By Sheila Baylis - TheMessenger - 30.10.2023 [USA] - [PREVENTION]
Despite efforts by sexual assault survivors’ advocate groups and media to expose sexual misconduct by physicians, the systems that allow abuse to take place for years have not evolved enough to protect patients.
Between 2016-2018, the Atlanta Journal Constitution did exhaustive reporting in its “Doctors and Sexual Abuse” series, analyzing public records from every state to find 3,100 doctors accused of sexual misconduct, with more than 2,400 of them involving patients.
These figures represent only a fraction of sexual abuse incidents since clinics and hospitals often fail to report doctors to regulators, AJC found. The Federation of State Medical Boards has also heard complaints that hospitals and clinics “regularly ignore” reporting requirements.
When doctors are reported, many state medical boards do not notify the public and may refuse information to patients and press who inquire about a physician under investigation.
Physicians who do make it in front of the state board and are found culpable by them are often allowed in some states to avoid discipline entirely if they agree to enter a private addiction recovery program.
The health care industry is slow to change
While the AJC investigation raised awareness (and was even a finalist for a Pulitzer in 2017), many of the systemic problems it uncovered have not been reformed.
“I don't know that there's been that much change, frankly,” Stefan Turkheimer, interim vice president of public policy at the Rape, Abuse and Incest National Network (RAINN) tells The Messenger.
“There's a tremendous amount of deference to physicians both in the law and in practice, both from patients and from legislators. And when you have that level of deference, there's not a lot of accountability,” Turkheimer, who worked with the AJC on their investigation into doctors and sexual abuse, says.
“The patient has very little power in that relationship, both individually with the doctor, but also structurally, and that leads to a lot of these problems,” he says.
Hospitals do not often report misconduct
In another criminal case, Zhi Alan Cheng, M.D., was charged with drugging and raping patients and filming the assaults.
One of accusers is suing New York-Presbyterian Hospital in Queens, alleging employees knew about the assault and failed to call police, suppressed evidence and continued to employ him for a full year following the assault.
A spokesperson for New York-Presbyterian denies the hospital was aware of the abuse prior to Cheng’s arrest.
“As soon as the District Attorney made us aware of allegations of sexual abuse against this individual, he was immediately placed off duty, banned from hospital property and terminated” the spokesperson said to The Messenger.
Although health care facilities in New York are required to report any assault to the OPMC, there is no penalty specified when they don’t comply. And in most states, you can’t research a physician to see if any abuse complaints have been made against them.
“It's very difficult to figure out if a complaint has been made about a particular doctor at all. And it’s then even harder to determine what the nature of those complaints were, especially if they weren't found to have merit or if they didn't result in a malpractice judgment,” Turkheimer says.
On a national level, The National Practitioner Data Bank (NPDB) established by Congress in 1986 was created to prevent practitioners from moving from state to state without disclosing any sort of malpractice — but the public can’t view the records. Only hospitals can request documentation when making hiring decisions, and they must keep the information confidential or are subject to a $10,000 fine.
Reported misconduct does not often result in discipline
A 2021 investigation into the reporting and disciplinary process in New York found the Department of Health was reluctant to penalize physicians for any violations, and the OPMC process involves physician input at every step. As a result, just 4% of all complaints (not just sexual misconduct cases) between 2007 and 2018 resulted in board action.
Sources in that investigation said “the vast majority” of sexual misconduct cases, which are not identified in the state data reports, were closed without any disciplinary action.
“If I were a person who was violated and I knew that system, I would never go in and tell my story,” a former OPMC investigator said in 2021. “Never, never.”
In 2020 and 2021, reforms to the OPMC were proposed in the New York state legislature, but did not pass after a physician advocacy group lobbied against it.
Doctors are protected by their peers
State medical boards that are responsible for disciplining doctors are often made up of other doctors. The Federation of State Medical Boards recommends that boards be made up of at least 25% non-physicians.
According to the latest numbers in the NPDB, 1,662 physicians from 2003 to 2021 were reported for sexual misconduct, Azza AbuDagga, Ph.D., a health researcher from Public Citizen’s Health Research Group tells The Messenger.
But Dr. AbuDagga says these numbers represent “the tip of the iceberg” of sexual assault cases. Not only do many victims stay silent, but physicians are unlikely to report sexual misconduct by a colleague, and those who are reported may never have their case filed by a state board or logged in the NPDB.
In addition, researchers have found that hospitals and clinics “have utilized a number of strategies to evade reporting requirements to the NPDB.”
If you have been affected by any of the issues raised in this article, you can contact Dignity4Patients, whose helpline is open Monday to Thursday 10am to 4pm.