Doctors and ‘appalling’ behaviour

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