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Physician Doctor Interactions in the Era of #MeToo, a Plastic Surgeon’s Perspective

Woman's eyes through flower

In 2014 Johns Hopkins Hospital settled a lawsuit for 190 million dollars for the inappropriate actions of a doctor.

This past year, USA Gymnastics team doctor Larry Nassar was sentenced to up to 175 years in prison for sexual assault of patients.

Reporter Connie Chung revealed that her doctor assaulted her when she was in college.

It’s reasonable to assume that physician misconduct is more common than reported.  At the same time, allegations of misconduct can be difficult to prove, or disprove.  Furthermore, being wrongfully accused can be extremely damaging.

As a plastic surgeon, I am routinely examining and operating on patient’s intimate areas.  Here are my thoughts.

“Whenever I am looking at somebody’s undergarments, I need to have a chaperone.”

This is a quote from one of my professors during my plastic surgery fellowship.  Simple to apply, I like how this principle is gender neutral for both the provider and patient.  It works for both the hospital and office setting. This is important to protect me as a provider, as well as to reduce the anxiety of a medical exam.

Interestingly, after surgery, patients who were initially quite shy are often excited to show me “their results.”  Wait me a second – let me get an assistant.

It’s important to explain why a doctor does things

Before doing a breast augmentation revision surgery, I need to palpate the breast implant for signs of capsular contracture.  During a tummy tuck evaluation, I want to make sure the patient does not have an undetected umbilical hernia.  I think explaining my physical exam helps.

Jokes are not always funny

Jokes relieve stress. Health care workers make jokes because after a difficult situation, we are expected to see the next patient – with a smile.  So humor can be a mature coping mechanism.   Humor can also build camaraderie and team cohesion.

So it is natural for healthcare workers to tell jokes.  I am a big fan of self-depreciating humor, as it allows for self-introspection and improvement.  However, salacious jokes, or jokes at the expense of patients are not beneficial.

People will rarely tell you when they are uncomfortable.

People do not remember well what I say when they are in an examining gown.  It’s hard to carry on a serious conversation when half naked.  However, nobody has ever said, “Wait a second, can I put my clothing on so I can focus on what you are telling me?”

My practice is to step out of the room to allow patients to change back into their clothes.  Then I can come back in to discuss treatment options.

In conclusion, the medical field has some of the same problems with sexual misconduct as other aspects of society.  The #MeToo movement has increased awareness of the problem.  The use of chaperones and explaining the purpose of the exam are important. So is an awareness of the patient’s perspective.

Dr. Domanski
Curve Accent


Focusing on natural results, Dr. Domanski believes in helping patients regain control over their bodies.

Dr. Mark Domanski is a Double-Board certified Plastic Surgeon. Dr. Domanski is certified by the American Board of Plastic Surgery and the American Board of Otolaryngology – Head and Neck Surgery.

He has been recognized as a “Top Doctor” by Washingtonian Magazine, Northern Virginia Magazine and DC Modern Luxury magazine. However, Dr. Domanski’s favorite accolade is his Most Compassionate Doctor award by Patient’s Choice.

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