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.

PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksAn unforgettable anthology of contemporary reportage
Money
Welcome to tinsel town: retailers such as Selfridges will be Santa's little helpers this Christmas, working hard to persuade shoppers to stock up on gifts
news
News
i100
News
people
Arts and Entertainment
Architect Frank Gehry is regarded by many as the most important architect of the modern era
arts + entsGehry has declared that 98 per cent of modern architecture is "s**t"
Arts and Entertainment
Soul singer Sam Smith cleared up at the Mobo awards this week
arts + entsSam Smith’s Mobo triumph is just the latest example of a trend
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

Maths Teacher

£110 - £200 per day: Randstad Education Leeds: Secondary Maths Teacher for spe...

Business Analyst - Surrey - Permanent - Up to £50k DOE

£40000 - £50000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

***ASP.NET Developer - Cheshire - £35k - Permanent***

£30000 - £35000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

***Solutions Architect*** - Brighton - £40k - Permanent

£35000 - £40000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

Day In a Page

Wilko Johnson, now the bad news: musician splits with manager after police investigate assault claims

Wilko Johnson, now the bad news

Former Dr Feelgood splits with manager after police investigate assault claims
Mark Udall: The Democrat Senator with a fight on his hands ahead of the US midterm elections

Mark Udall: The Democrat Senator with a fight on his hands

The Senator for Colorado is for gay rights, for abortion rights – and in the Republicans’ sights as they threaten to take control of the Senate next month
New discoveries show more contact between far-flung prehistoric humans than had been thought

New discoveries show more contact between far-flung prehistoric humans than had been thought

Evidence found of contact between Easter Islanders and South America
Cerys Matthews reveals how her uncle taped 150 interviews for a biography of Dylan Thomas

Cerys Matthews on Dylan Thomas

The singer reveals how her uncle taped 150 interviews for a biography of the famous Welsh poet
DIY is not fun and we've finally realised this as a nation

Homebase closures: 'DIY is not fun'

Homebase has announced the closure of one in four of its stores. Nick Harding, who never did know his awl from his elbow, is glad to see the back of DIY
The Battle of the Five Armies: Air New Zealand releases new Hobbit-inspired in-flight video

Air New Zealand's wizard in-flight video

The airline has released a new Hobbit-inspired clip dubbed "The most epic safety video ever made"
Pumpkin spice is the flavour of the month - but can you stomach the sweetness?

Pumpkin spice is the flavour of the month

The combination of cinnamon, clove, nutmeg (and no actual pumpkin), now flavours everything from lattes to cream cheese in the US
11 best sonic skincare brushes

11 best sonic skincare brushes

Forget the flannel - take skincare to the next level by using your favourite cleanser with a sonic facial brush
Paul Scholes column: I'm not worried about Manchester United's defence - Chelsea test can be the making of Phil Jones and Marcos Rojo

Paul Scholes column

I'm not worried about Manchester United's defence - Chelsea test can be the making of Jones and Rojo
Frank Warren: Boxing has its problems but in all my time I've never seen a crooked fight

Frank Warren: Boxing has its problems but in all my time I've never seen a crooked fight

While other sports are stalked by corruption, we are an easy target for the critics
Jamie Roberts exclusive interview: 'I'm a man of my word – I'll stay in Paris'

Jamie Roberts: 'I'm a man of my word – I'll stay in Paris'

Wales centre says he’s not coming home but is looking to establish himself at Racing Métro
How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?

A crime that reveals London's dark heart

How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?
Meet 'Porridge' and 'Vampire': Chinese state TV is offering advice for citizens picking a Western moniker

Lost in translation: Western monikers

Chinese state TV is offering advice for citizens picking a Western moniker. Simon Usborne, who met a 'Porridge' and a 'Vampire' while in China, can see the problem
Handy hacks that make life easier: New book reveals how to rid your inbox of spam, protect your passwords and amplify your iPhone

Handy hacks that make life easier

New book reveals how to rid your email inbox of spam, protect your passwords and amplify your iPhone with a loo-roll
KidZania lets children try their hands at being a firefighter, doctor or factory worker for the day

KidZania: It's a small world

The new 'educational entertainment experience' in London's Shepherd's Bush will allow children to try out the jobs that are usually undertaken by adults, including firefighter, doctor or factory worker