Patients valued my proactivity: doctor

A doctor, formerly of the Ka¯piti Coast, says he was trying to save his patients’ lives by discussing breast health and initiating breast examinations.

Now accused of misconduct, the doctor says he treated about 20,000 female patients in eight years and only eight had complained about his behaviour.

‘‘The overwhelming majority of my female patients welcomed and valued my proactive approach to the issue of breast health,’’ he said.

‘‘They felt empowered by their new awareness and knowledge.’’

The eight complainants are part of a case brought before the Health Practitioners Tribunal by the Professional Conduct Committee. It alleges the doctor performed breast examinations, in 2011 to 2017, that were unnecessary, unwanted, performed without a chaperone and often unrecorded.

It also alleges he told a 15-yearold to consider masturbating.

Last week Professor Bruce Arroll gave evidence that the doctor’s alleged behaviour was harassing, breached sexual boundaries policies and was potentially traumatising to his patients.

The doctor has interim name suppression and denies all charges. Much of his defence rests on the validity of clinical and selfexaminations, which the prosecution says are outdated practices not recommended in New Zealand.

Instead there is now a focus on encouraging women to be ‘‘breast aware’’ although what that involves is debated by both sides.

Yesterday, the doctor told the tribunal he believed it was his responsibility to encourage proper breast self-examination, as breast cancer was the leading cause of death for women in New Zealand.

‘‘I told patients that knowing how to check themselves was like knowing how to swim – one day it could save their lives.’’

Some women complained of being examined in a sitting position. He said he instructed them how to do it upright as most would examine themselves in the shower.

They complained the exams took too long, but the doctor said evidence showed the likelihood of finding a lump was directly related to time spent on the procedure.

He said he was well liked by the vast majority of patients and some followed him to his new job.

He worked more than 70 hours a week at the centre and during his last year there saw 4400 patients, which was 1500 more than his closest colleague.

He also spoke of inadequate support from his previous employer, GPs’ reluctance to be proactive with care, and women’s embarrassment at discussing breast care.

Yesterday morning, the doctor’s wife told the tribunal he cared about his patients. ‘‘He is honest and trustworthy, he is humble, he is kind, he is gentle, he is a workaholic and he has a great passion for being a doctor.’’

GP James Reid, for the defence, said that while clinical and breast self-examinations were not routinely recommended for low- to medium-risk women, there was a slew of opposing opinions.

Encouraging a woman to be breast aware also included advice that she should feel her breasts for any changes, he said.

Some complainants alleged they weren’t offered a chaperone and there was no record in their notes they were offered one, but Reid said that was an acceptable omission.

The hearing continues today.