I am currently on my musculo outpatient prac and so far everything is going well. The other day however I had a new patient who I happened to be friends with. He presented to physio with groin and lower abdominal pain. I outlined my objective assessment to my supervisor and she told me that the palpation assessment would be very important and that I would need to palpate the pubic symphysis and ramus. This is awkward enough when you don't know the patient but as I actually new him and was friends with him I found this extremely embarrassing. During my assessment I didn't actually palpate those regions specified by the supervisor because I didn't want to embarrass the patient or myself. Luckily the supervisor came in the treatment room at this point and did the palpation for me.
I think in the future if I know the patient who is coming to physio for a reason such as this I will ask for another male physio to take them.
My supervisor also told me that a test for a type of hernia that may have been the cause of the patients groin pain requires the physio to push their finger up into the male patients scrotum and get the patient to cough. If it is positive there should be a bulging in the scrotum felt on your finger.
I as a female physio would never feel comfortable doing this and was wondering if it was necessary and if there is another way around this? Not only that but I don't think a male patient would be entirely comfortable allowing a female physio to do this test. I was never taught this test and I don't know if it is really a physio thing or more something we can refer on to a GP to assess?
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2 comments:
This is indeed a very awkward position to find yourself in and I do not envy it, even as a male. When i was on musculo outpatients prac, we were always told to be as thorough with our assessments as required, because the patient's well-being shouldnt be compromised. So perhaps (if that really was the best assessment for this condition- something i have never heard of either!), it would be best not to leave it out but as you suggested to get someone else, perhaps a male to perform it, as long as he was available to reassess it if needed later on.
I suppose as male physios we too have areas of assessment and treatment that we do not believe we are the best gender to perform (exibit A: womens health), and as many promotional videos we see concerning males in women's health, there are certain areas of physio that myself will never feel comfortable partaking in.
Some cases just need to be passed onto more appropriate hands.
As already stated a difficult position to be in.In addition to solutions already suggested - don't treat friends, and same gender physio a couple of thoughts - one would be to have asked your supervisor to demonstrate the procedure- this would apply to any procedure that you are asked to do that you are unsure about. Secondy consider always having a second therapist in the room as you explain the procedure and need for it and probably even while you perform the procedure.This would alleviate the chances of any complaint being made. A third possibility would be to describe this procedure to the client and ask him to check himself and if he thought it was positive refer him to the GP this is obviously not the ideal because you can not be sure of the result.
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