All kidding aside, I don't think you're obligated to be the pelvic specialist in your ED. If you're available, fine. If you're busy, or can't do it for whatever reason, then you're just plain "not available". The nurses and other docs should respect this. You'll try to help out but you can't guarantee it. It is not the job of, or right, for the nurses in the ED to volunteer you in triage for every female patient that has any pain between the knees and xiphoid process. Just because you are "in the building" does not mean you're "available". You could be running a code, multiple codes, have 60 seconds left in your shift, tired of doing pelvics or have a cramp in your dominant hand. WHATEVER. The doc can tell the patient, "We tried to accommodate your request, but there is no female physician available at this time. I will respect your request that I not perform your pelvic exam." Then he puts in the chart, "Patient refused pelvic for personal reasons. Requested female physician. Not available at this time."
GAME OVER.
You do not get to pick your doctor in the ED. For elective procedures and elective outpatient evaluations, fine, pick a female OB-GYN. If you're dying of some pelvic catastrophe: not so much.
(I know a pelvic is part of the physical exam, but when did it become a life saving treatment? When's the last time you know of a patient dying because they didn't get a pelvic exam?)
Move on. Order an ultrasound, CT, prescribe some antibiotics. Adapt. Whatever. Respectfully document that the patient didn't allow you to do your job as you were trained.
The patient does not have the right to your 24/7/365 iphone GPS tracking coordinates and a real-time "I'm available for Pelvics in 7 minutes" status update on your Twitter, Linkdin, Facebook and that MySpace account you just won't admit you still check from time to time.
Reasonable attempts to accommodate patients are good. Catering to a fast food, super-size it, "I want to pick my doctor, pick different doctors to do different parts of my exam, not pay my bill, be seen within 15 min, be discharged within 15 min, for free, get a sierra mist and a meal tray to go, and by the way, let me give you my real address so you can send the Press Gainey survey to my house (but not the bill)" mentality.
You are not a luxury Cartier watch concierge. (Now cue ED director/administrator to reply with post that says, "Times have changed, Yes you are")
La Gringa, you're right to be irritated, for what my 2 cent opinion is worth.
End of rant.