Health: A sore throat? Then kindly remove your blouse and bra, please

I've been much troubled by Tubes lately. I'm not talking hollow cylinders, or the wild American band that gave us "White punks on dope". No, my Tubes are far more unsettling. They're an acronym, courtesy of a group of medical students, for Totally Unnecessary Breast Examinations.

Now, a lot of medical examinations are of dubious necessity. We used to stick a finger up the backside of anyone who might have appendicitis, until someone pointed out that it was very uncomfortable and of no help in making the diagnosis. Nurses used to, and some probably still do, take half-hourly blood pressures from anyone who happens to be occupying a bed, again for no scientific reason.

These infringements are misguided rather than abusive, a reflection of protocols and procedures that had been taught many years ago and never updated. But the thought of a group of male students contriving to perform breast examinations in the knowledge that they are unnecessary, and to devise an acronym to celebrate their achievement, is in a different league.

To be fair, I'd never heard of the acronym before, and I'd never heard medical students use it, until Natasha from the Trust Me, I'm a Doctor research team unearthed it in a doctors' mess.

However, the taboo of doctors finding patients sexually attractive, and gratifying their desires through the physical examination, is not much talked about at medical school. No one wants to tackle the subject full on. An 18-year-old student bursting with testosterone encounters an incredibly attractive patient. Can he switch off his sex drive, just like that?

One answer came from a brave medic writing in a student journal.

"A 19-year-old woman was admitted to hospital for cystoscopy to investigate the possible causes of a series of urinary tract infections. I immediately noticed that she was very attractive. I began clerking but got nowhere, as I found myself staring into a pair of inviting blue eyes. The patient appeared to have developed an affection for me. As I plugged away with totally inane questions, I realised how devious I could be. I ran through a list of differential diagnoses trying to find one that would require me to examine her ample breasts that were being shoved towards me ..."

To his credit, the student bolted before following through with the assault, but was clearly affected by it ("you probably think I'm a worthless lump of hormone") and sought solace in the library.

A Dutch study found that more than half their doctors thought sexual feelings towards patients were acceptable, and 4 per cent admitted to actual sexual contact. In Britain, as you'd expect, the admission figures are lower. The GMC forbids it, and we just don't talk about it.

A breast surgeon did, however, describe his three switches to me. "One is as a man, who finds women sexually attractive; one is as a surgeon, who wants to remove a cancer for good, and one is as an artist who respects the female form and wants to achieve the best cosmetic result possible. Whenever you put on your white coat, think 'have I got my switches right?' If not, relieve yourself."

Fortunately, I've never needed to, but I was grateful for the advice. Most students get none and, as all doctors do, they displace awkward emotions into black humour and another acronym is born (Remember TF Bundy? - Totally Fucked But Unfortunately Not Dead Yet). But how often do acronymous attitudes become real behaviours?

To my horror, the Trust Me researchers found that the female perception of a male doctor examining their breasts unnecessarily is not unusual. Young women spoke of having their breasts examined without explanation when they'd gone in with a sore throat, a prescription for the Pill, for a new patient registration or even a school medical.

Not only did it cause lasting anxiety, but breast specialists agreed that such routine or opportunistic examinations are clinically unnecessary.

So what can you do to prevent Tubes? No one's ever shoved ample breasts in my direction, and I suspect (or, at least, hope) that the number of patients and doctors who get sexual gratification from consultations is small. Many patients have entirely trusting relationships with their GP and are happy to let the doctor decide whether an examination is necessary.

However, there is no diagnostic value in breast examinations as a "while you're here, let's do it" screening procedure or as a routine check (except for HRT, but even this is disputed). Some patients and doctors may be reassured by it, but if you don't want one, decline.

For specific breast problems or symptoms that may be related to breast disease (eg bone pain) then an examination may well be justified, but the onus is still on the doctor to convince you of the relevance and gain your consent. Otherwise, it's assault.

News
Jacqueline Bisset has claimed that young women today are obsessed with being 'hot', rather than 'charming', 'romantic' or 'beautiful'
people
Arts and Entertainment
Ben Affleck stars as prime suspect Nick Dunne in the film adaptation of Gone Girl
filmBen Affleck and Rosamund Pike excel in David Fincher's film, says Geoffrey Macnab
Sport
New Zealand fly-half Aaron Cruden pictured in The Zookeeper's Son on a late-night drinking session
rugby
Arts and Entertainment
Lena Dunham
booksLena Dunham's memoirs - written at the age of 28 - are honest to the point of making you squirm
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksAn unforgettable anthology of contemporary reportage
News
Liam Payne has attacked the media for reporting his tweet of support to Willie Robertson and the subsequent backlash from fans
peopleBut One Direction star insists he is not homophobic
Arts and Entertainment
A bit rich: Maggie Smith in Downton Abbey
tvSeries 5 opening episode attracts lowest ratings since drama began
News
i100
Life and Style
A new app has been launched that enables people to have a cuddle from a stranger
techNew app offers 'PG alternative' to dating services like Tinder
Sport
Greg Dyke insists he will not resign as Football Association chairman after receiving a watch worth more than £16,000 but has called for an end to the culture of gifts being given to football officials
football
News
people
Arts and Entertainment
Jake Quickenden sings his heart out in his second audition
tvX Factor: How did the Jakes - and Charlie Martinez - fare?
Sport
premier league
Sport
Frank Lampard and his non-celebration
premier leagueManchester City vs Chelsea match report from the Etihad Stadium
Arts and Entertainment
Rachel, Chandler and Ross try to get Ross's sofa up the stairs in the famous 'Pivot!' scene
tv
Arts and Entertainment
'New Tricks' star Dennis Waterman is departing from the show after he completes filming on two more episodes
tvOnly remaining original cast-member to leave crime series
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

C# asp.net Developer - West Sussex - permanent - £40k - £50k

£40000 - £50000 Per Annum + excellent benefits package: Clearwater People Solu...

SQL Report Analyst (SSRS, CA, SQL 2012)

£30000 - £38500 Per Annum + 25 days holiday, pension, subsidised restaurant: C...

Project Manager (infrastructure, upgrades, rollouts)

£38000 - £45000 Per Annum + excellent benefits package: Clearwater People Solu...

Project Manager (App development, SAP, interfacing)

£50000 - £60000 Per Annum + excellent company benefits: Clearwater People Solu...

Day In a Page

A roller-coaster tale from the 'voice of a generation'

Not That Kind of Girl:

A roller-coaster tale from 'voice of a generation' Lena Dunham
London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

London is not bedlam or a cradle of vice

In fact it, as much as anywhere, deserves independence
Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

Vivienne Westwood 'didn’t want' relationship with McLaren

Designer 'felt pressured' into going out with Sex Pistols manager
Jourdan Dunn: Model mother

Model mother

Jordan Dunn became one of the best-paid models in the world
Apple still coolest brand – despite U2 PR disaster

Apple still the coolest brand

Despite PR disaster of free U2 album
Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

Despite the result, this is the end of the status quo

Boyd Tonkin on the fall-out from the Scottish referendum
Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

Manolo Blahnik: Flats, Englishness, and Mary Beard

The shoe designer who has been dubbed 'the patron saint of the stiletto'
The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

Scrambled eggs and LSD

Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

'Normcore': Blending in is the new standing out

Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

New leading ladies of dance fight back

How female vocalists are now writing their own hits
Mystery of the Ground Zero wedding photo

A shot in the dark

Mystery of the wedding photo from Ground Zero
His life, the universe and everything

His life, the universe and everything

New biography sheds light on comic genius of Douglas Adams
Save us from small screen superheroes

Save us from small screen superheroes

Shows like Agents of S.H.I.E.L.D are little more than marketing tools
Reach for the skies

Reach for the skies

From pools to football pitches, rooftop living is looking up
These are the 12 best hotel spas in the UK

12 best hotel spas in the UK

Some hotels go all out on facilities; others stand out for the sheer quality of treatments