Doctor guilty of telling patient she has good looking breasts will be named

A North Island doctor found guilty of performing unjustified clinical breast examinations must undertake an 18-month education course on ethics and sexual boundaries. Photo / File

A North Island doctor found guilty of performing unjustified clinical breast examinations won't be suspended.

In an oral decision, the Health Practitioners Disciplinary Tribunal ruled the doctor must undertake an 18-month education course on ethics and sexual boundaries, pay a fine of $5000 and abide by conditions proposed by the Professional Conduct Committee (PCC) for three years.

These include notifying current and future employers of the tribunal's decision, having a chaperone when doing intimate examinations and having a sign notifying patients he can't conduct these exams without a chaperone.

The man and the practice have not been granted permanent name suppression and the interim order will expire 20 working days after the suppression lift was communicated.

Tribunal chairman David Carden emphasised normally a tribunal would impose a suspension for this level of misconduct, however because of other processes the doctor had already spent 13 months off work.

Today's conditions will not be finalised until it has been given in writing.

The man was found guilty of telling a patient she had good looking breasts and telling a teenager to consider masturbation.

He was also found to have raised the topic of breast health in situations that were not clinically justified and not offering a chaperone when conducting breast exams.

Included in the charge was the doctor's failure to record several breast examinations and when he commented "for your age, they're quite full".

The tribunal also found the doctor had brought up the topic of breast health despite committing to "utterly avoid" it in a written undertaking to the health centre.

PCC lawyers submitted a costing of $362,133 for the legal and tribunal fees.

In the penalty submission document, the PCC said it was not reasonable for the profession to fork out the entire bill, and recommended the clinician pay half the total fee.

In particular, the PCC said the cost award should reflect that each of the patients were required to attend the hearing.

Defence lawyer Dr Donald Stevens said it seemed wrong for the man to have to pay for two prosecution lawyers when his client had already spent 13 months with no income.

"Put frankly, he's not in a position to meet substantial costs," Stevens said.

He argued the doctor had already missed out on about $190,000 in lost income and had learned his lesson after this "hideous and shocking" ordeal.

"He has already suffered significant punishment from extreme stress and anxiety he has seen his wife enduring."

Carden also raised concerns about the doctor's denial of wrong-doing.

"He is still adamant it's a good theory [self and clinician breast examinations] and he's still adamant it should be practised in New Zealand."

Much of the defence's case rested on whether clinician and self-breast exams were beneficial.

Throughout the tribunal, Stevens argued there could be utility in clinician and self-breast examinations and that the doctor was just practising a preventative style of medicine.

Last week the tribunal heard from University of Auckland professor Dr Bruce Arroll who told the hearing three randomised trials had been conducted on self-breast examination which showed no benefit.

"It doesn't alter mortality so, therefore, recommending bodies that are evidence-based don't recommend doing it," Arroll said.

Stevens made an application for permanent name suppression to be applied, but this was ultimately denied.

He said the man had wanted to keep suppression because his relative is also studying medicine and will have their reputation severely affected.

The tribunal took two weeks to come to a decision, with many emotional testimonies from complainants to nurses at the practice and even the man's wife.