Report card: How Indiana protects patients from sexually abusive doctors

Transparency: 68
Is complete and accurate information on physician discipline provided to help patients protect themselves? More...
The best states make it easy for the public to find comprehensive information on physicians, including whether they have been disciplined for sexual abuse or other violations. To assess transparency, the AJC used five measures. Top grades went to states where medical regulators posted disciplinary orders on websites going back at least 15 years; fully detailed the acts that led to sanctions; avoided private orders, reprimands or letters; provided easy web access to clearly labeled doctor information including disciplinary documents; and listed any hospital sanctions, criminal convictions and out-of-state disciplinary actions for each physician.
- Are all orders posted?: 20 of 20
  
  Yes
- Do orders or other information online detail violations that led to sanctions?: 16 of 20
  
  Pending criminal charges may not be reflected in any information on the board's website. The board said that information related to consumer complaints is confidential.
- Does doctor profile information include hospital sanctions, criminal charges and orders from other states?: 4 of 20
  
  The information is not listed.
- Is it easy to find all doctor information on the website?: 8 of 20
  
  Orders are not linked through the profile and the profile doesn't explain that. You have to do a separate search for them.
- Can boards issue private orders or letters?: 20 of 20
  
  The board reports that it doesn't issue private reprimands or orders.

Duty-to-report laws: 30
Are colleagues and institutions that are aware of potential physician misconduct required to notify regulators? More...
To break the code of silence that can shield abusive doctors, the best states have laws requiring all physicians and health care institutions to notify regulators of potential violations. To assess these laws, the AJC used five measures. Top grades went to states where a broad range of health care facilities, not only hospitals, are required to notify regulators of alleged physician misconduct; where there is a deadline of no more than 30 days for making those reports; where penalties for failing to report are clear and significant; where doctors are required to report fellow practitioners; and where courts or law enforcement agencies must notify regulators when a doctor is criminally convicted.
- Which health care facilities must report doctors to medical regulators?: 12 of 20
  
  Hospital governing boards must report the results and circumstances of any final, substantive and adverse disciplinary action against a physician if it results in a significant change in clinical privileges or staff membership.
- Does the law set a deadline for them to notify regulators?: 4 of 20
  
  None specified.
- Does the law establish penalties for failure to comply?: 4 of 20
  
  None specified. The board has no jurisdiction over health care facilities and therefore has no authority to require the reporting, the board said.
- Are physicians required to report peers?: 6 of 20
  
  A physician who has personal knowledge based upon a reasonable belief that another physician has engaged in illegal, unlawful, incompetent or fraudulent conduct in the practice of medicine must promptly report that information to a peer review or similar body. But reporting to the board under those circumstances is not required.
- Are courts or prosecutors required to notify regulators of physicians’ criminal convictions?: 4 of 20
  
  State law does not require courts to report criminal convictions to the board.

Board composition: 60
Are consumer members included to balance physicians’ tendency to identify with their colleagues? More...
A blueprint developed by The Federation of State Medical Boards recognized the importance of having independent public members on physician-dominated medical regulatory agencies. To assess the composition of disciplinary agencies, the AJC used three measures, with the most weight given to consumer representation. Top grades went to states where public members make up at least 40 percent of the board; where those members represent consumers and where neither they nor their family members have professional or financial ties to health care; and where women hold at least 40 percent of the board seats.
- Is the public well represented?: 30 of 50
  
  The board has six physicians and one public member.
- Are public members independent and do they represent consumers?: 15 of 25
  
  Public members may not be associated with the medical profession in any way.
- Are women well represented on the board?: 15 of 25
  
  Two of the seven members are women.

Criminal acts: 36
Are medical regulators and law enforcement made aware of doctors’ criminal conduct? More...
The medical profession has long recognized the power imbalance between doctors and patients. But only in recent years have states enacted three key laws to try to protect vulnerable patients from dangerous doctors. The AJC considered two of these laws the most important. Top grades went to states where physicians must undergo criminal background checks, with fingerprints, at initial license application and periodically; and where doctor-patient sexual contact has been made a criminal offense in recognition that patients cannot give meaningful consent. In addition, the AJC also rated states on whether medical boards that learn of allegations of criminal conduct must alert law enforcement.
- Are physicians required to undergo criminal background checks?: 24 of 40
  
  Required at initial application, with fingerprints
- Is board required by law to notify law enforcement?: 4 of 20
  
  No legal requirement
- Has the state criminalized sexual misconduct involving doctors and patients?: 8 of 40
  
  The state has no criminal laws specific to physicians.

Discipline laws: 58
Do state laws strengthen oversight and discipline of problem physicians? More...
Abusive physicians can be protected by laws that limit regulators’ ability to investigate cases and don’t require permanent revocation of doctor licenses for egregious offenses. To assess the legal environment for doctor discipline, the AJC examined four key laws. Top grades went to states that require permanent revocation of doctor licenses for some violations; where physicians who have been convicted of felonies or who have lost their licenses in other states cannot be licensed; where medical regulators are entitled to records and other proceedings of hospital peer review committees that examine doctor misconduct; and where there is a reasonable standard of proof required for disciplinary action against physicians, especially in sexual misconduct cases where there may be no independent witnesses.
- Does state law require revocation for some violations? Can revocation be permanent?: 10 of 25
  
  After seven years, physicians whose licenses have been revoked can apply for a new license. Revocation is not required for any type of sexual misconduct or convictions.
- Do medical regulators have the legal right to hospital peer review records and proceedings?: 8 of 25
  
  At committee's option; AG may subpoena some records
- Does state law mandate that regulators deny licenses to physician applicants who have committed certain violations?: 15 of 25
  
  Licenses must be denied to those convicted of a crime that has direct bearing on a physician's ability to practice. Denial is discretionary for those convicted of a sex crime.
- What is the standard of proof for regulators to impose disciplinary sanctions?: 25 of 25
  
  The standard of proof required to discipline a doctor is preponderance of evidence. It basically means "more likely than not." That's also the typical standard for most lawsuits.

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