TWR Posted April 21, 2015 Share Posted April 21, 2015 Anyone who is doing immigration physicals, I was wondering if during the physical you visually look at the genitalia of both sexes? Also if you do, does that include children? Just curious to see how detailed these physicals have to be. Link to comment Share on other sites More sharing options...
Guest Paula Posted April 21, 2015 Share Posted April 21, 2015 I don't do them, know nothing about them. But, I would be sure to ask the right people about the completeness of the exam, and would certainly have a witness to all exams when doing the male/female aspect of the exam. Cultural differences come into play, I would think. Where are these done? Link to comment Share on other sites More sharing options...
TWR Posted April 21, 2015 Author Share Posted April 21, 2015 At my office. You are right about cultural differences coming in to play. I am personally uncomfortable with genital exam for Immigration physical and am not sure if it is necessary. I have no issues with Pap, etc during a well woman exam just as it specifically relates to the immigration physical. More than one husband has questioned me as to the "why". Tough question to answer when there are no genital complaint and all they want is a green card.! Thanks Link to comment Share on other sites More sharing options...
gbrothers98 Posted April 21, 2015 Share Posted April 21, 2015 How about writing deferred? GB PA-C Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 22, 2015 Administrator Share Posted April 22, 2015 If it's on the form and required for a government exam, you need to do it and be OK with doing it, or you need to not do those exams. Genital examinations as part of a comprehensive medical evaluation by a licensed provider serve as the most reliable way to establish the gender of a person not previously known to the U.S. medical community, short of chromosomal testing. Is that the reason why they ask it? I have no idea. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 22, 2015 Moderator Share Posted April 22, 2015 Link to comment Share on other sites More sharing options...
TWR Posted April 22, 2015 Author Share Posted April 22, 2015 actually, the exam is to rule out remants of third world diseases ie: leprosy and such things as STD diseases. After reviewing the forms for the exam, it is required to visually examine the external genitalia. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 22, 2015 Administrator Share Posted April 22, 2015 actually, the exam is to rule out remants of third world diseases ie: leprosy and such things as STD diseases. After reviewing the forms for the exam, it is required to visually examine the external genitalia. Then there's your answer: must be done, but given that it must be done, should be done in the most culturally sensitive way possible. If I were to approach such a topic, I'd definitely have one of my female staff in the room when examining a female patient--that's just standard of care, and 100% for my protection, not for the patient's comfort. Having said that, I'd allow the patient freedom to choose who all ELSE to be present. If you were going to be doing this with a specific immigrant population, I'd have explanations pre-translated for either the patient to read in her own language, or the interpreter to read to a non-literate patient, explaining the requirements, rationale, and her options. I find that for my own comfort, I prefer to keep explaining what I'm doing while I'm performing breast or pelvic exams, especially when I've never met the patient before. Link to comment Share on other sites More sharing options...
waky02 Posted April 29, 2015 Share Posted April 29, 2015 I do this fairly regularly I always have a MA with me for a opposite gender exam For females I split the exam I start with a mini interview HEENT,Lungs,heart then I have them lay back and remove the top part of the gown for a visual check of the breasts and abdomen then have them cover up followed by look at the external genitalia I then tell them that I am leaving the room and that they should get dressed then I come back and complete the exam Link to comment Share on other sites More sharing options...
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