'He said, she said': Sex and sensitivity raised in complaints about doctors

In one complaint, a female physician accuses one of the three male doctors she shares a clinic with of playing loud music and whistling while she's trying to consult with patients.

In another, an admittedly modest female patient accuses a male cardiologist of insensitivity after he comments on a necklace hanging between her bare breasts as she sits topless for an exam.

In the first complaint, the female doctor accuses her colleague of misogyny. And in the second, the female patient —a "well-educated business executive" — claims the experience left her feeling "stupid and unintelligent."

'It is the reality'

Both are files recently heard by B.C.'s Health Professions Review Board, which acts as a kind of appeal body for people unhappy with the decisions of medical profession regulatory boards.

They are separate cases, but combined represent a snapshot of a profession that, like many others, is being forced to grapple with attitudes about sex and sensitivity.

"Much as I would like to think that we as physicians are held to and hold ourselves to a higher standard, alas, we are part of society and the things that happen in other areas of society happen in medicine as well," says Susan Phillips, Queen's University professor in family medicine and public health services with an expertise in gender studies.

"So if there are pockets of sexism or bullying found elsewhere, they're going to be found in medicine too. I don't think this is rampant ... but it is the reality."

'Superiority due to his maleness'

Both the complaint from the female doctor and the complaint from the female patient were initially dismissed by B.C.'s College of Physicians and Surgeons. The Health Professions Review Board is tasked with deciding if the decisions were reasonable given the range of possible outcomes.

Their decisions, while made public, are anonymous.

In the case of the whistling, music-playing colleague, the female doctor said she asked him to either tone it down or close his door; he did neither.

She accused him of having "a problem with women or a sense of superiority due to his maleness."

The board said the matter basically amounted to a "he said, she said" situation, right down to their colleagues: "one offered a statement that was critical of the registrant and the other was largely supportive."

The college chose not to criticize the male doctor, instead sending "strongly worded correspondence insisting" they resolve their differences in a professional manner.

The review board found that decision fell within the acceptable range of outcomes.

"The fact that the complainant does not agree with the outcome does not make the disposition unreasonable," the board noted.

'Private when it comes to my body'

In the case of the cardiology patient, the board found the college had failed to address the central elements of the case: complaints the doctor hadn't adequately explained the scope of an exam that would see the patient sit topless in his office for a considerable amount of time and her discomfort over the comment about her necklace.

"I have never liked going to the doctor and it is because I am very private when it comes to my body. The only man who has ever seen me exposed was my husband," the woman wrote.

"I prided myself on that, as did my husband, but that was taken away from us when [the doctor] chose to perform a redundant test while leaving me exposed the entire time for no reason I can think of other than to 'have a look' for his own self-gratification."

For his part, the cardiologist, who has 30 years experience, responded by saying he was "deeply dismayed" by the complaint and is sensitive to any verbal or non-verbal cues of discomfort and would have invited the husband to accompany his wife had he asked.

"I usually chat with the patient about anything (their work, their necklace, their grandchildren, or anything else that comes to mind) in order to try to put them at ease," the doctor wrote.

"I take great pride in my 'bedside manner' and in being as affable and caring as possible."

The woman's husband countered by saying "there is a difference between chatting about the weather ... and inquiring about a piece of [jewelry] lying between the exposed breasts of your brand new topless patient."

The board said the college had "side-stepped" the woman's allegation that the statements were inappropriate according to guidelines that state that physicians "should be careful to ensure that any remarks or questions that are asked cannot be construed as demeaning, seductive or sexual in nature."

The college's inquiry committee must now reconsider the matter and issue a new finding that incorporates that criticism.

The review board's decision says that might cost money but "the key issues that were not addressed in the inquiry committee's decision are of sufficient concern to the complainant, the patient and to the public interest that these expenditures are warranted."

'This obviously struck a chord'

Phillips wouldn't comment on the specifics of either of the B.C. cases, but said they dovetail with research she's been conducting that suggests that decades after concerns were first widely raised about sexual harassment of female doctors, the issue is still very much a concern.

In 1993, she made international headlines with a study that revealed that nearly three quarters of female doctors responding to a survey said they had been sexually harassed by patients.

She is now part of a group looking at sexual harassment among medical students. She says their preliminary findings suggest the problem continues, particularly among female students from peers, patients and teachers.

"They wrote a lot and they thanked us for asking about this," she says. "But this obviously struck a chord with them."

Phillips says they hope to publish the research soon.