Illustrations by Richard Watkins / AJC

Reaction to series: Change needed now

Experts: Medical boards must get tough to curb ‘mind-boggling’ scope of problem

Ryon Horne/AJC

In response to a national investigation by The Atlanta Journal-Constitution, experts and patient advocates from across the country are calling for sweeping changes to systems that permit doctors who sexually abuse patients to keep practicing.

“In general, the (medical) boards are too lenient,” said Arthur Caplan, director of medical ethics at the NYU Langone Medical Center, the medical school at New York University. “The boards do not have enough public participation, the boards do not have enough accountability.”

Doctors must have a certain character and integrity , Caplan said. If doctors engage in sexually abusive behavior, especially involving children, “I don’t think you should hold your license,” Caplan said.

The AJC’s investigation, which was launched online last week and began in print Sunday, exposed a phenomenon of physician sexual misconduct that is tolerated to some degree in all 50 states.

Dr. Sidney Wolfe, co-founder of the Health Research Group at the advocacy organization Public Citizen, said the AJC’s reporting highlights a problem that has long been ignored.

“It’s mind-boggling how much the health care system fails when these cases arise,” he said, noting that his organization reached similar conclusions when it studied the issue in the late 1990s. “There’s no evidence of a significant diminution of these cases, and the reason is people are in denial.”

Wolfe said the problem of physician sexual abuse will persist until medical boards take meaningful action against offenders.

“The final common pathway is the medical board,” he said. “If they don’t do anything, the doctor is free to continue practicing. A fine, probation — that really doesn’t do it. If there is clear evidence that a doctor sexually abused a patient, that doctor should no longer be allowed to practice.

Boston attorney Stan Spero said he found the AJC’s findings consistent with what he has witnessed in more than three decades representing people sexually abused by physicians, members of the clergy and other professionals.

“The reason that your numbers ring true is the (state medical) boards are run by professionals who tend to know each other,” he said. “It’s like the old boys’ club.”

Spero has represented victims in several high-profile cases involving Catholic priests. He said those abused by physicians are left with the same scars as those abused by members of the clergy. That’s because doctors are “idealized,” creating “almost an adult-child” relationship, he said.

The Federation of State Medical Boards said state regulators take sexual misconduct seriously and have worked in recent years to address the issue. It noted that its House of Delegates adopted a policy in April that urges physicians, hospitals, health care organizations, insurers and the public to be proactive in reporting instances of unprofessional behavior, including sexual misconduct, to medical boards.

Ryon Horne/AJC

Doctors & Sex Abuse: Our Research

“Sexual misconduct by physicians is abhorrent and all stakeholders in health care must be vigilant in reporting suspected incidents,” the federation said in a statement to the AJC.

The Georgia Hospital Association said in a statement that “patient safety is the top priority of every Georgia hospital” and that it supports full investigations of sexual misconduct allegations involving physicians.

However, the Medical Association of Georgia, the lobbying organization for the state’s physicians, criticized the series as irresponsible.

“The overwhelming majority of physicians in Georgia hold themselves to the highest professional standards,” said Dr. John S. Harvey, the group’s president, in a statement posted to the association’s website. “We have dedicated our lives to making our patients better. Scaring people with this kind of broad brush without adequate context simply does not serve any productive purpose.”

The AJC’s series reported that the vast majority of doctors do not sexually abuse patients. But the investigation found that it happens far more often than the medical profession has acknowledged.

Caplan described the series as timely and important and deserving of a thoughtful response from lawmakers and medical boards in Georgia and across the country. “The correct response is, ‘What can we do to diminish this?’ because what we are now doing doesn’t seem to be working,” he said.

Kathy Kinlaw, a medical ethics expert at Emory University who has served as a consumer member on Georgia’s medical board, said the AJC’s report raised serious concerns about egregious conduct. She said allegations of sexual misconduct were taken seriously by the board, but medical boards need more investigators to respond to complaints.

“We need an infusion of resources … in order to have a serious and rapid ability to look at these cases and make sure these cases are brought to justice,” Kinlaw said. “There’s just no doubt about it.”

A patient safety advocate pointed out that sexual misconduct is only one area where state medical boards have treated physicians with deference.

“The failure of state medical boards to take action against doctors’ sexual abuse parallels their failure to act effectively against doctors that abuse drugs and alcohol, and also against doctors demonstrating gross incompetence,” John T. James, a toxicologist who is the founder of Patient Safety America, told the AJC. “Until state medical boards are comprised of mostly non-physician, public members, this sort of secret-keeping is going to work against safe care for patients. I hope your startling revelations will serve as a catalyst for changing the composition of medical boards.”

In addition to calls for change, the AJC also heard from people nationwide who said they have been victimized by doctors or witnessed abuse.

“Your story shined light on a very dark subject,” one reader wrote in an email. “I pray it encourages and empowers other victims to come forward and not be afraid to speak on their experiences to protect others. … I’m still haunted till this day by what happened.”

Rita Alister, a retired Air Force lieutenant colonel who spent 20 years in the Judge Advocate General Corps, sent the newspaper an email in which she recounted an incident that she said occurred while she was serving at Hill Air Force Base in Utah in the late 1990s.

“As a military prosecutor, I investigated and drafted court martial charges against an Air Force medical officer who sexually assaulted his enlisted patient while he conducted her annual Pap smear,” she wrote. “I regret that I was not successful in convincing commanders to formally charge the officer. They just couldn’t believe that he committed a crime. It sickens me to know that the young enlisted gal was given the message that no harm had been done to her. I hope, wherever she is today, that she sees the spotlight you have placed on predator doctors.”