A B.C. doctor who was the subject of three separate complaints from women about breast examinations was allowed to retire with no notice to the public about the reasons he promised not to practice medicine again.

One of the women fought a decision by the College of Physicians and Surgeons of B.C. to accept an undertaking with no public notification; she claimed she had been sexually assaulted.

Her complaint is detailed in a decision from B.C.'s Health Professions Review Board, an appeal body for patients unhappy with the outcome of complaints about medical professionals.

The woman — who is not named — claimed the doctor massaged her breasts during an exam while standing uncomfortably close.

"I could feel his penis in erection, just above my elbow," the woman claimed.

"Uncomfortably, I brought my arms as close as possible to my body. I was horrified. There was something very wrong with this exam. I felt incapable to move, vulnerable and at his mercy. I felt violated."

'The public ought to be notified'

The case highlights a disconnect which was the subject of a recent report on B.C.'s professional health colleges.

The former chief executive of the U.K.'s Professional Standards Authority who authored the report, Harry Cayton, lamented a complaints process shrouded in secrecy that "protects registrants but not the public."

B.C.'s professional health colleges were the subject of a recent report which examined a complaints process in which secrecy works to the benefit of registrants but not necessarily the public. (Yannis Behrakis/Reuters)

B.C.'s privacy laws dictate that the College of Physicians and Surgeons can only disclose a doctor's name if the case leads to discipline.

In an email to the CBC, the college said that in the case of the doctor accused of sexual assault, a voluntary undertaking not to practice medicine anymore satisfied the public interest.

"In general, voluntary undertakings, such as irrevocable resignation, eliminate the need for a lengthy, often emotional hearing," said college spokeswoman Susan Prins.

"Permanent resignation is the most definitive outcome possible to ensure patients are protected."

But the complainant disagreed.

"(She) is concerned the disposition makes no reference to the registrant's proclivity for 'sexual assault,' " the Health Professions Review Board decision says.

"It is her view that the public ought to be notified on the College website and the registrant should lose his licence to practice medicine 'anywhere and everywhere.' "

'Interview' about breast examination

The case, which began with a complaint in 2012, dragged on for years, mostly because the doctor in question was often out of the country and hard for his own lawyer to reach.

The woman worked in the same government health facility where the doctor was practicing when she asked him to investigate a lump on her breast in June 2012.

The doctor and the woman who complained about him worked in the same government health facility. (Goodluz/Shutterstock)

She filed her complaint the following December and the College of Physicians and Surgeons assigned an investigator to interview both the doctor and the patient in September 2013.

"Meanwhile two other women filed complaints with the college in regard to the registrant," the review board decision says. "Both apparently related to breast examinations which in opinions of the complainants were unnecessary and unrelated to their reason for seeing the registrant."

The doctor had also been the subject of an "interview" in 2010 about "how to approach doing breast examinations on patients and the concept of 'double consent.' "

'I attempt to avoid such contact'

The doctor denied the woman's complaint, but said "there may be the possibility of incidental contact when examining a patient."

"I attempt to avoid such contact," he responded. "But it is sometimes unavoidable."

The doctor denied the woman's complaint, saying that while he attempts to avoid incidental contact "it is sometimes unavoidable." (Shutterstock)

According to the decision, the doctor also said he recalled the 2010 discussion about breast examinations — "but not the details of what was discussed."

In 2016, the college was presented with agreement in which the doctor consented not to reapply to practice medicine in British Columbia or "in any other jurisdiction."

But in the months that followed, the doctor wanted to drop the words "in any other jurisdiction."

The final outcome is slightly unclear — as the review board decision says the undertaking in the consent order was limited to B.C. but that the college notified health authorities in Canada, the U.S., New Zealand and the U.K. that the doctor had "made an irrevocable commitment" to never re-apply in B.C. or anywhere else.

The college won't comment on the details of the case because it didn't result in discipline.

Consider this a 'victory'

The Health Professions Review Board upheld the decision.

Board member Marilyn Clark noted that she sympathized with the emotional toll on the woman.

"This should not be considered by the complainant as a loss but actually, because of her doggedness in pursuing the matter, a victory," Clark wrote.

But Raji Mangat, litigation director for West Coast LEAF, a legal advocacy organization that fights gender discrimination, says the decision is troubling.

"Is a reasonable member of the public reading this to infer that this is just the scratching of the surface?" she asked.

According to annual reports for the College of Physicians and Surgeons, most sexual boundary complaints in recent years have been blamed on "misperceived examinations."

There have been no disciplinary orders for sexual misconduct in the past four years despite dozens of complaints.

"Most complaints alleging sexual misconduct are found to involve misperception of sensitive examinations," the college said in its 2015-2016 report.

"Common points of criticism include inappropriate and unwelcome attempts at humour in the course of sensitive examinations; inadequate communication (failure to describe the examination and explain why it is necessary) and inadequate draping."

Mangat says the case speaks to a larger problems with a medical system in which complainants see the balance of power from examining room to investigative committee favouring doctors over female patients.

"I am awed by this woman who really did not stop. She really persisted in having this heard," Mangat said.

"That is not going to be the situation that other women would be in. They're not going to necessarily be able to pursue things this way to try to get a sense of justice."