Report card: How Pennsylvania protects patients from sexually abusive doctors

Transparency: 60
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?: 12 of 20
  
  Disciplinary orders issued before 2005 are not on the website because they were not scanned when they were issued. They are available by request and are then added to the website. Last year, the state said it was putting more records online.
- Do orders or other information online detail violations that led to sanctions?: 16 of 20
  
  Some disciplinary orders list only the type of violation, while other others detail the circumstances that led to the sanctions.
- Does doctor profile information include hospital sanctions, criminal charges and orders from other states?: 8 of 20
  
  Two of these are online but the information is not accessible from doctor profiles
- Is it easy to find all doctor information on the website?: 8 of 20
  
  You must choose between "medicine" or "osteopathic medicine" to find a doctor. Then to search disciplinary orders, you must re-enter information.
- Can boards issue private orders or letters?: 16 of 20
  
  The board cannot issue these. However, the Prosecution Division of the Department of State does issue private warning letters.

Duty-to-report laws: 56
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
  
  Health care facilities and hospitals must report actions curtailing a doctor's privileges or employment where the hospital has reasonable cause to believe malpractice or misconduct occurred. Hospitals also must report when a doctor resigns or withdraws privileges to avoid discipline and when hospitals receive written information that establishes a physician has been convicted of a felony.
- Does the law set a deadline for them to notify regulators?: 12 of 20
  
  Within 60 days after actions curtailing privileges or employment when the hospital has reasonable cause to believe malpractice or misconduct occurred.
- Does the law establish penalties for failure to comply?: 6 of 20
  
  None specified. However, the Department of Health has authority to assess a civil penalty.
- Are physicians required to report peers?: 10 of 20
  
  Physicians are required to report colleagues with addictive diseases for which they are not being treated; diversion of controlled substances; and mental or physical incompetence to carry out the duties of their license. State law doesn't require them to report other violations.
- Are courts or prosecutors required to notify regulators of physicians’ criminal convictions?: 8 of 20
  
  District attorneys must notify the board when a doctor is convicted, pleads guilty or no contest to certain misdemeanor drug convictions. But the law doesn't apply to felony drug offenses.

Board composition: 70
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
  
  Both the medical and osteopathic boards are composed of two public members, six physicians, the Secretary of Health, a commissioner and one other health professional.
- Are public members independent and do they represent consumers?: 25 of 25
  
  State law sets strict limits on public members. Among them, members cannot be a member of any profession regulated by the board, nor be related to or have an immediate family member who is.
- Are women well represented on the board?: 15 of 25
  
  The 11-member medical board had four women as of September. The 11-member osteopathic board had one female member.

Criminal acts: 20
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?: 8 of 40
  
  Criminal background checks are not required
- 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: 60
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?: 15 of 25
  
  Revocation or suspension is automatic after felony convictions in drug cases. However, even those whose licenses are revoked for felony drug convictions can reapply after 10 years.
- Do medical regulators have the legal right to hospital peer review records and proceedings?: 5 of 25
  
  State law shields proceedings and records of a peer review committee, aside from information submitted to it that is otherwise available from its original sources.
- Does state law mandate that regulators deny licenses to physician applicants who have committed certain violations?: 15 of 25
  
  To qualify for a license, applicants must not have been convicted or a drug felony unless at least 10 years have elapsed since the conviction and the applicant demonstrates personal rehabilitation. There is no requirement that Pennsylvania mirror disciplinary actions by 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.

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