What Your Pediatrician Should and Shouldn’t Do During a Physical Examination
As parents, we must trust our children’s doctors. But we also need to know what is standard procedure and what is not.
Several years ago, allegations of mistreatment against Larry Nassar rocked the US gymnastics world . Nassar was found guilty of sexually assaulting young girls under the pretext of providing them with medical care and ignoring protocols designed to ensure patient safety. No parent or child is to blame – Nassar used his powers in the most insidious way – but it can serve as a terrible reminder of what we should expect from our children’s routine medical examinations and what we should do if something goes wrong. I don’t feel quite right.
Here’s what parents need to know, based on the recommendations of the American Academy of Pediatrics and other reports:
Should parents stay in the examination room with their children?
Parents usually stay in the room with small children. But teens have a choice, and some prefer mom or dad to wait outside.
You have the right to request medical assistance.
For sensitive procedures such as breast or genital examinations, AAP recommends the presence of a medical attendant. You should be advised that you have the right to ask for an escort, who will usually be a nurse or paramedic. If a companion is not available and you want them to be there, you should be able to postpone the exam.
Doctors should leave when a child is undressing
Staff should leave the room when children are undressing. The nurse or assistant should first give the baby a robe and sheet to cover.
Doctors must keep the child comfortable
Doctors should do their best to keep the child physically and mentally comfortable. According to the AAP’s policy on protecting children from sexual abuse , “pediatricians must explain to parents and verbal children why they are performing each item of the test and respect their need for modesty by providing adequate drapery and confidentiality when dressing.”
Here are some standard tests to look forward to in your child’s annual exam.
Tests for girls
- Examination of the external genitalia. During a routine check-up, your pediatrician will examine the external genitals to check for abnormalities or physical signs of suspected abuse. If the child is uncomfortable or refuses, force should never be used .
- Breast examination. For a teenage girl, the doctor will usually just take a quick look at her breasts during the annual check-up to see where she is in her development. Most adolescents do not need a manual breast exam unless they have a family history of breast problems. If the clinician performs an optional test, it should be done “with the pads of the fingers, not the tips of the fingers or the palm of the hand, and the patient should wear a gown exposing only one breast at a time.” in a New York Times report.
- Pelvic examination. A girl under the age of 21 rarely needs a pelvic examination unless the patient is experiencing pain, abnormal bleeding, unusual discharge, or other symptoms. The doctor may also want to examine the pelvic organs of a young woman if she has not had a menstrual cycle by age 15 or three years after breast development begins. Here’s what you need to know if your daughter needs an exam. The process should take 3 to 5 minutes, and the doctor should be empathetic, gentle, and take the time to answer any questions you might have first.
- First visit to the gynecologist. According to the American College of Obstetricians and Gynecologists, girls should see a gynecologist between the ages of 13 and 15. This visit may simply be a conversation about the patient’s medical and sexual history and how to stay healthy. Pap test should be started at age 21 or three years after the start of vaginal intercourse.
Boys tests
- Testicular examinations: Starting in infancy, boys undergo testicular examinations during their annual examinations. They may refuse if they feel uncomfortable, but this is a way for doctors to check for potentially dangerous bumps and bumps and make sure everything is progressing normally. For this test, boys take off their underwear or drop them on their knees. Young children often lie down before the test, but from the age of 12 or 13 they usually get up. Gloves should be used by clinicians as they probe each testicle. There is no internal penetration and the test usually takes less than a minute. The doctor should also teach the patient to conduct monthly self-examinations of the testicles, starting at the age of 15.
What to do if you feel something is wrong with your child’s health check
The New York Times suggests that if you are unsure about any test or treatment your doctor recommends, you should ask if there is an alternative, as there usually is. If you are still uncomfortable, postpone the procedure and seek the opinion of another doctor.
The AAP says that if you have any concerns about sexually inappropriate examinations, please report them to the clinic or healthcare facility. You also have the right to report your actions to your state’s defense services for an investigation.
This article was originally published in 2018 and was updated on June 21, 2021 to provide updated context and align content with current Lifehacker style guidelines.