Illustrations by Richard Watkins / AJC

Why sexual misconduct is difficult to uncover

How pervasive is physician sexual misconduct?

The Atlanta Journal-Constitution, in an analysis of public records from every state, identified more than 3,100 doctors accused of sexual misconduct, including more than 2,400 doctors whose cases clearly involved patients.

But the AJC also found those numbers represent only a fraction of the doctors who had sexual violations since Jan. 1, 1999. Many violations never came to the attention of state regulators. In other cases, public board orders — i.e., public documents issued by a state agency that discipline a doctor — weren’t posted on violations that did result in sanctions. So while the vast majority of the nation’s 900,000 licensed physicians don’t sexually abuse patients, no one knows the extent of the problem. Here’s why physician sexual misconduct is concealed:

• Hospitals, clinics and fellow doctors fail to report sexual misconduct to regulators, despite laws in most states requiring them to do so. The only public board order on Dr. Michael Roy Sharpe came in Alabama, after he was arrested for raping a teenage patient. Before moving there, he had been fired by three hospitals in Tennessee, two for sexual misconduct, though there were no board actions against him in that state.  In Wisconsin, the state Department of Corrections failed to tell the medical board it had barred Dr. Brian Bohlmann from doing genital or rectal exams of inmates without a chaperone. The board found out in 2008, when he was charged with multiple criminal counts involving sexual abuse.

• Medical boards in many states issue private letters of concern or confidential agreements. The AJC became aware of these in select cases when doctors’ subsequent violations led to public board orders. In North and South Carolina, for example, Dr. Darlington I. Hart got multiple private letters of concern, dating back to 2001, before South Carolina issued a public order temporarily suspending his license in 2011 without stating a reason, and he surrendered his North Carolina license. It was 2013 before a public order detailed allegations of sexual misconduct. Other states told the AJC they use private orders routinely for first offenders.

Ryon Horne/AJC

Doctors & Sex Abuse: AJC 50-state investigation

• Doctors who sexually violate patients may enter “impaired physician” programs in most states and avoid public sanctions. In Michigan, doctors may be able to avoid the disciplinary process by going to a private recovery service. In Illinois, the Professional Health Program includes not only doctors who have abused drugs and alcohol, but also doctors with sexual violations.

• Medical regulators in almost every state, in response to open records requests from the AJC, said they could not provide data listing reasons that doctors were sanctioned. Minnesota ignored repeated requests for the information.

• Some medical boards have only a few years’ of orders on their websites. North Dakota only has public disciplinary documents issued since 2012; Hawaii, only orders issued in the past five years; New Mexico, only those since 2011. Vermont, New Hampshire and Massachusetts provide only 10 years’ worth of orders. In Kentucky, the AJC had to file written requests to obtain orders for some doctors it had identified as having sexual offenses. Some boards remove all information on doctors who are no longer licensed.

• Rather than post orders, some boards provide only a list of sanctions, sometimes without any information on the nature of the violation. Boards in Arkansas, Illinois, Mississippi, Wyoming and Oklahoma are among those that don’t post orders. Mississippi charges $25 per doctor for orders.

• Medical boards may decline to investigate some patient complaints because of time limits. California can only act on complaints reported within 10 years by adult patients. In New Hampshire, the statute of limitations for most board investigations is five years.

• In some states, regulatory authorities bring their investigations to a halt and list no allegations or findings when a doctor voluntarily surrenders his license. In Alabama, for example, the board’s website gives no reason why Dr. Cris Cole surrendered his license in 2004. But law enforcement records show that the pediatrician was arrested on charges of sexually abusing two minors when he was medical director of a children’s hospital.  While Ohio usually provides the public with very detailed board orders, it showed only that Dr. Samuel J. Bracken Jr. had surrendered his license; a reciprocal order in another state shows he had been charged with sexual assault of a 15-year-old.

• In many states, public orders are so vague that the AJC could only identify sexual misconduct cases through court documents, news reports or reciprocal orders from other states. Wyoming’s order gave no reason for revoking the license of Dr. Ronald L. Gooder, but a news report showed that the board found clear and convincing evidence that he had sexually exploited patients. Michigan said only that an administrative complaint had been filed against Dr. Kassem Hallak when it suspended him in 2011. The move came, though, as criminal charges were being brought alleging he had molested women and girls at his clinic.  Kansas redacts and marks as confidential large portions of some medical board orders, including the terms under which doctors may practice when they are on probation. In Nevada, remediation agreements the board negotiates with doctors are public records, but the board is required by law to remove the name of the doctor.

• Medical authorities have relied on physicians to self-report sexual misconduct with patients. They don’t.

• Because most medical authorities could not provide the AJC with information on doctor violations, the AJC amassed disciplinary documents through computer programs that collected them from regulators’ websites and rated the likelihood that they involved sexual misconduct. That process will have missed some cases on regulators’ websites and failed to identify all cases of sexual misconduct in the documents that were obtained.