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Doctor not guilty in first public probe

[Posted: Wed 04/03/2009 by Niall Hunter, Editor www.irishhealth.com]

A doctor has been found not guilty of professional misconduct in the first Medical Council inquiry to be held in public.

However, the Council ruled today that the GP concerned had used insensitive language to a female patient.

Dr Ross Ardill, of Custom House Square in Dublin, had told the hearing that he did not intend to cause offence to a female patient in the language he used when he asked her about her sexual activity.

Dr Ross Ardill said the expressions he had used, as to whether the patient had been near a man, had not caused offence to patients before. He had unreservedly apologised to the patient.

However, the patient, Alma McQuade, subsequently reported the GP to the Medical Council. The GP said he was horrified to get a letter of complaint and had apologised to the patient.

Dr Ardill suggested that the patient should "find a willy and have some sex" in order to deal with her medical condition, the fitness to practise hearing was told by the patient.

Ms McQuade, an art psychotherapist, also claimed Dr Ardill had also asked her when "she had last been close to a man's willy".

Dr Ardill, on foot of a complaint to the Council from the patient, was accused of using inappropriate language and suggesting the patient engage in sexual activity as part of her treatment during a consultation in September 2007, when this was not medically justified and did not take account of the patient's circumstances.

The hearing was told that Dr Ardill subsequently wrote to the patient to apologise to her for his use of language and any offence that it or he might have caused.

He said his reference to sexual activity was to outrule possible pregnancy or a sexually transmitted disease in the patient, who had flu-like symptoms and had been sleeping excessively.

Dr Ardill's legal team disputed the exact words used by Dr Ardill as described by Ms McQuade and said he had not intended to offend her.

He had, the hearing was told, been trying to outrule a sexually transmitted infection or pregnancy and had been advising on the patient's sleep problem.

Questioned by Patrick Leonard, counsel for the Medical Council Chief Executive, Dr Ardill admitted that in retrospect he had used language that was inappropriate.

Today's hearing was the first ever disciplinary inquiry into a doctor's behaviour to be held by the Medical Council in public. Under new laws governing the Council, which is the State medical watchdog body, the rules on whether a hearing can be held in public have been relaxed.

Around 30 members of the public attended today's historic hearing in Rathmines in Dublin

Neither Dr Ardill's legal team nor the complainant objected to the hearing being public, although Ms McQuade had asked that her name not be made public. Dr Ardill's legal team said he was keen to get it over with and was confident that he was not guilty.

However, concern was expressed about the advance press release about the hearing sent out by the Council yesterday.  Dr Ardill was not informed in advance that he would be the first person to be the subject of a public hearing by the Council, his legal representatives told the hearing.

No specific instruction was given to the media about whether the patient's name should be publicised, although Prof Anthony Cunningham, Chairman of the Fitness to Practise Committee, asked the media to use discretion in the reporting of the case.

Ms McQuade told the hearing she had been suffering from flu-like symptoms, including high temperature and a swollen throat. She had lost her energy and had been sleeping a lot.

Her symptoms did not improve and when she developed a bad headache and vomiting she attended the A&E in St James's Hospital in Dublin in September 2007. The doctor there told her to attend her GP if there was no improvement. Bloods and urine were taken and a letter given to the patient for her GP.

Ms McQuade attended Dr Ardill at the Custom House Square Medical Centre on September 25 2007. She had previously attended another doctor at the centre. Dr Ardill had been recommended to her by one of her colleagues.

She said in asking her about her symptoms, Dr Ardill asked if she was still close with her partner, as it was the policy of the practice to keep records of patients' partners. She told him she was no longer with her partner.

Ms McQuade said while she was having her blood pressure taken, the GP asked her when she was "last close to a man's naked willy". She hesitated and he reworded the question and asked if she had had sexual contact in the previous six months.

Later in the consultation, the patient said she told him she was sleeping for excessively long periods.

Dr Ardill then advised her, in relation to her sleep problem, to have a warm alcoholic drink before going to bed, to take exercise, read a book or "find a willy and have some sex". Ms McQuade said she was taken aback by this as it has already been established that she was single.

She wrote a short letter to the GP the protesting about the language she had used, which she felt to be was not appropriate for a GP.

The complainant said in a letter in response to her, Dr Ardill had apologised unreservedly for any offence caused
by his questions, which he said were related to trying to outrule possible pregnancy or a sexually transmitted disease, and in response to her inquiries about her sleeping patterns.

Ms McQuade said on reading the letter, she was relieved when she saw the apology but was upset with his subsequent justification for the inquiries, which she felt to be patronising. She felt that she had not been treated with dignity and respect by Dr Ardill and she objected to his "childish use of slang" in making his inquiries about her condititon

The patient said her symptoms gradually improved and she became stronger. She made a formal complaint to the Medical Council about Dr Ardill in October 2008, and the Council's decided that the doctor had a a case to answer.

Questioned by Eileen Barrington, legal counsel for Dr Ardill, Ms McQuade agreed that Dr Ardill had taken her symptoms seriously and had undertaken a very comprehensive review in a half-hour consultation.

The patient said it was her understanding the GP did not dispute the words she had said he had used when he wrote back to her following her letter to him.

Ms Barrington told the hearing that Dr Ardill, in a subsequent letter to the Medical Council following the complaint, referred to his inquiring about a possible STD or pregnancy and had asked the patient "had she been near a man's willy bits" in the previous six months.

The complainant said she did not remember those specific words being used. "He asked me had I been close to a man's naked willy."

Ms McQuade claimed the term "willy bits' would actually have provoked a stronger reaction from her "because I would have thought he was speaking to me like a child."

Counsel said Dr Ardill would contend that he had used juvenile or children's talk and was not aware at the time that the patient would be offended, and it was a term he had used before and it had not caused offence.

Ms McQuade said she understood that the doctor may have wanted her to feel at ease but it did not make her feel at ease.

If Dr Ardill had wanted to ask her had she had unprotected sex he could have simply asked her that. 

In relation to advice given about the patent's sleeping problems, counsel said the doctor had suggested a warm drink, taking more exercise or reading a book, but had used the phrase "rumpy pumpy" rather than what was alleged by the complainant.

The complainant disputed this however, and Dr Ardill had to her recollection used the words "find a willy and have sex." She said however, that the term "rumpy pumpy" may have been used at some stage by Dr Ardill.

Ms McQuade said she had reasonable recollection of what had taken place.

Asked what she had wanted the doctor to do on receipt of the letter of complaint from her, Ms McQuade said she wanted him to understand why she was unhappy. She admitted that if the GP had just stated in his letter that he was sorry for having caused offence that would have been enough.

Counsel: "He said he was sorry but that was not enough?"

The complainant said she accepted that he did apologise but her problem was with the part of his letter where he was trying to justify what he said. "I am a woman and an adult so I did not want to be spoken to like a child. It was explained to me as though I could not understand what he was trying to say."

Asked why she had waited 13 months to complain to the Council, the complainant said she had other things on her mind at the time. She had been ill and was trying to regain work. However, she did not make the complaint lightly.

The hearing was told that in a draft of the eventual letter of complaint she sent to the Council, Ms McQuade had discussed what happened in the consultation with female and male friends, and male friends had suggested that the GP was just trying to be approachable and that it was "just a guy thing"

She said she had been surprised at this conclusion.

Consultant cardiologist Dr Brian Maurer told the hearing that Dr Ardill had worked under him as a junior dotcor.

He said Dr Ardill was excellent, competent and caring and his communication skills were more than adequate.

The Council's fitness to practise committee, in its ruling, found the GP not guilty of professional misconduct. However, it found the allegation that Dr Ardill had used inappropriate and insensitive language proven.

The committee decided that the second charge of his having prescribed sex as part of the patient's treatment when it was not medically justified was unproven.

 

 

 

 

 

  maryedel  Posted: 05/03/2009 14:46

Frownhhmm. must say that I would be horrifed if anyone spoke to me like that. Still it was a bit unfair to have the docs face splashed all over the media even before the hearing began. Maryedel

 
  coolio123  Posted: 05/03/2009 18:51

I think its even more unfair that the patients name was plastered all over the media before and after the hearing. 

The whole idea of these public hearings is that malpractice of GP's etc is available for scrutiny, putting patients details out there will only discourage them from coming forward. 

 
  mc  Posted: 05/03/2009 20:21

This does not give me confidence in the Medical Council. They waste thousands on this perceived slight and ignore deaths caused by negligence. Whoever put this case forward as the first case to be held in public just wanted to distract attention from the real problems of cancer misdiagnosis, a&e, mental health problems.  Hanging this poor unfortunate doc out as a sacrifice to the media is just a sop to hide from the huge problems in the health service. How many lawyers, barristers, doctors, secretaries, etc. were paid for this charade? And the media swallowed it hook, line and sinker!

 
  Eibhlin  Posted: 06/03/2009 07:59

What age was this doctor, where did he train and when did he train?  Current medical training in Irish medical schools involves considerable time given to doctor/patient communication skills which would certainly have helped this individual!  However, the problem here is the arrogance of a small number of people who end up in the medical profession (and other professions) and whose behaviour is often reinforced and unchecked by colleagues.  It is unfortunate that this individual is splashed all over the media but it might server to root out this type of behaviour in the profession and ensure doctors treat their patients and work collegues with the respect and dignity they deserve. 

 
  sammi  Posted: 07/03/2009 15:32

hmmm is right.

Why didn't he just say " i'm concerned it could be an STD, would that be likely?"
I wouldn't be happy with his terminology  i'm also concerned about the extent of media involvement for something which on the whole seems trivial, although it was probably very upsetting for the lady involved.

 
  brandy  Posted: 14/03/2009 16:52

mc,

Thank you....exactly correct....you echoed my thoughts exactly

Thanks again.

 
  Chrissie  Posted: 12/04/2009 02:19

No General Practioner should ever talk this way to any patient. However they used the G.P. as well. Let's see come next public hearing if there is one that will be about enquiry of Consultant/s or their Hospitals, I doubt it.

 

 
  TK  Posted: 12/08/2009 18:57

Personally I don't know why this got to the stage of the Medical Council. As some other posters have pointed out, there can be all sorts of problems with doctors. It took me over years to get diagnosed and that has meant my health has been ruined but I don't think I would have been able to get to the stage of going to the medical council. It seems perhaps to me because this was somebody/a woman complaining of something vaguely sexual (even if there seems to be no suggestion he was coming on to her) that suddenly this is treated as extra important. I think that complaints are important in medicine but that there should perhaps be a level below the full medical council (with legal representation and all the other costs involved) for complaints to be judged and then if they are very serious than maybe they go to the full stage.

 
 
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