When health-care is a hazard

Up to 16 per cent of women have experienced sexual harassment from doctors and 3 per cent report having been sexually assaulted in the consulting room, according to a new survey of 472 Melbourne women.

Women who had a negative or abusive experience with a doctor rarely took action because of fear, shame and self-doubt, including anxiety that they would not be believed, the study found.

The research project, Towards Women-Sensitive Medical Practice, was conducted by Victoria University and Women’s Health West. A researcher and senior lecturer in psychology at Victoria University, Ms Heather Gridley, said the study originally set out to examine broader aspects of relationships between doctors and women patients but delved into sexual misconduct after women raised the issue.

Five-and-a-half per cent of women reported having been “sexually harassed” but this rate increased when they were asked about specific experiences that constitute harassment: 14 per cent believed they had been asked to undress unnecessarily and 16 per cent said they had been “touched intimately” when it was not medically required.

Overseas-born women were more likely to say they had been molested.

Ms Gridley says the higher rate for migrant women could be related to their more restricted choice of doctor due to language barriers. Women’s immediate responses to being molested varied. One said, “I’m normally assertive but I couldn’t say anything; I just walked out.” Others reported, “I cried all night and thought, `What have I done?’ But it wasn’t me.”

The long-term consequences of inappropriate or abusive encounters with doctors included impairment of subsequent relationships with health professionals, which had implications for the women’s health, and ongoing psychological distress, the report found. Many women felt grief and anger in regard to the loss of trust in the doctor/authority figure. But, while some women later tried to avoid doctors, many reported positive experiences with subsequent GPs.

The report said there was a need for improved medical education and increased sanctions against offending doctors as well as education for women about what they have a right to expect when they undergo intimate examinations.

Ms Gridley says it would be an overreaction for male doctors to feel that the abuse phenomenon means they should never see a woman without a chaperone. “Most women can actually tell the difference between a clinical examination and something creepy. ”

Ms Gridley says the medical profession is “no better or worse than other professions with the same opportunities. But they should also not deny that it happens. They need to take (the prevalence of abuse) on board in the same way the churches and schools have had to take it on board. The professionals are the next ones and the sooner they do it, the better”.

Dr George Segal, the Victorian president of the Australian Medical Association, says the profession takes the issue of sexual misconduct very seriously: “It’s totally inappropriate for a patient to be harassed sexually or in any other way during a consultation.”
But there are many patients with psychological problems whose perceptions of what happened might not always fit with the reality, he says.

* SATURDAY EXTRA: Sex in the forbidden zone

* “Melinda’s” doctor fondled her breast. “He was supposedly doing a chest examination at the time. I think I was probably absolutely stunned and … I can remember having a really high temperature and I was just dizzy and I thought, `I can’t deal with any of this …’.” The doctor later visited her at home uninvited and made constant phone calls to her workplace.

* “Carole” went to see a doctor for pelvic inflammatory disease. The doctor examined her rectally; she protested and he stopped. After a few days of antibiotic treatment she felt no better and returned to him. He examined her and then lay on top of her. She said, “Get off this minute.”

* “Lee” said: “I know some (ethnic) girls who were actually raped. They kept the miserable situation to themselves; they could only whisper it to close friends for comfort. They dared not contact authorities for fear that their names would be released to the media. (Their) culture made them believe that they were to be blamed.”

* “Elaine” said: “When I found out that I was pregnant, I came to a doctor for confirmation. He asked me to undress and lie on the couch, explaining that I needed an internal check-up to make sure everything was all right for me. But for about 15 minutes he let me lie naked like that without touching me. He just watched me from about one metre away. I got impatient, asking him, `What are you doing to me?’ Then he told me that he changed his mind; I didn’t need an internal check-up any more.”

* “Sarah” said: “A male doctor examined me internally with both his hands inside me. Not only was it extremely painful but his method … seemed very awkward compared to my previous experience of internal examinations. He took a lot longer than I expected … I felt angry and wanted him to stop, as he seemed to be morbidly enjoying this. After it was over I wanted to tell him off but couldn’t due to my difficulties with the language. I shared my experience with other women whom I knew had been to see the same doctor. They had similar experiences.”

First published in The Age.