Report card: How Kentucky protects patients from sexually abusive doctors

Transparency: 64
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?: 8 of 20
  
  Only orders still in effect are posted.
- Do orders or other information online detail violations that led to sanctions?: 20 of 20
  
  Orders are detailed
- 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?: 12 of 20
  
  The home page link is confusing. Disciplinary documents are labeled "board actions."
- Can boards issue private orders or letters?: 20 of 20
  
  Even letters of concern are public.

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?: 12 of 20
  
  Hospitals and their medical staffs are required to report all actions against physicians. The law does not require reports from nursing homes or clinics.
- Does the law set a deadline for them to notify regulators?: 12 of 20
  
  Within 30 days of final adjudication of actions
- Does the law establish penalties for failure to comply?: 20 of 20
  
  Misdemeanor charge
- Are physicians required to report peers?: 12 of 20
  
  Physicians must report within 10 days violations they see.
- Are courts or prosecutors required to notify regulators of physicians’ criminal convictions?: 20 of 20
  
  Clerks of all the state's district and circuit courts must report all criminal convictions of doctors.

Board composition: 55
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 medical school deans, the state health commissioner and three public members.
- Are public members independent and do they represent consumers?: 15 of 25
  
  The medical school deans and one consumer rep are ex-officio members. Public members cannot have an interest in the delivery of health care or be associated with or financial interested in the practice or business regulated.
- Are women well represented on the board?: 10 of 25
  
  There were three women on the board as of September.

Criminal acts: 42
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 & for good cause shown, with fingerprints
- Is board required by law to notify law enforcement?: 6 of 20
  
  No legal requirement. But the board notes that any investigation that involved prescribing is put into state database that is shared with law enforcement.
- Has the state criminalized sexual misconduct involving doctors and patients?: 8 of 40
  
  The state has no criminal laws specific to physicians.

Discipline laws: 75
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 two to five years, depending on circumstances, doctors whose licenses are revoked can reapply. State law doesn't mandate revocation for any type of sexual misconduct or convictions. But the board must suspend the license of doctors who are convicted of or enter an Alford plea to certain crimes.
- Do medical regulators have the legal right to hospital peer review records and proceedings?: 25 of 25
  
  Yes, KRS 311.06
- Does state law mandate that regulators deny licenses to physician applicants who have committed certain violations?: 15 of 25
  
  State law says the board cannot license anyone with certain criminal convictions, including sexual offenses. But the law leaves it to the board to decide whether to license those whose license was sanctioned in other jurisdictions. The board, though, said it has adopted a regulation that it must mirror actions of other states
- 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.

Kentucky

State report card

More from Kentucky

Highlighted case

Read more in this series

Researching a doctor

Complaint process

Where to file a complaint

Quoted

Key fact