Panel hearing summary 2012.0155

Decision of the Medical Board of Australia

Performance and Professional Standards Panel

Jurisdiction: Victoria

Date of Hearing: 11 October 2012

Date of Decision: 8 November 2012

Classification of Notification:

Communication – Insensitive or inappropriate comments (not sexual)

Allegations

The patient was referred to the doctor for diagnosis and treatment for alcohol abuse. The doctor, who provided an initial consultation, was alleged to have behaved in a way that constituted unprofessional conduct under section 191(1)(b)(ii) of the National Law in that:

1. the examination was inappropriate as the doctor did not obtain informed consent or provide prior adequate information, did not provide the patient with a cover sheet or gown for modesty, performed clinically unnecessary examinations and unnecessarily and inappropriately touched the patient’s breasts
2. the doctor failed to provide good patient care in that they made inappropriate inquiries about the patient’s medical history, used slang expressions with sexual connotations and failed to take into account the patient’s potential additional needs associated with co-morbid trauma and substance abuse when communicating
3. the doctor failed to coordinate care with other doctors in that they did not refer the patient back to the referring GP to receive the breast examination and did not provide the referring GP with a report of the consultation.

Finding

The panel found that the first allegation was not proved, though noted that a breast examination was not necessary or appropriate in the context of the referral. The patient ought to have been referred back to the referring GP if the doctor thought the examination was necessary.

The panel found that the second allegation was proved and that the doctor had behaved in a way that constituted unprofessional conduct. The doctor admitted the allegation and to ‘misreading the patient’ and speaking in a way that may have been misinterpreted and distressful. They admitted to inquiring about the patient’s medical history and often using slang so as to encourage patients to share this information. The doctor acknowledged that in retrospect the consultation could have been better handled in light of the patient’s vulnerability.

The panel found that the third allegation was proved. However, while the doctor’s coordination of care was less than satisfactory, their omissions did not reach the level of unprofessional conduct.

Determination

The panel cautioned the doctor to use language that showed respect for the sensitivities of all patients.