Report card: How Maryland 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
  
  Orders remain forever on practitioner profiles
- Do orders or other information online detail violations that led to sanctions?: 18 of 20
  
  A 2011 state review said in cases involving allegations of sexual misconduct, the board sometimes closes cases with confidential advisory letters when it lacks evidence to prove the charges. The audit also noted the board struggled with a backlog of cases.
- Does doctor profile information include hospital sanctions, criminal charges and orders from other states?: 10 of 20
  
  Information is limited to the most recent 10 years. The board noted that posting of hospital sanctions is not required by law.
- Is it easy to find all doctor information on the website?: 18 of 20
  
  Be aware the search results list names with Jr. of III in a separate grouping after other names.
- Can boards issue private orders or letters?: 12 of 20
  
  The board issues non-public advisory letters.

Duty-to-report laws: 66
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
  
  Hospitals and related institutions must notify the board when they take disciplinary action against a doctor.
- Does the law set a deadline for them to notify regulators?: 16 of 20
  
  Within 10 days of taking disciplinary action and every six months
- Does the law establish penalties for failure to comply?: 8 of 20
  
  The board said it anticipated having regulations in place in November that will allow it to sanction hospitals. State law specifies a penalty of up to $5,000, but it has never been applied because of what the board said was a lack of due process procedures.
- Are physicians required to report peers?: 4 of 20
  
  State law does not require physicians to report possible violations by fellow doctors.
- Are courts or prosecutors required to notify regulators of physicians’ criminal convictions?: 18 of 20
  
  Courts are required to report crimes of moral turpitude to the board within 10 days of conviction.

Board composition: 75
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
  
  On the board are 15 physicians, five consumer members, one public member with risk management experience, and one physician assistant
- Are public members independent and do they represent consumers?: 25 of 25
  
  The consumer members may not have a substantial personal, business, professional or financial connection with a medical field or a medical school or health care facility. Note that the public member with risk management experience is nominated by the Maryland Hospital Association.
- Are women well represented on the board?: 20 of 25
  
  As of September, there were eight women on the 22-member board.

Criminal acts: 68
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?: 32 of 40
  
  Screening began at initial application, at renewal and reinstatement, with fingerprints, starting in October 2016. This began after a state examination found that the board's licensing practices were not sufficient to protect patients.
- Is board required by law to notify law enforcement?: 12 of 20
  
  Yes, but only when the board or a disciplinary panel investigates and determines that possible criminal activity has occurred.
- Has the state criminalized sexual misconduct involving doctors and patients?: 24 of 40
  
  Since 2013, an activist had pushed the legislature to pass a law to criminalize sex abuse by therapists when the relationship was so-called consensual. Then in 2016, the General Assembly passed a bill that prohibits a "professional counselor or therapist" from engaging in a sexual act, sexual contact or intercourse with a person receiving therapy at the time or within the two years of the therapy. Violators are guilty of third-degree sexual offense and subject to up to 10 years in prison. The law defines therapists, and physicians are included.

Discipline laws: 70
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?: 20 of 25
  
  Revocation can be permanent. State law says the board must suspend a doctor convicted of a crime of moral turpitude. If that conviction is not overturned on appeal, the doctor's license is revoked. However, the board has discretion to determine whether the crime involves moral turpitude.
- Do medical regulators have the legal right to hospital peer review records and proceedings?: 20 of 25
  
  The board may subpoena to obtain proceedings, opinions and records from hospital peer review.
- Does state law mandate that regulators deny licenses to physician applicants who have committed certain violations?: 5 of 25
  
  Maryland has no legal mandate to exclude applicants with active disciplinary orders in other states. The board has discretion.
- 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.

Maryland

State report card

More from Maryland

Highlighted case

Read more in this series

Researching a doctor

Complaint process

Where to file a complaint

Quoted

Key fact