Health Practitioners Disciplinary Tribunal Decision No. 541/Med 12/223D (23 May 2013)
In a case brought by the Director of Proceedings, a general practitioner pleaded guilty to a disciplinary charge of professional misconduct for undertaking an intimate examination of a patient without first offering a chaperone. The examination had involved the abdomen and breasts. The context of the charge is important. The doctor had undertaken the unchaperoned examination against the following background:
- Previous Medical Council requirements to use a chaperone.
- A previous voluntary undertaking to the Medical Council to use a chaperone.
- A Medical Council recommendation that the doctor use a chaperone.
- An obligation in the doctor's contract for services requiring him to comply with the practice's reasonable directions, policies, and instructions.
- The practice's chaperoning policy.
In April 2005, following a complaint regarding an unchaperoned breast examination that the doctor had performed on a young female patient, the Medical Council had imposed conditions on the doctor's practice, including that he not see any female patients without a third person being present. Another health practitioner was to be present during any intimate examinations of female patients. The requirement for the doctor to have a third person present whenever he saw female patients was removed at the doctor's request in August 2006.
In February 2007 the Medical Council was notified that the doctor's employment at a Medical Centre had been terminated following a complaint from a female patient on whom he had performed an unchaperoned breast examination. The Council subsequently placed conditions on his practice, including that he have a chaperone present when seeing female patients for any intimate examination.
In May 2008, on application by the doctor, the Medical Council removed all conditions from his practice. However, in doing so, the Council required the doctor to sign a voluntary undertaking to use a chaperone for every intimate examination on female patients. In May 2009 the doctor made an application for the voluntary undertaking to be removed, and this was accepted by the Council. However, in a letter to the doctor the Council strongly recommended that he continue to use a chaperone for any intimate examination on female patients.
The practice in which the doctor was by then working had a chaperoning policy and processes around it that included a chaperone being present for breast and abdominal examinations on females. On two occasions in 2009 the practice's clinical coordinator emphasised to the doctor the need to adhere to the practice's chaperoning policy.
The consultation that resulted in the charge being brought before the Tribunal occurred on 15 February 2011 when a female patient, aged 22, was seen by the doctor. She advised that her breasts were sore and aching, that she had stabbing pains where her ovaries were, had missed her period, and had been vomiting. She also informed the doctor that her "areola were larger than normal". The doctor conducted abdominal and breast examinations. He did so without offering his patient a chaperone. After leaving the consultation room the patient appeared upset, and after speaking with a nurse and with the clinical coordinator she made a written complaint to the practice.
The Tribunal was concerned that there might be a recurrence of the offending and by way of some further deterrence imposed a term of suspension on the doctor for a period of six months. The operation of the suspension was deferred for a period of one year. If any further complaint concerning an inappropriate intimate examination is received within the 12-month period, the term of suspension will automatically come into effect. The Tribunal imposed conditions on the doctor's practice, including that he have a female chaperone present when seeing female patients for any intimate examination, and display notices to this effect. The doctor was also censured, fined $1,000, and ordered to pay costs.
The Tribunal's decision is available at: https://www.hpdt.org.nz/Charge-Details?file=Med12/223D
Last reviewed February 2019