger issue that has to do with a lack of information being shared with women, a lack of truly informed consent being asked from women, and a corresponding lack of sensitivity on the part of some medical practitioners.


At Friday, April 26, 2013 1:49:00 PM, Anonymous Medical Patient Modesty said...


Medical Patient Modesty has received both sexual abuse and patient modesty violation cases.

Female doctors and nurses can certainly abuse men. But it is much more common for men to abuse women.

Many people falsely assume that nurses help to prevent sexual abuse in medical settings. Check out Do Chaperones Really Protect Patients?.

Also, many male patients are upset and embarrassed when their male doctors have female nurses present at their appointments. Look at some male modesty violation cases.


At Friday, April 26, 2013 7:54:00 PM, Anonymous Anonymous said...

I have to take issue with the percentages you put forth. There are studies that will give you about any support you look for. I saw a study that said a huge percent of women were abused by their husbands. When you dove in abuse was defined as rasing voice, menancing tone, or harsh looks. I would assume applying those terms to wives would give the similar numbers. Sexual contact by teachers and students is treated completely different when the teacher and the students gender is changed. There are more incidents in prisons of female guards and male prisioners having improper contact..yet whom is more likely to be characterized as an abuser. Do I think males are more likey, yes I do, do I think it is as prevelant as the studies you chose including 100%, no I don't. Do I think rape and other intentional abuse is what this blog is i don't. This is about modesty, here is a number, 90% of nurses are female, that I think is more relevant to this paticular thread. It is about modesty issues in the medical community not rape. Without attaching some number that means nothing, the vast majority of providers are great people not preditors.....don

At Friday, April 26, 2013 9:16:00 PM, Blogger Maurice Bernstein, M.D. said...

I fully agree with Don and that this thread about physical modesty is about a human phenomenon which much broader than PTSD or rape. Modesty, in general, is an inherent behavior of mammals and physical modesty has a long history and is itself a complex sociological and psychological process.

PLEASE, PLEASE.. all my visitors..go to the link below and read "Studies in the Psychology of Sex" by Havelock Ellis (1927) which is presented as a relatively brief free online book by

The book starts out with "That modesty—like all the closely-allied emotions—is based on fear, one of the most primitive of the emotions, seems to be fairly evident.[4] The association of modesty and fear is even a very ancient observation, and is found in the fragments of Epicharmus, while according to one of the most recent definitions, "modesty is the timidity of the body." Modesty is, indeed, an agglomeration of fears, especially, as I hope to show, of two important and distinct fears: one of much earlier than human origin, and supplied solely by the female; the other of more distinctly human character, and of social, rather than sexual, origin."

On reading this presentation, one wonders whether instead of experiencing sexual misbehavior of healthcare providers, most of everybody's modesty concerns may have to do with the individual's own view of their physical appearance and how that appearance will be evaluated by the physician, nurse or other healthcare provider that attends them. This possibility for concern has really never been discussed on this thread and yet it may be one very important mechanism regarding modesty issues presented here.

So take a half hour or less and read from the above link and then return and write! ..Maurice.

At Friday, April 26, 2013 11:15:00 PM, Anonymous Anonymous said...


My point was not to criticize the sexual orientation
of Dr Sparks and the crna, rather to illustrate the
the circumstances and the culmination of their
relationship and how it negatively impacted the
professional relationship between patient and physician.


At Saturday, April 27, 2013 1:39:00 AM, Anonymous Anonymous said...

Isn't it considered psychological torture to humiliate people by stripping them naked and allowing people to gawk at them? That's something they do to terrorists at Guantanamo, or is it banned now? Whether that's legally considered a sexual assault or not it is still torture.

Hospitals may not have the same intent but it nonetheless is the same treatment.

At Saturday, April 27, 2013 2:00:00 AM, Anonymous Anonymous said...

"Males commit the vast majority of sexual offenses"

I think that should be changed to "Males are charged with or convicted of the vast majority of sexual offenses". What is the criteria for these studies anyway? Who is it that decides what is or isn't a sexual offense?

We've read countless times in this blog and others that females are allowed to do things in a medical setting (among others) that men aren't. Men get in trouble for doing the same things that women almost always get away with, which pads these double standard statistics. Misandrynistic "studies" like that should be ignored unless specific criteria is explained, and even then we can never know how true it is since women's bad and unethical behavior is so often undocumented. -

At Saturday, April 27, 2013 4:00:00 AM, Anonymous Anonymous said...

Dr Bernstein, "why" asked 25 April "And why is it that teenage girls don't seem to have to go through the same humiliation?" with respect to hernia exams. I'm disappointed you haven't specifically addressed the issue because there certainly seems to some controversy over the effectiveness of screening for hernias at all and certainly for one gender and not the other. Is this just another example of the double standard males are routinely subjected?


At Saturday, April 27, 2013 7:01:00 AM, Anonymous Anonymous said...

While this article is interesting, there are a couple of aspects that relate to medical situations and the emotion called humiliation.

Secondly, when one of my children was about 2 we were in a shopping mall. There were no changing tables at that time so I found an out of the way area with a bench to change the child's diaper. Everything fine, child happy. When I started to remove the diaper, the child started to cry. It was puzzling to me, but happened after my horrific hospital experience.

I asked the child if they would rather go to the bathroom. As if on cue, the child stopped crying, walked with me calmly hand in hand to the washroom. There in the stall, I changed the diaper.

I was amazed that my young child would feel such emotions and questioned the doctor who told me that young children do experience feelings about modesty at about this age; not 4 as the article suggests.

The article points to the very reason why modesty issues are extremely important in healthcare.
It talks about naturally wanting to cover private areas. So, what happens when you can't?

Here's what's missing from the article. Bodily exposure against your will, loss of control, humiliation. Then there's the other category of a recent poster that goes with cruel and degrading treatment/torture. These are the issues that make exposure of the body so traumatic in a medical setting, not a mild embarrassment of being exposed in the course of treatment.

Yesterday a family member was taken to the hospital. It was a woman. A male tech came in to give her a cardiogram. He removed her gown on one side, put on the probes and left her exposed while he was doing the test. I knew this person did not care and didn't want to upset her, but couldn't help but wonder, why the need to expose when leads could have been put on her upper chest by lowering the gown a bit, and then under the breasts by raising the hospital gown (while covered with blanket0 to below the breasts where leads need to be placed.

I just don't understand why there needs to be a loss of dignity for no reason.

Until the medical industry looks at this modesty issue in it's full context, inherent in our DNA, the detrimental affects current practices have on patients and a serious look at what they're doing, not only will nothing change but a few courses in mental health might help. The medical industry is resistant to recognizing something they know is there; they just don't want to change. In my opinion, it's negligent behavior just as ignoring a medical need.

At Saturday, April 27, 2013 8:55:00 AM, Anonymous Anonymous said...


More female prison guards are convicted
of raping male inmates than their male guard
counterparts,according to the U.S. Dept of justice.

More female nurses have been reprimanded
for boundary violations than their male nurse
counterparts. More female nurses were found to
have felony convictions than their male nurse
And finally, an alarming trend from
a recent study suggests male juveniles in detention
have been subject to sexual assaults more often
than their female juvenile counterparts.

How do these statistics fit into your evidence
based model.


At Saturday, April 27, 2013 9:42:00 AM, Blogger Maurice Bernstein, M.D. said...

Ed, I see no benefit for the child of either gender to have routine inguinal or femoral hernia exams prior to sports unless symptomatic. If symptomatic, the child should be evaluated for surgical repair rather than for sports activity. Males are much more likely to develop inguinal hernias than females and females are more likely to develop femoral hernias than inguinal. These hernia exams before school sports in asymptomatic students is only for the legal protection of the school and for no other benefit. ..Maurice.

At Saturday, April 27, 2013 9:59:00 AM, Blogger Maurice Bernstein, M.D. said...

Belinda, I would like to return to the theory which was suggested by the description in the writing by Ellis in the book previously referenced. As you recall the following experience was described: "Long ago, when a hospital student on midwifery duty in London slums, I had occasion to observe that among the women of the poor, and more especially in those who had lost the first bloom of youth, modesty consisted chiefly in the fear of being disgusting. There was an almost pathetic anxiety, in the face of pain and discomfort, not to be disgusting in the doctor's eyes. This anxiety expressed itself in the ordinary symptoms of modesty. But, as soon as the woman realized that I found nothing disgusting in whatever was proper and necessary to be done under the circumstances, it almost invariably happened that every sign of modesty at once disappeared."

So maybe much of this issue of physical modesty in the context of being a patient is related to a simple need of the patient to protect their body from the eyes of others if the patient feels, let's say, "unattractive" or more negative, "disgusting". Would you deny the possibility that this might be a common cause for physical modesty in medical situations? ..Maurice.

At Saturday, April 27, 2013 10:33:00 AM, Anonymous Anonymous said...

Re: Anonymous April 27 2:00:00 AM.

First, I should start by noting that I agree with you on at least one point: I do think it is important to identify instances when males are victimized. It is wrong regardless of the gender of the victim.

That said, I strongly disagree with your apparent denial of the evidence in relation to gender differences in sexual offending.

Do you have any evidence (other than anecdotal) to support your position?

It is easy to find crime statistics or carefully done research that supports the conclusion that women are far more likely to be the victims of sexual offenses, and that men are far more likely to be the perpetrators. In situations when men have been victims, men are far more likely the perpetrators.

One of the statistics that I cited comes from the U.S. Bureau of Justice Statistics. Their data indicate that 91% of rape victims are female and 9% are male, and 99% of rapists are male.

In 2010 the US CDC has also published a large-scale study that points to a similar pattern -

These studies clearly state their criteria and I challenge you to demonstrate (with evidence - not just your unsubstantiated but strongly held opinion) they are "misandrynistic".

You can also check the following article for additional: -

Do you have any facts to support your claims? Any studies you can point to?

You also made an unsubstantiated comment about a double standard. You are applying a double standard by denying any evidence that does not support your bias and endorsing as fact any opinion that aligns with your prejudice.

I am not disputing that both men and women can engage in unethical behavior, and that it should be identified and addressed regardless of gender. I am arguing against a recurrent tone in this thread in which anti-female comments are often made and endorsed or left unchallenged (e.g., "Fem Nazi's"). The tone of this ethics discussion often seems to make it a nice safe space for men to vent, but not so much if you happen to be a woman.


At Saturday, April 27, 2013 5:50:00 PM, Anonymous Medical Patient Modesty said...

To anonymous at 2 AM on April 27th,

The truth is many female medical professionals get away with abuse or patient modesty violation cases because many men do not complain. When men do complain, their complaints are often not taken seriously. Many men feel intimidated about speaking up when they have been abused. You will notice on the male patient modesty violation cases page. that many male patients had their wishes violated by insensitive female nurses.

There is so much mistreatment by female nurses. I suggest you read Dr. Sherman’s blog about the Juicy nurse.


At Saturday, April 27, 2013 6:17:00 PM, Anonymous Medical Patient Modesty said...

Dr. Bernstein,

I am glad that you agree with Dr. Sherman and me that there is no need for a genital exam for sports physicals. Most athletes do not have hernias. They can easily self-examine for hernias. If a hernia causes problem, an athlete can always go to the doctor.

We need to educate parents about the truth so they can protect their children from unnecessary intimate examinations for sports physicals. Have you shared Dr. Sherman’s article about sports physicals with your medical students?

I spoke to a pediatrician at a conference that Medical Patient Modesty was a part of last week. She agreed that intimate examinations were not necessary for sports physicals. She thought it was terrible that a male doctor in a small town in North Carolina did breast exams on teenage girls whose mothers were not present for sports physicals .

I find it interesting that you mentioned that hernia exams were done for legal protection of schools. Can you share more details about this part? Does this mean that some schools are afraid that they would be sued if a boy has a hernia? I have never heard of an athlete dying playing sports due to a hernia. Are you aware that a school in Pennsylvania that did genital exams on girls was sued many years ago? You can see more information at


At Saturday, April 27, 2013 7:07:00 PM, Anonymous Medical Patient Modesty said...

Dr. Bernstein,

I’m concerned about the below comments you made to Belinda below.

So maybe much of this issue of physical modesty in the context of being a patient is related to a simple need of the patient to protect their body from the eyes of others if the patient feels, let's say, "unattractive" or more negative, "disgusting". Would you deny the possibility that this might be a common cause for physical modesty in medical situations?

While it may be true that some people may want to protect their body from the eyes form others because they feel unattractive, many people who are concerned about their modesty in medical settings cherish their body. One of the top reasons why many people do not want opposite sex intimate medical care is due to the fact that they want their spouse to be the only person of the opposite sex to see and examine their private parts. As you know, many patients who are concerned about patient modesty are open to receiving medical care from opposite sex medical providers for non-intimate health issues such as ear infections, sinus infections, etc. as long as they are able to remain clothed. I am sure that most men concerned about being exposed to female medical personnel in this discussion would not mind having a female nurse giving them a flu shot in the arm.

Many young women are taught at a certain age that they cannot let their dads or brothers see them naked anymore. They are set with those boundaries and do not feel differently in medical settings. Many young women and teenage girls have been devastated when they were forced to have an intimate examination by a male doctor because they were taught that they should keep themselves pure for their future husbands and that they should not let any man see or touch certain parts of their body covered by a 2 piece bathing suit.

Also, many people value their privacy. Many men would be extremely upset if a lady walked in a men’s restroom to watch them using an urinal. Why should it change in medical settings? My sister went in a men’s restroom with only one toilet at a restaurant last year because she needed to use the bathroom so badly. She of course locked the door. When she came out, a man looked shocked that she went in a men’s restroom. Gender neutrality in medical settings has caused a lot of problems. It would be prudent for medical facilities to follow the similar boundaries that have been set in public restrooms and locker rooms.

You can see some information we have collected from people about why patient modesty is important to them at


At Saturday, April 27, 2013 8:51:00 PM, Anonymous Anonymous said...

Maurice, I don't think it matters why patients feel the need for privacy, however, unless one is an exhibitionist, it would seem that nobody wants the eyes of others gawking at them in a state of undress; especially those of the opposite sex.

I will say, that if someone is elderly, obese, ready to deliver a ten pound baby or has some physical anomaly that makes them sensitive about their bodies, that others viewing them against their will would enhance the feeling of humiliation, but not be the reason for refusing opposite gender care.s

I also note, that I doubt that knowing someone else communicates that they don't find you disgusting would elleviate any feelings of humiliation, fore, those feelings are the feelings of the beholder. To me, that equates to medical personnel saying, "don't worry, we see it all the time and it doesn't mean anything to us". So, I would not support that position.

There is, though, the interesting notion that we humans equate nakedness with sexuality. The idea that a medical setting is not sexual and people do not look their best and are made to look ridiculous with those shower caps, nasal cannula and awful hospital gowns, that is also, furthers feelings of humiliation.

The biggest problem though is the power differential, loss of control without informed consent.

At Sunday, April 28, 2013 12:19:00 AM, Anonymous Anonymous said...

"These hernia exams before school sports in asymptomatic students is only for the legal protection of the school and for no other benefit." So schools need legal protection from boys due to the infinitesimal possibility of injury complicated by a hernia! Really? Do you also believe schools don't need legal protection from girls with hernias?


At Sunday, April 28, 2013 9:02:00 AM, Anonymous Anonymous said...

Reply to PT

I am not disputing that women can engage in harmful actions, and I am not advocating that a double standard be applied when they do so. The evidence from about prison guards perpetrating sexual offenses is very concerning, and the finding that female guards are more likely to do this raises interesting questions for which I don’t have the answer.

In reply to some of your other comments:

First - it isn't MY evidence-based model. I was simply referring to evidence in support of my comments, and good to see you doing the same. Perhaps you can also respond to someone else’s request that you provide the source/evidence for some of your earlier comments about Dr. Sparks?

Second - the evidence that you referred to does not alter the main conclusions found in the research I referred to. Even incorporating the findings regarding the female prison guards - men are more likely to be perpetrators of sexual offenses (based on data from the US Bureau of Justice statistics and other sources I have cited in my other comments). This is not to say that women are not capable of harm, as the prison research indicates, but overall they remain more likely to be victims than perpetrators. I’m curious about your reasons for seeming to take such exception to the finding that men are more likely to be perpetrators. Are you saying these findings are false? Are you pointing to some sort of conspiracy? Are you suggesting that we, as a society should ignore findings about this type of gender difference? Don’t you think it important to take steps to protect the girls and women in your life from this kind of increased risk of being victims of sexual offences?

Third - your data about there being more female than male nurses convicted of boundary violations, and of having criminal convictions is interesting - but I wonder if that is because they used total number rather than a ratio/percentage? With there still being far more male than female nurses, perhaps a simple number count is not going to yield the best metric for comparison?

I did a very quick search and found the following:

An Australian review of this topic stated "it is noteworthy that two thirds of the respondents in the boundary violation cases were male, in contrast to the percentage of men in the nursing profession, which was about 9%".

The same study cited two other sources (one from Canada, one from Ohio) that found similar patterns in which the higher percentage of boundary violators were male. A study out of California reported there were more female than males who received disciplinary action, and who had prior criminal convictions (based on total numbers). The same study pointed out that males only made up 9.1% of the nursing population. Like the other studies I cited, they also found that, when percentages were used, male nurses were more likely to be disciplined and more likely to have prior criminal histories. You appear to have found some research that runs contrary to this, so certainly welcome you sharing the reference, as I did not find it in my search.

Finally, IMO, we will all be better off when take steps to identify and address the systemic and cultural issues that put women and girls at greater risk for harms, including those that are part of the medical system and part of the “modesty” issues that are the subject of this thread. Changes that afford greater protection for women and girls will also improve the conditions for men and boys. I believe that men will benefit a great deal from societal changes that result in their being less violence (sexual and otherwise) that harms women. My hope is that this is something we can agree on.

At Sunday, April 28, 2013 9:19:00 AM, Anonymous Anonymous said...

"Protecting women's safety from medical system trauma requires a review of "standard practices" that cause harm based on women’s experiences and perspectives. Belinda's experience is one that should be viewed as something to prevent rather than justify or rationalize."

Agreed. But shouldn't we be saying "Protecting People's Safety" and (please no offence or disrespect to Belinda) in view of "everyone's experience" ? Let's be fair and for that matter realistic. Both genders are vulnerable. Both genders have weak moments. Both genders should have a safe medical environment.

SD...I have statistics as well.
One in 4 girls and 1 in 6 boys will be sexually assaulted by the age of 18.
An estimated 92,700 men are forcibly raped each year in the United States. Since this is not an updated statistic, one can only imagine how high it is today.

There are websites to help men survive abuse, and especially abuse by females.

Times are changing. Information is changing. Let's all change with it.


At Sunday, April 28, 2013 9:30:00 AM, Anonymous Anonymous said...

"Changes that afford greater protection for women and girls will also improve the conditions for men and boys. I believe that men will benefit a great deal from societal changes that result in their being less violence (sexual and otherwise) that harms women. My hope is that this is something we can agree on"

I'm not a man, but still find this rather offensive. This is how it reads to me:

"We will help men by not allowing them to be in a situation to harm and abuse women."

I see a point in there (somehow...maybe...(?)) but who protects men and boys from abuse? After all of this time, I am still baffled by the insistance of gender separation and one-sided blame.

At Sunday, April 28, 2013 10:34:00 AM, Blogger Maurice Bernstein, M.D. said...

Simply a reminder: yesterday and today were comments posted but unidentified. If you sign on anonymously, please check to be sure you end your comment with some consistent pseudonym. It makes the discussion much more meaningful to know "who" wrote "what". Thanks. ..Maurice.

At Sunday, April 28, 2013 10:45:00 AM, Blogger Maurice Bernstein, M.D. said...

Ed, I believe that every school needs legal protection from unintended harm to students of either gender from required or allowed sports activity. The schools don't want to have to respond to a parent's "why did you permit my daughter to injure herself?" ..Maurice.

At Sunday, April 28, 2013 11:00:00 AM, Anonymous Anonymous said...

Sorry Dr. Bernstein: April 28th 930
was me as well.


At Sunday, April 28, 2013 11:15:00 AM, Anonymous Medical Patient Modesty said...


I agree completely with your position:

To me, that equates to medical personnel saying, "don't worry, we see it all the time and it doesn't mean anything to us". So, I would not support that position.

Many patients who are concerned about their modesty are well aware that medical personnel see private parts of many people. That does not help to change their feelings. I think that those comments are very unethical. Medical personnel need to stop making those comments and work to honor patients’ wishes for modesty.

It does not matter why a patient feels strongly about her/his modesty in medical settings. Medical personnel should always work to respect patients’ wishes regardless of reasons.


At Sunday, April 28, 2013 11:53:00 AM, Anonymous Anonymous said...

Reply to Suzy:

I agree with your comment that the better phrase is "protecting people's safety". That is a good reminder to me to be careful and appreciate your comment about that.

As I noted at the start of my earlier comment "I am not disputing that women can engage in harmful actions, and I am not advocating that a double standard be applied when they do so".

I am not "blaming" men - and I did not state "We will help men by not allowing them to be in a situation to harm and abuse women." That was your interpretation and it is inconsistent with my intent, so my apologies if I wasn't clear. My intention was to state that changes that protect everyone will benefit everyone.

That said, I find it quite disappointing to see you taking offense to your incorrect interpretation, and to some of the others who have responded to my citing of the data about gender inequality in relation to sexual offenses. My citing the data is not = to blaming men. The reasons for male behavior are complex and I won't claim that I understand all of the reasons why the gender differences in this area exist. I am not out to "blame anyone" - I am citing data, not interpreting them.

The statistics that you cite clearly indicate that males can be harmed to, but you did not include any data about the gender of the perpetrators. As far as I know, men and boys are at significantly greater risk from other men than from women. I do believe they need every bit as much protection and support as women, but I don't believe the systemic issues that contribute to gender imbalance in sexual victimization can be addressed if you advocate denial of the reality that such imbalance exists in the first place.

And finally, where were you and the others who've jumped in to complain about my comments when the following were included in other comments on this blog?:

"By the way, obese female nurses make snide comments about obese female patients and just about
every thing else regarding odd body habitus they see on other female patients. Sounds like a common female nurse issue."
"Female nurses are not the sharpest set of pencils in the box..."
"State nursing board disciplinary records show many females reprimanded for sexual assault on male patients, they hold the record among the genders on boundary violations."
{by the way, that last one might not be accurate given that the studies I located suggest the opposite is true if adjust for numbers of men vs women in nursing profession}

I find it very disappointing that you and a few of the others seem to miss my main point, pick at the edges of my comments, but appear very content to sit silent when hostile comments are made about females. I'm starting to appreciate that there does appear to be a double standard in place.


At Sunday, April 28, 2013 4:33:00 PM, Anonymous Anonymous said...

SD you will find that I and others have on numerous ocassions challenged posts who characterize female providers as evil or malicous. The main points that come up are on a couple fronts. 1. the gender dispairity in the medical community, paticularly nursing makes the issue of modesty more difficult and pronouced and prevelant for males 2. that male modesty concerns are taken less seriously and viewed differently than females 3 but to a lessor degree male providers, especially nurses are sometimes treated differently than their female counter parts when it comes to opposite gender care. (the only time gender has disqualified a provider has been males in L&D). Most of the posters here challenge the view that female providers are evil or bad people anymore than males. I challenge your posts on two fronts, 1st I do not think rape and other henious crimes have a major part in modesty or even healthcare providers as a whole. One are criminals, the others are providers. 2. it is obviousl the under tone of you posts are male providers are not to be trusted because they are males. Thank you for providing evidence closed minded sexist are alive and well. Last restate, you can get what ever results you disire if you look hard enough to find reports that support your position and then interpet them to to fit your needs. Dr. bernstein allows everyone to post, but your statistics of rape and sexual misconduct have little place in a conversation about modesty....Don

At Sunday, April 28, 2013 5:32:00 PM, Anonymous Anonymous said...

In regards to the nurse who blew the whistle on Dr. Sparks, PT has stated the following:
"But this behavior went on for years despite the fact that finally one of the or nurses who as you say blew the whistle. That her and Dr Sparks were in a lesbian relationship and they had a falling out."

PT, you have continued to ignore three different requests to substantiate your statement with supporting evidence. Time does not seem to be a factor in your failure to provide a reference/supporting evidence as you have since posted comments.

Your failure to provide any evidence that your comments in regards to the nurse being in a "lesbian" relationship has left me wondering if this statement was your own fabrication. If so, the comment is slanderous. One can only imagine the distress of the nurse who attempted to protect patients from Dr. Sparks. The nurse put her career in jeopardy to do so, and in fact was terminated from her job. She most likely alienated herself from colleagues and her superiors as well. PT's unsubstantiated comment changes the nurses actions as coming from a place of integrity and a desire to protect patients, to one that is petty and mean spirited.

If PT cannot substantiate his claims, I would like to see the slanderous comment about the nurse removed. Its presence reflects poorly on the profession and also on the integrity of this forum.


At Sunday, April 28, 2013 5:59:00 PM, Anonymous Anonymous said...

I'm finding the argument of who is the worst perpetrator of offenses a bore. It doesn't matter.

Here's what does. Both women and men are not getting what they need in regard to privacy and same gender care. The healthcare system is ignoring this issue and pretending it doesn't exist despite patients are adversely affected by certain behaviors and standard of care practices that might as well be out of the Middle Ages.

We we should all be focusing on is getting our needs met whether we are male or female.

What we should all be focusing on is how to change the medical lobby.

It seems like a monumental feat, however, like all social change, it must start with civil disobedience.

Therefore, all you men must stand up for your rights or stop complaining.

And for those of you who have a mandate and feel that women are being accommodated, they are not when it comes to procedures and operations.

Same gender care will come when there's a mandate for it.

And, finally, there are those on this blog who in my opinion are mean spirited and have an agenda against women. Consider the source and ignore it or it will have everyone tail spinning as it has in the past.

At Sunday, April 28, 2013 6:24:00 PM, Blogger Joel Sherman MD said...

I haven't the slightest idea what real difference it makes, but just for the record I do remember at the time concerning Dr Sparks that there was a report somewhere that she had been in a prior lesbian relationship with the nurse who complained about her.
I'm not going to bother trying to find it though.

At Sunday, April 28, 2013 7:24:00 PM, Anonymous Anonymous said...

I googled east Stroudsburg area school district to try and find more info on the outcome since it happened in 1999.It said it went to trail on july 1999.They said the families were each awarded $7,500 in damages and they had to pay $289,000 of the plaintiffs legal fees. The doctor settled out of court. You would think they learned a lesson. Now fast forward to December 2011. They did the same thing to a male student. You would think if they were punished the first time they just might change. No, not them. They all know what's best for you and your children. No need for a signed consent form. I can't believe the arrogance of all involved. If talking to the school board and the legal system can't bring change what can. AL

At Sunday, April 28, 2013 8:41:00 PM, Anonymous Medical Patient Modesty said...


Can you please send me a link to the web site that you found the information about the male student in December 2011?

Parents must protect children against unnecessary intimate exams. Sadly, I think it is best for parents to accommodate their children for sports physicals to ensure that they do not have breast or genital exams.


At Sunday, April 28, 2013 10:23:00 PM, Anonymous Anonymous said...

In reply to Joel Sherman MD:

You may not have the slightest idea what "real difference" it makes, but I'm fairly certain it would make a great deal of difference to the nurse who PT has felt compelled to make negative and unsubstantiated claims against. Also, Don has stated the following:

"I got involved in the local papers commontary on the issue and as I recall the nurse who reported it, was fired, filed a wrongful termination suit, was actually engaged to a Dr,. (male), So curious where the lesbian thing came from. I realize Dr. Sparks was lesbian but did not recall that about the nurse"

While you may consider your memory of a "report somewhere" as "evidence", I do not feel the same. You may not feel like going to the bother to find the report, and that is fine. But if there is no other evidence to substantiate PT's slanderous comment than your memory I would like to see the comment removed.


At Monday, April 29, 2013 6:35:00 AM, Anonymous Anonymous said...

Hi Misty. The site I referred to is " Lebanon couple sue over physical exam of 9-year-old son at school ". But there in another site that will really raise your blood pressure. It's " Federal government headstart program violates - The Cutting Edge ". They are doing genital exams on 3-5 year old preschool kids. One father was threatened with jail time for spanking, forcing his kids to go to church, saying prays before mealtime and bedtime, and forcing them to read the bible. If this isn't big brother what is. I hope this helps. Good luck. AL

At Monday, April 29, 2013 3:52:00 PM, Anonymous StayingFit said...

Misty and SD:

Your claims that female sexual abuse, perpetrated against men, is an “outlier”, or that men abuse women much more often than the reverse, is based upon flawed evidence and assumptions. You provide statistics that likely suffer from sample bias, for the following reasons:

1.) Men are socialized to not complain, lest they be considered “whiners”.
2.) Men are taught that they are strong, and therefore cannot ever admit to being abused, and especially not sexually abused.
3.) Men's complaints are not taken seriously in those rare instances when they do complain about mistreatment.
4.) In those extremely rare times when men complain, and their complaints are taken seriously, they are much less likely to be categorized as sexual abuse, even if they would meet the necessary criteria.
5.) In support of item #4, and pertaining to the Sparks situation (she lost the right to be called “doctor”, in my opinion), I can't tell you how many comments I saw stating that her patients were “lucky”, that the commenters wished she was their doctor, she was just being thorough, or that this really wasn't sexual assault. You should still be able to find some articles on this case online. Have a look at the comments, if you can stomach them.
6.) Sexual abuse of men, though not often called that, is usually treated as humorous. How many prison rape jokes have you heard?

As a result of the above, your statistics, wherever it is that you got them from, are fundamentally flawed, and in no way prove the point that you are trying to make. The fact is, very little is truly known about the rate of incidence of sexual abuse of men, whether perpetrated by females or by other males.

What we do know is those rates must be higher than those that you report, given that the vast majority of health care workers are female, if you consider such workers as consisting of doctors, nurses, CNA's, MA's, and technicians. Unless you subscribe to the amazingly sexist theory that women, by their nature, are unlikely to commit such abuse, then the rates must be higher than shown, simply because women, as a group, have many more opportunities to abuse men than men do women. At least, they do in a medical setting.

At Monday, April 29, 2013 4:00:00 PM, Anonymous Anonymous said...


For the record, the nurse who reported Dr. Sparks
is a crna, certified registered nurse anesthetist. For
the uninitiated, she is a nurse who went for additional
training in anesthesiology. Normally, a medical doctor
with additional training performs this function.

If you use google or yahoo and do a search with
the words, Dr Sparks, New Mexico, you should be
able to answer your own questions. Look for the
articles under outpatient surgery among a few.

The articles state that Dr Sparks lied about her
teaching appointment at the university of New
Mexico, a position she never held and never will!

I should point out that you cannot sue for slander
unless you can show that you incurred a loss or
suffered undo stress. The points and references I
made were public knowledge from her OWN website.

Furthermore Ms. Garner, the crna knew for some
time the unprofessional behavior, yet for years she
said nothing. Ms. Garner was terminated from the
hospital due to an error on her part, giving
anesthesia to a patient with a full stomach, which
resulted in the patients demise.


At Monday, April 29, 2013 8:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Anon1, I am not here to defend PT though I have encouraged all, including PT, to attempt to document here the source of all controversial statements.

Though you might disagree, I just can't see that PT's description of the nurse's sexual preference, particularly in these days of changing and accepting views of homosexuality as slander.

I do not have the time to do research on each controversial comment by my visitors. In the context of discussion (which is part of the title of this blog), I think it is the responsibility of the discussants to validate others' statements if they are uncomfortable with its validity. ..Maurice.

At Monday, April 29, 2013 8:25:00 PM, Anonymous Anonymous said...

I like to commend StayingFit's comments from 29 April. You very eloquently stated the fundamental problem males face when receiving gender specific medical care.

Thank You


At Monday, April 29, 2013 8:39:00 PM, Blogger Maurice Bernstein, M.D. said...



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