Health: Sexual harassment? It's all in a day's doctoring

"Doctor, I haven't had an orgasm for 10 years. What are you going to do about it?"

This is the closest I've got to sexual harassment from a patient. Of course, it could have been an entirely innocent question begging my professional expertise, but the fact that it came through on an emergency phone call aroused my suspicions. Fortunately, I'd been taught exactly how to respond in such a situation: "That sounds nasty. I think you should go straight to casualty." Alas, I decided against the inappropriate use of scarce hospital resources and invited her to make an appointment. Three days later, I was treated to 20 minutes of irritable bowel and nothing else. Very stressful, but hardly harassment.

As a student, I did once encounter a pair of crotchless pants, but as they were the one (and only) pair I've ever seen, I assumed the poor woman must have snagged them alighting from her bicycle. Or perhaps they'd been specially designed by a gynaecologist to keep you warm during the speculum examination. Either way, I didn't find them threatening, so I was intrigued to hear a GP describe (on Radio 1 last Thursday) how common and stressful it is for doctors to be faced with "inappropriate underwear".

The GP, alas, did not specify how a patient should judge appropriateness before panting up to see the doctor. Will only pristine white cotton ones do? What if your entire pant collection consists of black leather thongs? Are you expected to make a special trip to M&S before you see the doctor? And what about cross-dressing? Should I be alarmed by a woman in boxer shorts? Well, only if they're mine. On the whole I prefer a cleaner pant, although gut pathology doesn't always allow for this, but the only underwear I can think of that would be unequivocally inappropriate would have "F*ck me, you're a doctor" splashed across the front.

All this pant talk was on the back of a survey by Doctor magazine, which found that nearly a quarter of the 1,514 GPs who responded have been sexually harassed by patients. This makes great copy, but it's worth remembering that each GP has around half a million consultations in a professional lifetime, so we're bound to encounter the extremes of human behaviour. Also, the survey was not a random sample - GPs who read Doctor were invited to fill in the questionnaire - which may bias it towards those who have had bad experiences. These consisted of (in order of frequency) "suggestive remarks, inappropriate requests for physical examination, inappropriate physical behaviour and unwelcome gifts".

At the extreme end, 7 per cent of respondents had been victims of stalking and three doctors were so distressed they had resigned from their practice. A few months ago, I met a female GP who'd given up medicine altogether after a male patient had masturbated in front of her in the "safety" of her own consulting room. She's now studying law. "At the time, I was just paralysed with fear and disgust. But I can remember thinking just how unsafe the consulting room was. The panic buttons were on order, and the only door was behind the patient, with me trapped behind the desk. I did have a window, but this was Liverpool, so it had bars on it. So I just sat there. I did think about complaining but in the end, I thought it would be less stressful to get out altogether. It wasn't just that one incident - it was also that I was a woman, I was known in the practice for being very empathic and a good listener - and everyone eventually just took advantage of it. I just felt abused all round."

For comparison, I spoke to a female doctor who works in genito-urinary medicine. Did she feel sexually threatened working in the male clinic? "The context of the work makes a big difference. People who come to this clinic know that they're going to have their genitals inspected so we all know what to expect. If someone suddenly gets his penis out, it isn't much of a surprise. Also, I always have a chaperone available to take in with me, a luxury you don't often have in general practice." "Do patients ever get aroused?" "A few get erections, but usually it's out of anxiety - you know, doing something you know you shouldn't but you just can't control yourself." "Like farting in church?" "Exactly. But very few men sustain an erection when the swabs go in." "And do you ever feel sexually harassed?" "I get chatted up a bit - but to me that's far less offensive than the thought of men sitting at home with untreated gonorrhoea and spreading it all over the city. So you just go with the flow."

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