Are you comfortable touching a patient during the course of your practice?

Read the letter that inspired the poll.

The following letter was sent by Jim Barker, St Ives, Cornwall and was published in the 28 January 2012 issue of The Journal.

Referring to the letter on physical examinations (PJ, 14 January 2012, p34), I have fitted many trusses over my many years in pharmacy, including for two satisfied patients in the past 18 months. I defy anyone to do this without touching the patient, probably in an intimate area. Years ago, I remember one colleague referring to the task as “fiddling with old men’s knickknacks”, so he was not a fan of doing it. There always seems to be a knick or knack caught up in the strap that goes between the legs and around the buttock. It is also good practice to check that the hernia will retract when the patient is lying down and the pharmacist may wish to assess the lump if it does not. Similar circumstances can arise when measuring patients for elastic hosiery. Again, it is likely that a pharmacist will be touching the patient’s leg. Both of these traditional areas of pharmacy are still in the Drug Tariff and still attract a fee.

A link to the original letter can be found here.

Ayshe Ismail
PJ Online team

Nick H If the profession is to move forward then we have to take risks. That said touching patients is something pharmacists have been involved in for decades as detailed above by Ayshe Ismail. Albeit some years ago since I qualified the training in physical examination and fitting was provided during my pre-reg year and perhaps something we had time to do then when there was not the pressure of another exam.

I think that the issue of examining patients is contentious. I regularly examine patients with suspected respiratory tract disorders, this can often involve requesting patients to loosen / remove one or more items of clothing. Unaccompanied female patients are offered a chaperone, however few have ever accepted my offer. I do see some patients with skin rashes though would only ever request to see these if they were situated in non-intimate areas. I am fortunate to work closely with GPs who are there to help if required. I have never had my examinations questioned, even though my consultations and clinical impressions are often reviewed by a GP mentor. I do feel that extended practice could be an area that many pharmacists will aspire to, however we do need to be aware that many patients are unfamiliar with this role. We must do all we can to reassure patients that we are developing & maintaining our competencies in line with accepted good practice. Having come so far, it would be unforgivable to falter at this time Dr Keith Pearson Manchester