Report card: How Kansas protects patients from sexually abusive doctors

Transparency: 78
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?: 8 of 20
  
  Details may be scant in some orders and portions may be redacted and marked as confidential.
- Does doctor profile information include hospital sanctions, criminal charges and orders from other states?: 18 of 20
  
  Some of the information is not independently verified by the board.
- Is it easy to find all doctor information on the website?: 12 of 20
  
  You must read through a disclaimer to access the information. You may have to know if the doctor is an osteopath or allopath, or sort through a list of those with the same last name.
- Can boards issue private orders or letters?: 20 of 20
  
  A 2015 law eliminated private orders or letters.

Duty-to-report laws: 76
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?: 20 of 20
  
  Medical care facilities must report any information that appears to show that a doctor acted in a manner that would be grounds for disciplinary action.
- Does the law set a deadline for them to notify regulators?: 20 of 20
  
  Within 30 days of having any information that appears to show doctor misconduct
- Does the law establish penalties for failure to comply?: 20 of 20
  
  $1,000 per day each day late (but the board said no facility has ever been fined.)
- Are physicians required to report peers?: 12 of 20
  
  Any physician who has knowledge that a fellow physician has committed an act that may be grounds for disciplinary action must immediately report that knowledge to the board. State law defines "knowledge" as direct involvement or observation of the incident.
- Are courts or prosecutors required to notify regulators of physicians’ criminal convictions?: 4 of 20
  
  State law does not require courts to report physicians' 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 eight physicians, three chiropractors, one podiatrist and three public members.
- Are public members independent and do they represent consumers?: 20 of 25
  
  No public member can be the spouse of a licensee of the board or have an interest in or be married to someone with a financial interest in any person's practice of the healing arts.
- Are women well represented on the board?: 10 of 25
  
  Two women were on the 15-member board as of September.

Criminal acts: 48
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?: 28 of 40
  
  Required at Initial application, reinstatement & investigations, 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?: 16 of 40
  
  Rape by deception that it was medically or therapeutically necessary is a crime.

Discipline laws: 81
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?: 18 of 25
  
  After three years, physicians whose licenses are revoked can reapply. While state law says the board must revoke a physician's license following conviction of felony or substantially similar offenses, it also says that a two-thirds majority of board members present can reinstate the doctor. In such cases, the licensee must prove by clear and convincing evidence they will not pose a threat and have been rehabilitated.
- Do medical regulators have the legal right to hospital peer review records and proceedings?: 20 of 25
  
  The board can subpoena for peer review information.
- Does state law mandate that regulators deny licenses to physician applicants who have committed certain violations?: 15 of 25
  
  If the applicant has been convicted of a felony or class A misdemeanor in another jurisdiction, the license must be denied. However, it's up to the board to decide whether to license a physician whose license was revoked, suspended or limited or censured in another jurisdiction.
- What is the standard of proof for regulators to impose disciplinary sanctions?: 28 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. Kansas says that if a doctor has a felony conviction, revocation is presumed and a doctor must prove by clear and convincing evidence that he or she is rehabilitated.

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