Report card: How Utah protects patients from sexually abusive doctors

Transparency: 48
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
  
  Administrative disciplinary actions commenced more than 10 years ago are not online.
- Do orders or other information online detail violations that led to sanctions?: 16 of 20
  
  Disciplinary orders include charges that led to sanctions, but some of the charges may be vague, such as failure to maintain appropriate professional boundaries.
- 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 is very complex.
- Can boards issue private orders or letters?: 4 of 20
  
  The board issues some private reprimands, orders or letters.

Duty-to-report laws: 46
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 other health care facilities are required to report when a doctor is terminated for cause or has privileges curtailed; when a doctor is subjected to disciplinary action for more than 30 days; or when a doctor is found to have committed acts of moral turpitude or violated professional standards or ethics.
- Does the law set a deadline for them to notify regulators?: 14 of 20
  
  Within 60 days after taking certain disciplinary action or when a doctor is found to have committed acts of moral turpitude or violated professional standards or ethics.
- Does the law establish penalties for failure to comply?: 4 of 20
  
  None specified
- Are physicians required to report peers?: 4 of 20
  
  State law does not require physicians to report possible violations by fellow doctors (unless requested to do so by medical regulators).
- Are courts or prosecutors required to notify regulators of physicians’ criminal convictions?: 4 of 20
  
  State law doesn't require courts to notify the board of doctors' criminal convictions.

Board composition: 50
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 11-member board is composed of two public members and nine physicians.
- Are public members independent and do they represent consumers?: 5 of 25
  
  State law doesn't limit the professional or financial ties of public members.
- Are women well represented on the board?: 15 of 25
  
  Three women were on the 11-member board in September.

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?: 12 of 40
  
  Utah is among 18 states that have joined the Interstate Medical Licensure Compact, which will require the state of principal licensure to conduct a criminal history check of doctors who wish to be licensed in multiple states. The compact is set to go into effect early next year.
- Is board required by law to notify law enforcement?: 8 of 20
  
  No. However, physician board members are required to report potential threats to public safety
- Has the state criminalized sexual misconduct involving doctors and patients?: 16 of 40
  
  Therapeutic deception is a crime. This applies to any licensed health professional who provides professional physical or mental health services, diagnosis, treatment or counseling and who under the guise of providing services commits sexual contact and the victim reasonably believed the act was for medically or professionally appropriate diagnosis, counseling or treatment. This law applies to those under age 18.

Discipline laws: 55
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?: 5 of 25
  
  Licensees who are revoked are allowed by law to reapply at reasonable intervals. State law doesn't require revocation for any type of sexual misconduct or conviction.
- Do medical regulators have the legal right to hospital peer review records and proceedings?: 5 of 25
  
  While state law says that peer review information may be reported to the department, it doesn't state that the boards or agencies with authority to investigate physicians have the right to this information.
- Does state law mandate that regulators deny licenses to physician applicants who have committed certain violations?: 20 of 25
  
  Licenses must be denied to those applicants with an investigation or action pending in another state or anyone whose license was suspended or revoked elsewhere and has not been not fully reinstated.
- What is the standard of proof for regulators to impose disciplinary sanctions?: 25 of 25
  
  Preponderance of evidence is the standard of proof for administrative hearings. It basically means "more likely than not." That's also the typical standard for most lawsuits.

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