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Sexual Misconduct: Case of the "naughty speculum"

Congratulations, You Should Be Proud At Your Age!

 By Dr. Gifford Jones  Friday, September 3, 2010

It was not a good day at the office. My morning was just ending, when two female investigators from the College of Physicians and Surgeons, arrived without notice and asked to see me. I was handed an envelope and one woman immediately started to take notes. This was not a good sign. So I asked the reason for the sudden visit and was shocked to hear I had been accused of sexual misconduct.

That same day I was meeting my wife for lunch so I told her with trepidation what had just occurred. She immediately laughed and said, “Congratulations! At your age you should be proud of yourself!” But I didn’t share her sense of humour at the time.

As a medical journalist I’m used to criticism. For my stand on various controversial issues some readers over the years have wanted to hang me. This goes with the territory and I have no complaint with those who share differing views. As Harry Truman remarked, “If you can’t stand the heat get out of the kitchen”. But sexual misconduct is a serious charge, one I’ve always abhorred especially in the medical profession, and have said so in this column.

So as I quickly surveyed the document I wondered what I had done. I had no recollection of the patient who was making the charge.

No mention was made of sexual intercourse with her. I certainly would have remembered that if it had happened. Nor was there any mention that I’d examined her breasts in a sensuous way during the visit.

Reading the document further I wondered if I had told her she was attractive. But I’m very aware this is a “no, no” in my profession and that it’s also not prudent to even comment about a pretty dress. Nor had I asked her to have dinner with me, the prelude to a clandestine affair. At this point I worried I had momentarily gone bonkers and in a moment of utter senility told her a lewd joke.

Finally after extensive reading I discovered the charge. I was accused of using a vaginal speculum during examination in a sexual way. It had been inserted more than once during pelvic examination. This would have been a laughable incident if it had not required so much time with lawyers explaining the rationale in the use of a speculum.

I calculated that I had performed around 230,000 pelvic examinations using a vaginal speculum. Not once had I been accused of sexual impropriety of any kind or that the speculum had been naughty.

But why had I inserted this instrument more than once while placing a contraceptive intra-uterine device inside the uterus at the patient’s request? A small speculum may be too small to find the opening of the uterus and a larger one required. The exact position of the uterus must be determined to avoid perforating it during insertion. A single speculum insertion is not always possible.

After intense investigation and many weeks of torment I’ve now been exonerated of this charge. So why not forget about it? But I believe this case shows how dangerous it is to practice medicine these days. Some doctors tell me they no longer examine women’s breasts for fear of being charged with sexual misconduct. It’s a sad situation as some malignancies will be missed. And in general examinations, I’m told doctors do not even conduct a vaginal examination for the same reason.

Let’s assume I had been a young doctor with a wife and young family who had just opened a medical office in a small town. You can bet your last dollar that the word would have quickly spread that doctor X had been accused of sexual misconduct. Can you imagine the devastation that would cause?

Has the case of “the naughty speculum” (it must be the first in history) changed my attitude about medical practice? It certainly hasn’t improved my impression of lawyers. I’ve wondered why this patient’s attorney didn’t advise her against laying charges when the evidence was so ridiculous.

I admit I’m more likely now to explain to patients why more than one vaginal speculum is used. And I momentarily wondered if in this litigation riddled society it was time to quit. One never knows what the next patient will imagine.

But I do hope I never have to hear my wife say again, “Congratulations, you should be proud of it at your age.”

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Dr. Gifford Jones  Bio
Dr. Gifford Jones Most recent columns

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He’s been a ship’s surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: http://www.mydoctor.ca/gifford-jones

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