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Inappropriate care by general practitioner (13HDC00059)
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General practitioner ~ Medical centre ~ Eating disorder ~
Alternative rituals ~ Personal comments ~ Prescribing ~ Referrals ~
Rights 4(1), 4(2)
A woman attended a medical centre for approximately 14 years.
For the last five of those years the woman usually consulted one
general practitioner (GP) and remained under his care until she
left the medical centre. The woman presented to the GP on numerous
occasions with various concerns including an eating disorder,
anxiety, and obsessive-compulsive disorder.
The GP discussed "self pleasure" with the woman, indicating that
it would be a useful treatment for her eating disorder. The GP also
made comments about the woman's body, and the woman said that the
GP told her that he liked seeing her and thought of her after work
The GP recommended therapeutic use of sexual behaviours, low
pressure water enemas, and deep abdominal massage as treatment for
the woman. The GP prescribed the woman with glycerol suppositories,
despite her known risk factors including a history of laxative
abuse, her eating disorder, weight loss, and her apparent fixation
on purging. When the woman complained of constipation, the GP did
not conduct an abdominal or rectum examination.
The GP prescribed zopiclone for the woman for five years. He
continued to do so when, after three years on the medication, the
woman took an apparently accidental overdose of the medication. For
a period of 12 months, the woman was prescribed zopiclone in
significant amounts with no review.
The GP wrote a referral letter to a psychologist, but the letter
was never received by the psychologist. The GP did not follow up
the referral and the woman self-referred to the same psychologist
two years later.
It was held that the GP's repeated discussion of masturbation
and his inappropriate comments to the woman were a breach of sexual
boundaries. As a medical professional it was the GP's
responsibility to recognise and maintain professional boundaries
between himself and his patient. The GP did not do so, and
therefore breached Right 4(2).
The GP's treatment of the woman was clinically inappropriate in
that he recommended the therapeutic use of sexual behaviours, low
pressure water enemas and deep abdominal massage, and prescribed
glycerol suppositories and large amounts of zopiclone with
inadequate review. The GP failed to follow up the referral of the
woman to the psychologist. The GP failed to provide services to the
woman with reasonable care and skill and therefore breached Right
Adverse comment was made about the medical centre for not having
in place a reminder system for following up specialist