Wisconsin Medical Society
August 18, 2022

The state of Wisconsin Medical Examining Board (MEB) put the final touches on its revamped chaperone rule for sensitive physical exams at its monthly meeting August 17, significantly scaling down the proposal’s scope following individual physician and Wisconsin Medical Society (WisMed) advocacy ever since the potential rule was first discussed in April 2021. The current version of the rule would require physicians to post their clinic/office’s chaperone policy “in at least one location reasonably likely to be seen by all affected patients.” If a self-employed physician does not have a chaperone policy, the rule requires the physician to create one and follow the posting requirements. The rule does not specify any parameters for what a chaperone policy must include – those decisions are left to the physician or their employer.

The MEB grappled with a thorny issue inherent in a state where so many physicians are employed by large health care systems: what if the physician has little or no control over their employer’s practice of posting a chaperone policy?

“My specific question on this new language is that it does put some of the onus on the physician to make and post the copy of these rules – which is effective in a small practice or a clinic where a physician has more control over those things,” said MEB member Emily Yu, MD. “But many people practice in an environment where that's more of a hospital responsibility of posting procedures – and so how would an individual physician be affected if their hospital corporation didn't comply with some of this language?”

Wisconsin Department of Safety and Professional Services legal staff acknowledged that the MEB’s authority does not extend to hospitals or non-physician employers – prompting MEB public member Rachel Sattler to ask, “Wouldn't this compel the hospitals to actually do that as well?”

”One would hope,” replied the MEB’s Sumeet Goel, DO.

“Sometimes it's difficult for an individual physician in a big corporation to make sure those things happen,” Dr. Yu said, “and I don't think it's fair to ask a physician to be responsible for that – not that it shouldn't stay in this language, but I think it's a consideration as far as who is actually responsible for that part of the process if a complaint is filed against a physician in that situation,” Dr. Yu said.

“If there is a complaint directed at a specific doctor for not having this posted in the hospital, we have the discretion to handle that,” Sattler said. “And if their position is ‘I don't control what the hospital does,’ that seems legitimate.”

Following discussion, the MEB unanimously approved moving forward with the new rule language, triggering another public comment process. The first step will be an Economic Impact Assessment period where physicians and other entities can comment on the projected fiscal effects of complying with the new rule. Following that feedback, the MEB can decide whether to continue moving forward with the proposal. If it decides to do so, the MEB would schedule a public hearing as part of a future MEB monthly meeting. Stay tuned to future editions of Medigram for news of when these comment periods are officially scheduled.