By Dr. W. Gifford Jones
Is it possible to miss the diagnosis of breast cancer? If so, how? And why? Some women are so fearful of finding a lump that they neglect monthly examinations of their breasts. Or fail to see their doctor for annual breast examinations. Malignant masses may also escape attention because mammography sometimes fails to detect its presence.
Now, thanks to the legal profession, there's yet another way to miss the diagnosis of breast cancer. This disaster was waiting to strike as sure as night follows day. And women must be careful not to fall into its trap.
What's happened? A patient recently divulged that she had seen her family doctor several times over the last few years for several medical complaints. But he had stopped checking her breasts for lumps. Suddenly a sizable breast malignancy was found that could have been diagnosed earlier.
Time and time again I see patients whose doctors have not examined their breasts. One doctor explained, "I used to routinely check women's breasts for malignancy. Now, with all the talk about sexual harassment, I no longer do so."
Obviously this is not the way to practice preventive medicine. But alas, medicine isn't what it used to be. Lawyers are now lurking in the shadows. Even medical organizations warn physicians to be careful about touching patients.
But this "no-touch" policy can also kill patients. And why single out the medical profession for a hands-off approach? The hands-on technique works well in so many therapeutic procedures.
Chiropractors would be out of work if they were restricted from laying their hands on a patient. So would osteopaths and acupuncturists. Their "laying on of hands" is an important part of the cure. Patients are happy to be getting more than just a bottle of pills.
I don't deny that scoundrels exist in the medical profession who should be hung up by their thumbs for sexual harassment. But as always, the pendulum of change has swung too far.
Let's not forget that touching is also a two-way street. I have patients of many nationalities in my practice. Touching for them is often a means of expressing relief, comfort and gratitude.
How am I to receive the grateful kiss on the cheek of the elderly patient who has come to my office for years? Or the overtures of a young woman suffering from infertility who is overjoyed at the news she's finally pregnant. Her sudden hug is an expression of heartfelt happiness.
There is no way I'm going to rebuke her. Or turn her away.
Nor are bureaucrats going to stop me from placing my hand on a patient's shoulder after I've told her she needs surgery for breast cancer. Patients know the difference between a caring hand and a lecherous one.
I was recently moved by the remark of one physician whose wife has cancer. He wrote, "My wife has two of the most caring doctors I've ever encountered. They sit on her bed, hold her hand, touch her arm, and explain in detail what is happening to her."
He continued, " Women are better at it than tight-arsed men; generally they're nicer human beings, it's their lack of testosterone."
He's also right when he adds that putting a hand on an arm or giving a cancer victim a hug costs nothing, but is worth millions.
So what does all this mean? Newspaper headlines accusing doctors of sexual abuse are not going to go away and will continue to have a "chilling effect" on doctor-patient relationships.
Remember too that sexual harassment cuts both ways. Office seduction presents a formidable task and has been highly overplayed by the media and lawyers. But occasionally the physician can be the victim.
I have never met a physician who has lighted candles, mood music and a bottle of Mouton Cadet in his or her examining room. And with other patients waiting in line it would have to be the speediest seduction in town.
Obviously if your physician keeps a hand on your knee for five minutes get another doctor. And surely judges should be sceptical of the female patient who has slept with her doctor for two years and then decides to sue him!
Our society has tossed common sense out with the garbage. But you can make sure you don't become a needless statistic. If your doctor fails to examine your breasts during an annual examination insist that he or she does so.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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