An expert has accused a former doctor of taking excessive time to conduct breast examinations that weren't clinically justified.
University of Auckland professor Dr Bruce Arroll told the Health Practitioners Disciplinary Tribunal today that one woman claimed her breast exam took 15 to 20 minutes and it should have taken no more than two minutes per breast.
A former North Island doctor who is facing a misconduct charge is accused of telling a 15-year-old patient she should try masturbating, and initiating inappropriate breast examinations with multiple patients between 2011 and 2017.
His name is suppressed and he denies the charge.
During the fifth day of evidence, Arroll said there was no clinical guidance about the topic of masturbation and a note should have been left on the computer saying a sensitive topic had been discussed.
"It is highly likely to be very embarrassing for a teenager," he said.
Another patient alleged the doctor had pressured her into getting a breast examination by not taking no for an answer.
"A woman should only have to deny a breast screening once," Arroll said.
The Professional Conduct Committee (PCC) alleges the former doctor's actions amount to misconduct and the examinations were not "clinically justified" or expected by the patients.
Arroll said comments the doctor had allegedly made to female patients were extremely inappropriate and it was a major concern women had reported not being offered a chaperone.
The comments allegedly included, "You know that you're very attractive don't you?" and "for your age, they're [breasts] quite full".
With another patient, it is alleged he brought up breast health when it was not clinically justified as she was suffering diarrhoea at the time.
She alleged the doctor spent the majority of the appointment talking about breast health and offered to examine her breasts, but she declined because she was so unwell.
It is also alleged the doctor offered to perform a cervical smear on a woman without offering a chaperone and offering to show patients how to self-breast examine.
During cross-examination, defence lawyer Dr Donald Stevens argued there could be utility in breast self-examination and clinician examinations.
Stevens said a document submitted to the court by Arroll was designed for consumers and therefore had limited value to practitioners as a source of guidance.
"It does not say BSE [breast self-examination] should not be taught," Stevens said.
Arroll refuted this and said three randomised trails 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.
Arroll said there had been numerous breaches of sexual boundaries and there seemed to have been little acceptance or reflection from the doctor that patients might have been harmed.
The hearing is set to run through next week.