こちらは認めてますが

　歯科医が産婦人科の医業（診療行為）をしたから医師法違反！(。_・☆＼ ベキバキ

　トピズレですが…。

　この國では、乳がん検診は主として外科が担当するケースが多いです。産婦人科の先生が担当してくださる地域や施設もあるようですが、希な例外です。

…むかしは一日百人以上触診したこともあります。見落としがあってはならないというプレッシャーがありますから、酷く疲れます。乳がん検診が楽しいという外科医に会った例しがありません。

　触診による検診はあまりアテにならないというデータが出て来ているので、今のメインはレントゲン検診に移ってきています。こちらが楽というわけではありませんが、必要ならあとで見直しできますし、同僚上司にpeer reviewしてもらうことも簡単です。多少なりとも気は楽です。また読影技能の認定制度もあるので、そういう意味でもオープンです。

僕の昔のバイト先、人間ドックの婦人科健診のバイトだったんですけど、乳がん健診もセットで産婦人科医がやらされていたんですね。
でも、実は僕、乳がん健診のトレーニングなんぞした事が無い。見よう見まねでやっておりました。

その施設、数年前に乳がんの見逃しがあって民事で訴えられて負けららしいです。

今でも乳がんは産婦人科と誤解している患者さんが少なくありませんが、乳がんの専門家は乳腺外科医です。健診は、是非外科の専門医に！産婦人科だと見逃されるかもしれませんよ～。

＞No.2 rijin さま
＞この國では、乳がん検診は主として外科が担当するケースが多いです。産婦人科の先生が担当してくださる地域や施設もあるようですが、希な例外です。
＞No.3 最前線産科医 さま
＞乳がんは産婦人科と誤解している患者さんが少なくありませんが、乳がんの専門家は乳腺外科医です。

　Σ(ﾟДﾟ)マヂスカ！　知りませんでした。
　家内が高校同期の先生が勤めているガン研で急きょ乳がん検診となったときも「ガンセンター内の産婦人科」とばっかり思ってました。m(._.*)mペコッ
　素人の無知先入観では､トピズレ洒落もできません（汗
　穴があったら入りたいです。穴を間違えないでf(^_^;)

私は乳がん検診大嫌い。変な疑いをかけられないよう神経使って、疲れてしまう。マンモグラフィーみてるだけならいいけど、誰が好きで、バーさんのおっぱいいじるんでしょうか。
　なるべくほかの先生に回して逃げてる。
　たとえ、若ければ若いほど説明に時間がかかるし、自己検診の方法も教えなくてはいけないし、今日は若い人が多かったなんていおうものなら、”よかったじゃない”なんて妻に皮肉を言われてしまう。おまけに、乳がんの患者さんは生き残る率が高いし、まじめに外来に通うから、乳がんの外来は初診、再診含めて年とともに増える一方！
　私の同級生の乳腺専門医は夕方5時に冷えた、マックをお昼として食べてた。

小生も外科医の時は乳ガン検診をしていました。結構手が疲れるんですよね。あと、日本の多数の貧乳(失礼)の方では問題ないのですが欧米人みたいな巨乳の場合は触診ははっきり言って無力かと(^^;)

一般の人は今でも乳ガン検診は産婦人科だと思っている方が結構多いです。確かに乳ガン検診でも被検者は女医さんの方を好まれますからね。(外科の女医さんは極端に少ないです)

　そうなんですか、今時の巨乳の娘をもつと不安です（親馬鹿。

　乳房の大きい方、乳腺の硬い方の場合は、定期的なレントゲン（マンモグラフィー）検診をお勧めします。

　触診だけでは正直言って自信がありません。

　ただ、レントゲン技師さんでも女性はあまり多くなくて、彼等は彼等で大変なようであります。

　あ、自己検診はいいですよ。心配なら毎月でもできます。やり方は本読んでも覚えられますし、医者でなくても教えられます。

　たいてい、検診センターの隅っこにパンフレットが置いてありますから、職場検診や人間ドックの時にでも、もらって来て読むようにお勧め下さい。

　自分で見つけて来る方は予後が厳しいのが一般的ですが、定期的に自己検診している方だけは例外です。

＞ rijin 先生

　重ね重ねのアドバイスありがとうございます。m(_ _)m
　娘に聞いたところ、日本のマンモグラフィの読影を信頼しているし、自己検診よりも外科医の先生の触診でもいい、ただし女医さんよりもイケメン先生をキボンヌとのことでした。m(_ _)m
　娘は昨年まで医師志望で某外科手術見学までこなしたので、医療の限界とそれに立ち向かう日本のお医者様には絶対的信頼をおいているようです。外科の先生が触診で発見できなければ、それは医療の限界を超えたもので運が悪かっただけ、だそうです。m(_ _)m

「でも」さんへ

　　ＫＹでＸＸ真面目なトビズレお許しください、でも、politically incorrect, 「指導的注意」、イエローカードでは。高齢女性も自由に出入りするサイトですよ。

＞　誰が好きで、バ ーさんのおっぱいいじるんでしょうか

＞　乳房の大きい方、乳腺の硬い方の場合は、定期的なレントゲン（マンモグラフィー）検診をお勧めします。

私は乳腺の硬い方や若い方にはマンモグラフィーはお薦めではないと思ってます。
超音波検査が好き。
問題は超音波は術者によるばらつきが大きい事ですが。（上手な人でも検診として腐る程やると疲れて見落としが出るでしょうし.....

昔々、経過観察の超音波検査やってたら患者さんが「前回は怖かったんですよ〜。男の先生が検査中すっごく厳しい表情だったんで悪いものが見つかったんじゃ無いかとドキドキしました。」って言うんです。
いや〜男の先生はニコニコしながら検査すると誤解されるからそういう顔になるんですよ〜って答えましたが。
普段は愛想がいい先輩だったんで、苦労なさってるんだなって思いました。（その後、恥ずかしいから触診できませんという研修医の男の子が現れたときにはぶったまげましたが。笑

その昔まだ学生だったころ,ポリクリで教授が｢キミ、乳房触診しないでガンを見落とし訴えられたら負けるよ｣とまことしやかにのたまい、やおら乳房触診をはじめたのを覚えてます。
触っても地獄,触らなくても地獄,どうすればいいんでしょうね。

　すんません。そのとおりです。高齢の女性で、乳がんの診断の遅れのため、"花が咲いた"といわれる悲惨な状況の患者さんのことを思い出しました。不適当な発言でした。

> 超音波検査が好き。

　自分も現場にいた頃はやむを得ずやってました。ただ、これも偽陰性が少なくないと言われていますので、精一杯頑張ってます！以上の意味はないのかも知れません。

> …ただし女医さんよりもイケメン先生をキボンヌとのことでした。m(_ _)m

…見てくれがよくて腕も良いという人も、いないことはないとは思いますが、…すっごい混んでます。

　見てくれが悪くても腕は良いという奴の方が、ずっと多いだろうと思います。そういう奴は人柄もまずまずです。

　最後は、信頼関係でしょうから、なぜか人柄がいい先生に腕のいい先生（若い先生が尊敬のまなざしで見ている）が多いですね。私の昔の主治医も、口の悪さはＸＸ（道府県）医師会筆頭のガラッパチで一見乱暴に見えますが、見てくれと逆で慎重丁寧な診察で鋭い観察眼をもってます。
　実は、患者を安心させるムンテラ演技が習い性になったんじゃないかと思います。生存率が低い致死率が高い症例の告知を受けていても、なぜかこの先生に委ねればなんとかないそうと生きる希望がわいてきたりします。m(_ _)m

NNN　http://www.news24.jp/135247.html　から

わいせつ行為の歯科医院長を処分保留で釈放＜5/14 0:06＞

　先月、東京・文京区で自らの歯科医院に勤務する女性に無理やり抱きつくなどしたとして、強制わいせつの疑いで逮捕された院長の男性（４４）について、東京地検が８日に処分保留のまま釈放していたことがわかった。被害者と示談が成立し、告訴が取り下げられたためで今後、不起訴処分となる見通し。

　内視鏡事件の続報がきませんが、、、、歯科医の事件を参考にすると、たとえ無実であってもお金を払って、示談を成立させて告訴を取り下げてもらって不起訴処分にしてもらうのが得策のように思えますが、、、（実利的には）
　医道審には影響はどうなのでしょうか。

　もし私がこの立場で、実名報道されていなく、起訴されなければ医道審にかからないという条件であれば、たとえ実際に故意でないということでも示談に応じてしまいそうな気がします。
　しかし、実名報道された今なら、無実なら徹底的に戦ってついでに、実名報道したTBS,フジ、サンケイ、朝日それぞれに徹底的に損害賠償を請求していただきたいと思います。

　しかし、あの報道の後、ポスト、現代、文春、新潮などのこの手の話題が大好きな大衆週刊誌に続報が出てこないのが不気味ですね。

　内視鏡事件は28日午前零時が時効だそうですから、27日までに起訴しなければなりません。
　ですので、26日・27日の報道が要チェックです。
　起訴に至らなかった場合、ＢＰＯ放送倫理・番組向上機構などへも通報してもいいかもしれません。
　何社かのストリーミング・ニュースを保存してあります。

このような事案は起訴できないんではないでしょうかね。誰か検察側の鑑定やる人間いれば別ですが。

モトケンブログのほうでは取り調べやら、弁護士の刑事弁護に対する対応の仕方など激しいやり取りがなされているようです。（頭の上を砲弾が飛び交ってはいるようですが、ここらには落ちないので他人事のように感じていました。）

　さて内視鏡誤挿入の件で、仮定として。
　１．本人はこのようなことで問題を指摘されたことがなかった。
　２．それ以外でも特に女性患者に対する問題を起こしたことや、苦情の申し立てもなかった。
　３．誤挿入を認めるがこれは事故であるとお話ししたが納得されずに終わっていた。
　４．誤挿入を認めたが、損害賠償に応じてはいなかった。

　さて、忘れた頃に本人の申し立てにより、わいせつ罪でいきなり警察に事情聴取を受けた。（逮捕はされていない。）まだ、マスコミには漏れていない。警察ではわいせつ罪を認めて慰謝料を払えば被害者が申し立てを取り下げるからそれで終わりになる。起訴はされない。

　本人としてはもし逮捕されれば責任ある地位のこともあり、周囲に迷惑をかける、外来の患者さんや手術を待機している人にも迷惑をかける。でも、でも、“間違えただけで、故意ではなくわいせつなことなど絶対、してない。弁護士の付き合いはなく法律を相談する相手もいない。
　罪を認めずにいれば逮捕されて取り調べを受けることになると暗に示される。ずっと拘置される。

　逮捕されることを覚悟で、無罪を主張するか、自らを偽ってわいせつ医師との非難を受け入れるか。もし、このとき弁護士に相談できる状態であれば、弁護士はどのようなアドバイスをするだろうか、正義を貫き、徹底抗戦しろというか、ここは自分に最も実利的な対応を取って、偽って罪を認めるか。偽って罪を認めれば、このトラブルはお金でけりがついたことになるが、わいせつ医師としての傷はずっと付きまとう。

　さてケース2、いきなり逮捕されてしまった。でも、絶対してない。まだ、マスコミには漏れていない。この時点で、本人が最も求めるものが、名誉ではなく実利的なことなら、弁護士にすぐ示談にして訴えを取り下げてもらうことに第一の力を注いでもらうべきのか、真実、故意ではない、わいせつ医師ではないということをたとえ、最高裁までいこうが戦うべきなのか、その時の弁護士が、社会正義を貫くことを第一とすると却って苦痛を大きくする経過とはなりはしないだろうか、、、

　まとまりのない仮定で申し訳ありません。現場にいる人間として、内視鏡の誤挿入はいつでもありうるトラブルで、一度やってしまったことのある人間としては、二度とやらないという覚悟で内視鏡をしていますが、やらないという保証があり得ないことも分かっています。もし、自分にこのような事態がおきたのなら、まずどうしたらいいのか、もし、弁護士の知り合いがいるならまずどうすべきか、、、、
　(同僚もしくは部下にこのような事態が起きた場合には、恐らくモトケンさんの法律相談コーナーで本業を始めてもらうことになると思いますけど、当事者であればそのような余裕はないと思うので]

　警察に刑事事件でお世話になるなどという想定は、医者になる頃はあり得ない話であったのですが、世の中がこのようになってくるとやはり心配になってしまいます。もちろん、この件は今まで腐るほど論議がなされた、医者の過剰な業務上過失致死事件の心配とはまったく話が異なりますが、、、

＞警察に刑事事件でお世話になるなどという想定は、医者になる頃はあり得ない話であったのですが、世の中がこのようになってくるとやはり心配になってしまいます。

　我田引水で恐縮ですが、業過などの過失犯にとどまらず、医療行為に基づく故意犯の嫌疑を受けた場合も想定し、医療側弁護ナショナルセンターからの医療実務を熟知した弁護士の緊急派遣サンダーバード構想を夢想します。m(_ _)m

…むかしは一日百人以上触診したこともあります。見落としがあってはならないというプレッシャーがありますから、酷く疲れます。乳がん検診が楽しいという外科医に会った例しがありません。

　大学の腫瘍グループにいた時は良く乳がん検診バイトに行ってましたが、やはり好きにはなれませんね。

　今でもあるかどうか分かりませんが、北海道の某市では「厄年検診」なるものがあって、一度だけそれで乳がん検診をしたことがあります。その検診に来たのは・・・
http://ja.wikipedia.org/wiki/%E5%8E%84%E5%B9%B4
↑参照

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