Sexual Misconduct

Case of the "naughty speculum":
Congratulations, You Should Be Proud At Your Age!

by Dr. W. Gifford Jones

Wednesday, October 11, 2006

It was not a good day at the office. My morning was just ending, when two female investigators from the College of Physicians and Surgeons arrived without notice and asked to see me. I was handed an envelope by one and the other immediately started to take notes. This was not a good sign. So I asked the reason for the sudden visit and was shocked to hear I had been accused of sexual misconduct.

That same day I was meeting my wife for lunch so I told her what had just occurred. She immediately laughed and said, "Congratulations! At your age you should be proud of yourself!" But I didn't share her sense of humour at the time.

As a medical journalist I'm used to criticism. For my stand on controversial issues some readers have wanted to hang me. I have no complaint with those who share differing views. As Harry Truman remarked, "If you can't stand the heat get out of the kitchen". But sexual misconduct is a serious charge, one I've always abhorred especially in the medical profession, and have said so in this column.

So as I quickly surveyed the document I wondered what I had done. I had no recollection of the patient who was making the charge.

No mention was made of sexual intercourse with her. I certainly would have remembered that if it had happened. Nor was there any mention that I'd examined her breasts in a sensuous way during the visit.

Reading the document further I wondered if I had told her she was attractive. But I'm very aware this is a "no, no" in my profession, and that it's also not prudent to even comment about a pretty dress. Nor had I asked her to have dinner with me, the prelude to a clandestine affair. At this point I worried I had momentarily gone bonkers and in a moment of utter senility told her a lewd joke.

Finally after extensive reading I discovered the charge. I was accused of using a vaginal speculum during examination in a sexual way. It had been inserted more than once during pelvic examination. This would have been a laughable incident if it had not required so much time with lawyers explaining the rationale in the use of a speculum.

I calculated that I had performed around 230,000 pelvic examinations using a vaginal speculum. Not once had I been accused of sexual impropriety of any kind or that the speculum had been naughty.

But why had I inserted this instrument more than once while placing a contraceptive intra-uterine device inside the uterus? A small speculum may prove to be inadequate to find the opening of the uterus so a larger one is required. The exact position of the uterus must also be determined to avoid perforating it during insertion. A single speculum insertion is simply not always possible.

After investigation and weeks of anxiety, I've now been exonerated of this charge. So why not forget about it? But I believe this case shows how dangerous it is to practice medicine these days. Some doctors tell me they no longer examine women's breasts for fear of being charged with sexual misconduct. It's a dangerous approach as malignancies will be missed. Other physicians, for the same reason, do not conduct a vaginal examination and serious problems may go undetected.

Let's assume I had been a young doctor with a wife and young family who had just opened a medical office in a small town. You can bet your last dollar that the word would have quickly spread that Doctor X had been accused of sexual misconduct. Can you imagine the devastation that would cause?

Has the case of "the naughty speculum" (it must be the first in history) changed my attitude about medical practice?

I admit I'm more likely now to explain to patients why more than one vaginal speculum is used. And I momentarily wondered if in this litigation-riddled society it was time to quit. One never knows what the next patient will imagine.

But I do hope I never have to hear my wife say again, "Congratulations, you should be proud of it at your age."

Dr. W. Gifford Jones can be reached at