Hospital believed doctor over victims

MADISON, WIS. — Shanta Hereford can’t shake the memory, try as she might. Bend over and touch your toes, she remembers the doctor saying, before his hands went where she was certain they didn’t belong.

Even now, a dozen years and hundreds of miles removed from that day at a clinic in Wisconsin’s capital city, she says she still gets nervous when she needs medical attention.

“It’s just the whole thought of going to the doctor, being in the doctor’s office, being one-on-one in a small, isolated space like that and not knowing if I’m protected,” she said. “Unfortunately, I haven’t been able to get over it to this day.”

Hereford was one of four Wisconsin women whose complaints of sexual misconduct led that state’s medical board to discipline Dr. Frank Salvi, a prominent spine specialist affiliated with the University of Wisconsin hospital system, in 2009.

Hereford, a 39-year-old mother of three who moved to Atlanta eight years ago, had never spoken publicly about the case. But this past summer she read the first installments of The Atlanta Journal-Constitution’s national investigation of physician sexual misconduct and how it is tolerated to varying degrees in every state. The AJC’s stories prompted her to agree to a series of interviews in which she described how the University of Wisconsin closed ranks behind Salvi.

Ryon Horne / AJC

“It never made sense to me, ” said Shanta Hereford, one of four women who came forward with complaints against Dr. Frank Salvi, a former spine specialist at the University of Wisconsin. When Hereford and the other women complained about Salvi, they ran into a wall that can shield doctors accused of sexual misconduct: the doctors’ peers.

“Everything the UW did was for the benefit of protecting their hospital and the doctor,” she said. “And I don’t really think they cared as much about Dr. Salvi as they cared about their reputation.”

Hereford’s frustration isn’t unusual. The AJC found that when patients muster the courage to complain about a revered physician, it’s not unusual for doctors, hospitals and state medical boards to discount or ignore them. Even when sexual misconduct is confirmed, the AJC found, doctors are routinely allowed to continue practicing.

“That can be as damaging as the (abuse) itself,” said Mary Gail Frawley-O’Dea, a North Carolina psychologist who specializes in treating survivors of sexual abuse. “Then you are really alone with it and being told you are a liar or you are crazy or somehow this nasty person trying to get money out of this poor, wonderful guy.”

Ryon Horne / AJC

The University of Wisconsin hospital is located near the campus in Madison, Wis.

A respected institution

Located on the edge of the sprawling University of Wisconsin campus, the UW hospital is one of the largest and most respected healthcare organizations in the Midwest.

But as the Salvi case played out over eight years — in court, in a peer review process and in medical board hearings — it left some to wonder whether the hospital had its patients’ best interests at heart.

Dr. Frank Salvi

“The people in the institution who responded to these complaints were too close to Dr. Salvi,” said A. Steven Porter, a longtime civil rights attorney who represented one of the doctor’s accusers. “I’m not attributing any wrongdoing or intentional attempt on their part to discount the complaints or give Dr. Salvi an unfair advantage. I just think they were incapable of being objective.”

Hereford contacted the hospital to complain about Salvi in June 2004, shortly after being examined by the doctor for back and neck pain, a problem she has been dealing with since her teens.

“It was nothing out of the ordinary until he asked me to touch my toes, and, as I did that, he just so nonchalantly came between my legs with his hands,” she said. “From that point on, I blanked. I don’t even remember being in the room. Physically, yes, but mentally, no. I kept having thoughts running through my head, `Did he just do what I think he did?’”

She said she was so angry she refused the request to make a follow-up appointment.

“I just walked right out of the clinic,” she said. “I’m driving home and all these thoughts are running through my head. And by the time I got home, I was literally in tears.”

Hereford said she heard nothing in response to her complaint for months, which surprised her.

“Such an esteemed institution, I would think they would take complaints like that seriously,” she said. “To me, it was like they just blew me off.”

Records show that two other women, acting independently of Hereford, lodged similar complaints at roughly the same time.

However, after a one-week investigation based primarily on assurances from Salvi’s immediate supervisor, the hospital determined that there were logical explanations for the doctor’s conduct. It found no reason to keep him from seeing female patients or even have a chaperone present.

The same attitude prevailed a year later when another woman complained about Salvi’s conduct, this time to campus police.

According to the police report, the woman, who was seeing Salvi for chronic back pain, cried while recounting how the doctor grabbed her crotch and asked, “Is everything OK here?”

After that accusation, Salvi was scrutinized through a peer review process in which four UW physicians from other departments studied his treatment of the four women.

According to the committee, Salvi could have done a better job explaining himself to the women, but the behavior they viewed as sexual was legitimate medical practice.

“The touchings that were reported … were justified as part of the examination of the physical conditions of the patients,” the committee decided.

‘Weird, abhorrent behavior’

A year after the peer review committee reached its conclusion, the Wisconsin Medical Examining Board weighed in with a different opinion: Salvi had to be punished.

“There are normal ways to examine patients, and he was not doing anything close to normal,” Dr. Sheldon Wasserman, a Milwaukee physician who was on the board at the time, said in a recent interview. “It was so clear-cut.”

Handout

Spine specialist Dr. Frank Salvi (right) demonstrates during a deposition how he would normally conduct examinations when it's required for him to touch a patient's breast. Salvi was accused by four women while he worked for a clinic run by the University of Wisconsin.

Wasserman, an OB/GYN, said the determining factor for him was watching Salvi demonstrate for the board the methods he used in examining the women.

“I went to school for this, and his examinations made no sense,” Wasserman said. “It was just weird, abhorrent behavior that begged all logic.”

The board tried to reach a negotiated settlement with Salvi, but he refused, sending the case to an administrative law judge for a hearing that lasted four days and included testimony from all four women.

Salvi stated that he was following a “strict protocol” that supported touching sensitive areas to diagnose pain.

But the judge, Ruby Jefferson-Moore, sided with the women. Arguing that Salvi’s license should be revoked, she wrote: “None of the reasons that he gave or the arguments that he made to (rationalize) his behavior justify his misconduct.”

A check for $7

The board, citing Salvi’s “potential for rehabilitation,” ordered that the doctor’s license be suspended for at least 90 days and that his practice be subject to a series of restrictions.

Salvi challenged the suspension in court and initially won a ruling overturning it, but the board’s decision was upheld on appeal.

Salvi, 54, has never spoken publicly about the case and did not respond to the AJC’s interview requests. Because he has yet to undergo a board-mandated psychiatric exam, his license remains suspended. He now reviews worker’s compensation cases for the State of Wisconsin.

Wasserman, a former member of the Wisconsin State Assembly, struggled for words when asked to account for the hospital’s support of the doctor.

“I don’t have an explanation for their rationale,” he said. “It is absolutely beyond my comprehension that they just let this thing go.”

A hospital spokeswoman declined to make anyone available to discuss the case with the AJC, citing legal reasons.

All four women filed lawsuits, but only two got financial settlements. The largest was $27,500, paid by the university to the woman who went to campus police.

Hereford’s suit was dismissed because she didn’t file a notice of claim within the 120 days required by law. She said she didn’t realize she had a claim until she learned during the peer review process that other women had also complained, and, by then, too much time had passed.

The only thing she received was a check for $7 from Salvi’s attorney to pay for transportation when she went to his office for a deposition. She still has the check. Cashing it, she said, “wasn’t worth anything I went through.”

Her move to Atlanta was based on several factors, she said, including the city’s racial diversity. But she also knew she needed a new start in a place where the University of Wisconsin isn’t a constant presence.

“I felt like it was me against the world, because UW hospital, they have a very reputable history in our state,” she said. “Going to UW, you feel like you’re getting the best care. … So I trusted the hospital and I trusted all the doctors because I assumed I would only get the best.”

— AJC staff writer Carrie Teegardin and video journalist Ryon Horne contributed to this article.