Doctors and ‘appalling’ behaviour

Imaan Joshi

26/04/2019 2:13:21 PM

Dr Imaan Joshi reflects on the recent case of a doctor’s incendiary online comments on domestic and sexual violence.

Hands at keyboard
The doctor received a six-week suspension following ‘numerous inappropriate and offensive comments’ made about women online.

A story broke in recent days about an emergency medicine registrar who was suspended by the Australian Health Practitioner Regulation Agency (AHPRA) following a series of comments on an overseas online forum inciting violence against women.
The AHPRA tribunal hearing also revealed that the 31-year-old had previously received a warning for accessing clinical notes without clinical need or consent on 21 occasions.
In spite of this, as well as the incendiary online comments – in which he wrote, for example, ‘Some women deserve to be raped’ and ‘If my marriage fell apart, it would not end in divorce. It would end in murder’ – he received only a six-week suspension and an order to undertake education on ethical behaviour and communications.
Given emergency doctors, much like GPs, are often at the coalface with patients who may present after family violence and sexual assault, the six-week suspension was met by some with bewilderment.

At what point is the safety of women taken more seriously?
It is important that we, as doctors, remain acutely aware of the fact we are privy to a whole host of personal information and situations other people are not.

For starters, being in a room alone with a patient, being able to ask a slew of intimate questions (if appropriate), and to then be able to conduct a physical examination, with or without a chaperone, based on availability.
To cite a recent example, when I asked consent to examine a patient’s abdomen during a physical examination, she revealed the details of a previous examination by another specialist who allegedly asked her to strip down to her bra and underwear – despite the fact he only needed to examine a joint. While she thought this was strange, and felt uncomfortable, the patient complied with the request.

She told me she later felt riddled with guilt and anger without understanding why.
Once I had finished my examination and the patient had dressed, I explored with her the possible reason for her guilt and anger. She did not want to name the specialist or to take the matter further. 

Doctors are in a position of trust and privilege with the community. We are given permission – under specific conditions – to ask intimate and very personal questions of our patients, even if we are meeting them for the first time.
We are further allowed to see our patients and to touch them in various states of undress in which only intimate partners would normally see them.
This is not a privilege to be abused in any way, shape or form.
When a trained and practising doctor makes publicly available comments about women deserving to be raped because they disagree with him or ending a marriage in murder rather than divorce, what does it truly say about his beliefs, even if it has not, as was stated in his hearing, ended up affecting his work?
What does it say that he feels free to make comments like this about unknown women, let alone his wife, the person to whom he is married and presumably loves?
Women have often been regarded as commodities and objects for too long. Medicine is no exception, wherein female trainees face far more discrimination – in some specialities more than others – regarding issues like pregnancy, maternity leave and training time.
Now that we are finally speaking up and recognising the problems within the profession, is it really appropriate that we tolerate this towards our patients, who often see us when they are vulnerable, scared and completely under our authority?

AHPRA social media suspended

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Keith   30/04/2019 7:11:38 AM

I don't believe that a doctor who holds and expresses the views that he has belongs in our profession.

Alarms   30/04/2019 7:56:24 AM

This guy needs long-term rehabilitation and interventional help at many levels, otherwise expect some tragedies waiting to happen.

rufus   30/04/2019 8:58:18 AM

He needs to be reviewed by his college to see if he is an appropriate person to remain as part of their profession.

Dr Philip Ian Dawson   30/04/2019 10:15:23 AM

I thought incitement to murder was a criminal offence, which should be prosecuted in the criminal courts, not just in respect of his job. If he has clearly typed this and is identifiable as the author there should be no doubt as to his guilt.

Judith Virag   30/04/2019 11:27:26 AM

I find this incident frightening, both personally and professionally.
I expected an outcry from my peers.
Has AHPRA really accepted the word of this perpetrator of public, online messages of hatred and violence - that his personal feelings have not affected his work performance.?
Our most vulnerable patients are well used to being invalidated and belittled. What proportion make formal complaints, in a timely manner?
I certainly feel grateful to those who responded to the original article, and particularly to the men, who clearly recognise this as a social problem, rather than a women’s issue.
I’m particularly grateful to you, Dr Joshi, for keeping the topic open.

Dr. F. Mitra   30/04/2019 11:51:33 PM

Its amazing that APRAH has taken such a lenient stand on this issue. Perhaps they think women's safety is not such an important issue afterall. They have failed to recognize that such thoughts are precursors to their actions.

Jenny Brownless   1/05/2019 11:38:22 AM

What is APHRA doing? It's time they did a responsible job checking what needs to be checked. This doctor needs to be assessed and offered help with his misogynist views. His attitudes are repellant, and must make hima risk of inappropriate behaviour, at the least.
Re APHRA, did you know that medical practicing doctors now need to get a" working with children "check to teach tertiary students, because holding medical registration does not guarantee that there are no issues ,because APHRA only checks a small number of doctors , not every doctor when reregistering each year?

Cam   1/05/2019 6:09:37 PM

AHPRA are useless. I contacted them today about a health practitioner (not a doctor) who is currently serving a ban due to misconduct. I became aware that the ban is about to expire but the patient is still doing the at risk behaviours that got them banned in the first place. Their response was "we cannot do anything as they are not currently registered. Once they are re-registered you can then contact us about your concerns". How is this safe?!