Doctor breached standards by discussing issues with patient

An anaesthetist who made a chronically ill patient feel devalued by discussing his own health problems before giving the woman a painful epidural injection has been found to have breached standards.

The specialist, known only as Dr B, appeared before the Health and Disability Commissioner (HDC) after the patient complained about a two-hour consultation in April last year.

The woman, who had suffered chronic back pain since an accident in 1988, felt a popping sensation in her lower back while sitting up in January last year. A doctor referred her to Dr B for consideration of an epidural steroid injection.

During the consultation, Dr B talked at length about his own health, which she said minimised her experience. She also found him rude and disrespectful.

After she agreed to an epidural steroid injection, Dr B asked the woman to loosen her trousers. He then pulled down her trousers to expose her lower back, without asking her if he could do so.

The doctor also failed to offer the woman a blanket, despite a support person requesting one. The patient said she experienced significant pain after the procedure.

In its decision, the HDC found the doctor breached professional boundaries by discussing his own health.

The doctor gave evidence that he shared details of his own health with patients to help them understand their condition, and to illustrate how they could manage to cope and lead a reasonably functional life. He also said it was an attempt to be empathetic, and not to minimise the woman's condition.

But the HDC found doing so had minimised and devalued her experience.

It also found he breached standards by failing to conduct a thorough examination, failing to use an assistant, using inadequate sterile precautions, and failing to properly document the procedure.

The HDC recommended he review his practice and report back to the HDC. It also recommended the Medical Council conduct a review of Dr B's competence and conduct.