A forty-five year old female patient complained that a male GP locum had inappropriately touched her breast during a chest examination. The patient said that she had presented with a cough and with pain in the left side of her chest. She alleged that the doctor had felt around her left breast and had inappropriately cupped it in his hand. He had then held onto her breast whilst he had listened with his stethoscope.
She did not understand why he needed to listen to the front of her chest with his stethoscope as he had already listened to her chest from the back. Because of the seriousness of the allegation the practice felt they had no alternative but to ask the doctor not to work whilst this was investigated. The doctor rang the MDU for assistance.
The MDU adviser assisted the doctor in writing his response. The doctor explained that he had felt around her left ribs to try to isolate the area of pain and to exclude a rib fracture. He had also felt for her apex beat as part of his cardiovascular examination and he may have lifted her breast away with his hand whilst he listened with his stethoscope.
He explained that as part of his cardiovascular and respiratory examination he had listened to her chest both front and back but had not realised that the patient had felt uncomfortable during the examination. He had diagnosed bronchitis, advised her to stop smoking and had prescribed antibiotics.
In the written response, the doctor also apologised for causing the patient distress and for not explaining to her adequately how he wished to examine her. He said that in future he would explain to patients more thoroughly about what an examination might involve.
The MDU adviser suggested that the practice meet with the complainant if it would be helpful to her. The complainant agreed to the meeting, and she and her husband met with the locum doctor, the senior partner and the practice manager. The senior partner explained that the examination as described by the locum was similar to how he himself would have conducted that type of examination.
The locum doctor apologised again for not explaining what the examination would involve. He told the patient that he had now discussed this at length with other doctors, had taken advice about the use of chaperones and had changed his practice to ensure that before he examined a patient he provided information and obtained consent. He apologised for the distress caused to the complainant.
The senior partner informed the patient that they had no other concerns about the doctor and apologised on behalf of the practice. He told the complainant that the practice had now written a protocol on the use of chaperones and this had been discussed at the practice meeting. The complainant accepted the explanation and apology.
The use of chaperones can help to avoid this kind of complaint and should be considered whenever carrying out what may be perceived as an intimate examination.
Doctors need to give a full explanation to the patient about the nature and purpose of investigation or treatment and to ensure the patient understands exactly what it entails.
The MDU advises its members to keep clear notes detailing conversations with patients, including details of whether a chaperone was offered and was present, or if a chaperone was refused. The MDU advises all GP practices to set up a practice policy on chaperones.
This page was correct at publication on 01/05/2009. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.