Rumpy Pumpy Medicine

An interesting case came before the Medical Council in Ireland this week. The first public hearing of a fitness-to-practise committee inquiry took place following a complaint lodged by a female patient. A  Dublin GP who used inappropriate and insensitive terminology, was found not guilty of professional misconduct.

sexual-harassment1The woman attended the GP complaining of lack of energy, difficulty sleeping and flu-like symptoms.  The doctor conducted a thorough examination and referred her for a brain scan for her headaches. In the course of the 30-minute consultation, the doctor asked his patient was she “next or near a man’s willy bits” in the last six months.  She was offended at this because she had already told him she was single. He then suggested  “rumpy pumpy” as one of the possible ways she might relax in order to help her sleep.  The woman later wrote to the doctor to say that she felt his language was inappropriate for a doctor. The doctor replied apologising unreservedly for the remarks and said his questions related to the possibility she might be pregnant or have a sexually transmitted disease. The woman felt his explanation was patronising as he had tried to justify his inappropriate terminology so she decided to lodge a complaint with the Medical Council.

The fitness to practise committee found the allegation that the doctor had used inappropriate and insensitive language proven but did not find this to be professional misconduct.

What’s your reaction to this story? Would you be comfortable if a doctor spoke to you in this manner? Was the patient right to complain? I’d love to hear your views.

17 Responses to Rumpy Pumpy Medicine

  1. Baino says:

    Well it’s inappropriate alright but I’m not sure I’d bother taking it to court. Then I’m pretty outspoken, I’d have told him then and there to lift his game!

  2. Steph says:

    Baino – I once had an orthopaedic surgeon ask me if I had an ‘exciting’ sex life. I was 6 months pregnant at the time and on crutches as my pelvic ligaments had given way due to my connective tissue problems (EDS). I actually thought it was quite comical at the time but on reflection, I felt that it was inappropriate questioning.

    It’s not easy to complain when you’re in the middle of a consultation so I think the patient on this occasion, was right to write a letter of complaint afterwards to the doc. That’s where I’d have left it though.

    See the link below for the doc’s response to the case. I’m afraid, I don’t have a lot of sympathy for him. He got what he deserved frankly.

    http://www.herald.ie/national-news/courts/patients-are-right-to-complain–doc-in-rumpy-pumpy-comment-case-1663747.html

  3. I think it’s a hard call to make, because one would have had to have been there to infer the tone of voice and attitude. When you get to the he said, she said point, it becomes academic and the only way a judgement can be reached is based on all other conduct – of both parties. Maybe she over-reacted, maybe he was genuinely out of line and patronising (what doctor isn’t?!). Sometimes (most times) doctors are just gormless gits who open their mouths to change feet. They don’t usually mean to offend, but it’s kind of like their writing, they can’t help themselves… Not that that’s any excuse! Perhaps some lessons may be in order for the good doctor, even if he wasn’t guilty of misconduct, which I doubt he was, but he was certainly inappropriate.

  4. Steph says:

    AV – Thanks! I would agree that doctors don’t usually mean to offend but I think that sometimes arrogance gets the better of some and it takes a brave patient to bring them down a peg or two.

    Personally, I’m glad the ‘rumpy pumpy’ doc got a taste of his own medicine by having his words reflected back at him in public. His exposure by the media will also have been a lesson to others to mind their P’s and Q’s in future!

  5. Dr.JaneDoe says:

    Is this not a complete waste of the Medical Council’s time and money though? And by extension, our money? She wanted an apology, supposedly, and that was all. However, she got one before this ever went to an FTP hearing.
    While I don’t approve of what the GP said, the Medical Council should not be used for slightly frivolous matters like this, which was childish on both parties’ parts. Real cases of negligence, and worse, may be happening and we waste time on THIS?

  6. Steph says:

    Hi! Jane

    I don’t see it as a waste of time and money. The Medical Council is there to protect the interests of patients.

    http://www.medicalcouncil.ie/about/faqarticle.asp?FID=2&T=F

    Look at this situation from the patient’s perspective. She got her apology from the doctor but she felt patronised by his explanation. She had a clear choice at that stage. She could either put up and shut up or take the matter further by reporting the doctor’s behaviour to the Medical Council. Personally, I think she was right to expose his behaviour and she’s paid the price in terms of having her own identity exposed.

    I agree that the matter was relatively frivolous in the bigger scheme of things but this doc obviously needed to have his knuckles rapped and the case will serve as a warning to other doctors, to treat their patients with the respect they deserve.

  7. Annb says:

    Surely this is a question of abuse of power. The balance of power is ALWAYS in the doctors favour. If he feels it’s appropriate to disrespect a patient enough to use this sort of language – where will this level of disrespect lead? Godlike complexes are prevalent in the medical profession because nobody shouts stop. Because this issue could be viewed as trivial, this makes this woman all the braver. She has risked ridicule for saying no to abuse of power. As patients, we should salute her.

  8. Steph says:

    Ann – I agree that this incident was an abuse of power. However, I feel obliged to point out that doctors frequently experience disrespect from their patients in terms of physical and verbal abuse i.e visit any A&E Dept! Having said that, doctors are in a position of power and should therefore always show respect. As I’ve already stated, I believe that the woman was right to take him to task no matter how trivial the issue.

  9. Annb says:

    Sorry Steph, I was addressing my comment to Jane. I fully agree that doctors too take a lot of abuse, I suppose I’ve just been on the receiving end of so much crap, that I tend to leap in all guns blazing when I sniff abuse of power.

  10. Dr.JaneDoe says:

    I respect your opinions on this, but I still disagree very much.
    Perhaps there should be a step below the “Fitness to Practice” level of complaint. Quite a few people I have discussed this with- non medics for the most part, feel that, while perhaps some action might have been necessary, that calling this a “Fitness to Practice” case was silly, frivolous in the extreme, and makes everyone, but particularly the Medical Council, look bad in this instance. Dramatic “Somebody shout stop” type reactions sound ridiculous in this context, and indeed, actually insult patients who have been involved in situations where that phrase and level of need for action is actually warranted, such as those damaged by Neary and Shipman, etc.
    I always seem to start my sentences with “In New Zealand” and it must get annoying, but they used to have a system whereby a patient could make a complaint at a local level to a Patient Advocacy and Complaints Dept-not run or staffed by doctors, and they would arrange meetings between the patients and the doctors involved, with both able to bring a support person if they liked. Real honest to God malpractice and negligence was left to the regulatory body, the Medical council of NZ. In almost all cases a speedy and effective resolution was obtained, at no cost to the patient, minimal stress to both parties, and an official record kept by the complaints and advocacy dept should an issue ever arise regarding the incident in the future. Efficient, speedy, open, transparent, and cheap and low stress.

    The thing is, FTP hearings are EXPENSIVE. I believe 25k was spent on one day of this alone. This IS, whether you choose to see it that way or not, a waste of money that right now could be better spent.

    I’m not saying that the GP didn’t possibly have to have his Ps and Qs examined and I’m not saying there was no need to address this. I will say that what is said, and what is perceived to have been said is often very different in SOME cases, but I do not have the facts in this case and would not presume to infer any further into this.

    But the way in which this very minor communications issue was handled was over the top, dramatic, stressful in the extreme for BOTH patient and doctor, and extremely cost inefficient, and this reflects very BADLY on our available methods for handling complaints against the profession.

  11. Annb says:

    Jane, I completely agree with your comment. I would welcome an advocacy service as a step below FTP, to deal with all issues which do not present a danger to the patient and therefore question the doctor’s fitness to practice. The problem I have with the current system is that as patients, we have no where to go with a complaint. I have been dealing with this for 5 years and have been stonewalled at every hand’s turn. Check for yourself on http://www.newkidney.blogspot.com There is a basic level of respect required in society,in the complainants view, this doctor was disrespectful. Her’s is of course is a subjective view which then needs to be mediated upon by an impartial body. My concern with the GP in question is, does this lack of respect represent the thin end of the wedge? This doctor did not put this patient at risk, however, she felt she had no where else to go to get redress. Having been in her situation more than once, I can understand her anger. That said, as a society, we should be able to deal with situations like this without spending 25k. I can also appreciate from a doctor’s point of view, this type of case completely trivializes the FTP mechanism.

    The biggest looser in all this, is yet again, our health service.

  12. Steph says:

    Look out you two! The boss is back 😉

    Thank you both for your valuable contributions to this blog post.

    To conclude:

    Jane has pointed out that a FTP inquiry in this case was not called for and incurred unnecessary expense. In NZ, they have a Patients Advocacy and Complaints Dept (not staffed by medics) which deals efficiently with complaints from patients.

    Ann feels that the problem was an abuse of power by the doctor. She makes the point that Irish patients have no where to go with a complaint and agrees that an advocacy service is needed.

    Steph says, if nothing else, this case has exposed that there is no suitable redress system in place for handling a patient’s complaint against a doctor. You have to hope that lessons will have been learnt from this costly exercise so that in future, patient advocacy is given the respect it deserves.

  13. Dr.JaneDoe says:

    Steph, you summed it up perfectly! And I agree, Ann, from the patients perspective it may well seem like this is the only course of action available to take.
    It’s so embarrassing though, that we are still so backwards that we have only this system and no more sensitive and appropriate methods of dealing with the myriad of issues that medicine commonly brings up.
    As a colleague succinctly put it, it’s like trying to kill a spider with a cannon.

  14. Steph says:

    Subsequent letters to the Irish Times on the Medical Council judgement…

    http://www.irishtimes.com/newspaper/letters/2009/0413/1224244556393.html

  15. Scotusa says:

    For God’s sake what’s this world coming to? Grow up you lot and smell the flowers. If common sense cannot prevail in situations like this it is time to have a good look at ourselves. Apart from the complete waste of public money (which we are paying for in this instance) surely the medical council have more important things to attend to and tell this attention seeker of a woman where to go!!!

  16. Steph says:

    Scotusa – You’re a bit late to this debate and frankly your comment strikes me as purely attention seeking.

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