Findings

Charge Characteristics

Additional Orders

Commonly
Cited Cases

Precis

Charge:  

A Complaints Assessment Committee charged the Doctor with disgraceful conduct.  It was alleged the Doctor:

1. Abused his position as a medical practitioner and took physical and emotional advantage of his patients by engaging in inappropriate sexual relationships with women patients in his care:

      Particulars

• In 1997 the Doctor advised Dr [C] that he had had sexual relations with unnamed patients;
• In December 1999 and subsequently the Doctor advised Dr [M] that he had sexual relations with two different patients namely Ms [S] and Ms [J].

2. Failed to act appropriately when performing cervical smears and/or internal examinations on women patients by not wearing surgical gloves and/or conducting examinations without an appropriate chaperone:

      Particulars

• In 1986 when employing Ms [HP] as a nurse he did not use a chaperone when seeing women patients.
• Between 1987 and 2000 when employing Dr [M] and Dr [C] he did not use a chaperone when seeing women patients;
• In 1999 in the course of discussion with Dr [M] the Doctor said he never used gloves when conducting cervical smears.

3. Made inappropriate remarks of a sexual nature, or asked inappropriate questions that were sexually orientated, or were sexually suggestive, when consulting patients.

      Particulars

• When seeing Ms [JK] he asked her about details of her sex life when not related to the consultation;
• He asked Ms [JP] about her ‘love life’ when not related to the consultation;
• When treating Ms [HK] he asked her to disrobe when the door was open and to bend over so that he could examine her bottom”.

Background: 

In February 1987 Dr C joined the Doctor’s practice.  In 1995 the Doctor and his wife separated for the first time.  In 1997 the Doctor had a relationship with Ms [M], a sister of a patient of Dr C, and subsequently also a patient of Dr C.  During 1998 the Doctor had a relationship with an employee of the practice (Ms F).  In late 1998 the Doctor reconciled with his wife. He rented a property to his patient Ms S.  In May 1999 Dr C decided to leave the practice.

In September 1999 Dr M commenced work as a locum with a view to becoming a permanent doctor at the Doctor’s practice. Dr M and the Doctor had a relationship that started in late 1999 and ended in February 2000.  In May 2000 Dr M left the practice.

The Doctor acknowledged having had extra marital affairs, a sexual relationship with Ms F when she was employed at the practice and having had a sexual relationship with Dr M.

The Doctor strongly denied having had sexual relationships with patients, or that he told Dr C and Dr M that he had engaged in sexual relationships with his patients. The Doctor said that Dr C was mistaken.  He said that Dr M was not telling the truth and that Dr M was a “woman scorned”. He said Dr M’s distress over the break-up of her relationship with him motivated her complaint.

The Doctor acknowledged that it was not his practise to use chaperones.   He explained that when patients who knew him well consulted him he did not believe it was necessary to use a chaperone, and that his practise was consistent with those of his colleagues in general practice.

The Doctor acknowledged that prior to 2000 he did not routinely use gloves when taking cervical smears.  He was adamant however that he always used gloves when performing internal examinations.

Finding:

The Tribunal found the CAC had not presented sufficient evidence to prove the charge laid against the Doctor to the requisite standard and therefore the charge against the Doctor was dismissed.

When considering the first particular the Tribunal was satisfied the Doctor probably did tell both Dr M and Dr C that he had had sexual relationships with patients. However, the CAC did not charge the Doctor with disgraceful conduct because he boasted about having had sexual relationships with patients. He was charged with disgraceful conduct because he abused his position as a medical practitioner by engaging in sexual relationships with patients. This allegation required the CAC to prove to a high standard that the Doctor did in fact have sexual relationships with his patients.

The evidence of Drs M and C was not corroborated by any person who might have been able to give direct evidence about the Doctor’s alleged sexual relationships with his patients. The evidence which was presented and accepted by the Tribunal did not establish to the requisite standard that the Doctor had in fact engaged in sexual relationships with one or more of his patients.

When considering the second particular the Tribunal accepted that prior to 2000 the Doctor did not use gloves when conducting cervical smears. The Tribunal was satisfied that whilst it is desirable for a doctor to use gloves when taking cervical smears, it is not a disciplinary offence to have failed to have worn gloves at the time in question. To avoid doubt, the Tribunal stated that a doctor performing an internal or intimate examination must always wear gloves.

The Tribunal concluded the CAC had not established, even on the balance of probabilities, the facts necessary to prove the third particular.

The Tribunal has no power to make orders against a doctor when disciplinary charges are dismissed. However, the Tribunal had significant concerns about the Doctor’s ability to maintain appropriate boundaries. The Tribunal strongly urged the Doctor to always use a chaperone when carrying out any internal or intimate examinations of female patients.