Monday, July 16, 2018

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AP investigation: Doctors keep licenses despite sex abuse

Medical profession seems to lag far behind #MeToo

  • Sexual-Misconduct-Doctors

    In this image provided by the Conway (Ark.) Police Department, Robert Rook is seen in this June 3, 2016, photo. An Associated Press investigation finds that even as Hollywood moguls, elite journalists and politicians have been pushed out of their jobs or resigned amid allegations of sexual misconduct, the world of medicine is more forgiving. Rook was allowed to keep his family practice open, so long as he’s chaperoned, despite facing multiple criminal charges for rape. Prosecutors subsequently downgraded the charges to more than 20 counts of sexual assault in the second- and third-degree, charges for which Rook says he is innocent. (Conway Police Department via AP)

    Associated Press

WASHINGTON — Even as Hollywood moguls, elite journalists and top politicians have been pushed out of their jobs or resigned amid allegations of sexual misconduct, the world of medicine is more forgiving, according to an Associated Press investigation.

Even when doctors are disciplined, their punishment often consists of a short suspension paired with therapy that treats sexually abusive behavior as a symptom of an illness or addiction.

The first time that Dr. Anthony Bianchi came onto a patient, California’s medical board alleged, the gynecologist placed a chair against the exam room door, put his fingers into the woman’s vagina and exposed his erect penis.

The second time, the board claimed, he told a patient that he couldn’t stop staring at her breasts and recounted a dream in which he performed oral sex on her in the office.

The third time, the board charged, he told a pregnant patient suffering from vaginal bleeding that she shouldn’t shave her pubic hair before her next visit because he was getting too excited.

These episodes led to disciplinary actions by the state’s medical board in 2012 and 2016. Bianchi agreed not contest the charges and held onto his medical license. Under a settlement with California’s medical board, he agreed to seek therapy and refrain from treating women during five years of probation.

Bianchi did not respond to telephone messages from AP left for him at the workers’ compensation clinic in Fresno, Calif., where he now evaluates occupational health claims.

Decades of complaints that the physician disciplinary system is too lenient on sex-abusing doctors have produced little change in the practices of state medical boards. And the #MeToo campaign and the rapid push in recent months to increase accountability for sexual misconduct in American workplaces do not appear to have sparked a movement toward changing how medical boards deal with physicians who act out sexually against patients or staffers.

“There’s been a failure of the medical community to take a stand against the issue,” said Azza Abbudagga, a health services researcher with nonprofit advocacy organization Public Citizen.

She published a report recently detailing sexual misconduct among physicians. Its findings showed of the 253 doctors reported to the National Practitioner Data Bank for having been sanctioned by their respective hospitals or health care organizations for sexual misconduct, or paid a settlement that stemmed from such an allegation, 170 of them were not disciplined by state medical boards, even though all boards have access to the reports filed with the data bank.

Current guidelines from the Federation of State Physician Health Programs, which represents doctor rehab programs in 47 states, are largely silent on handling sexual misconduct treatment and describe sexual harassment as a “cause of impairment” in a doctor. Programs to treat doctor impairment are inherently supposed to be “nondisciplinary,” per the federation’s guidelines.

State-authorized programs that attempt to oversee the rehabilitation of doctors who have committed sexual misconduct aren’t always forthcoming about their methods. In Florida, the Professional’s Resource Network asked AP to provide detailed questions and a list of sources before it would answer questions.

After AP provided the head of the program, Alexis Polles, with basic questions about the program’s approach to clearing doctors for return to work after instances of sexual abuse, she declined to answer any of them.

Examples of problematic behavior are easy to find in states across the country.

In Arkansas, Dr. Robert Rook was allowed to keep his family practice open, so long as he’s chaperoned, despite facing multiple criminal charges for rape. Prosecutors subsequently downgraded the charges to more than 20 counts of sexual assault in the second- and third-degree, charges for which Rook says he is innocent.

Rook did not return phone messages left with a secretary at his Conway office. He is set to face trial later this year.

The Idaho State Board of Medicine in May reinstated the license of Richard Pines, a child and adolescent psychiatrist who lost his license in 2013 after the board accused him of having sexual relationships with four former patients, including taking nude photos of a 14-year-old and convincing the boys that he needed to practice giving naked massages to keep his medical license.

The state’s highest court in 2015 ruled that Pines had engaged in sexual misconduct but determined that two of the four alleged victims were not former patients. The court remanded Pines’ case to a lower court and vacated his punishment, instead ordering the board to re-evaluate the scope of disciplinary action based on the charges the court upheld. The court’s order also blasted the board for being impartial, accusing its members of “passionately railing” against Pines in its decision.

AP reached out to Pines’ former employers and contacted his most recent attorneys but was unable to reach him. AP also left a message for a biller at Sage Health Care, where Pines still processes invoices. The receptionist said Pines bills through the office but was unable to provide more details about his current practice.

The lenience of penalties for sexually abusive doctors is sometimes a source of frustration, even for members of the medical board who administer the discipline, said Jason Rosenberg, a former chairman of the Florida medical board.

“This is incredibly inappropriate,” Rosenberg said during one 2013 meeting when Florida’s medical board allowed James Yelton-Rossello, a psychiatrist alleged to have molested jailed psychiatric patients, to keep his license. The settlement with the Florida board of medicine did not require Yelton-Rossello to admit guilt.

“You can’t do this and serve french fries,” Rosenberg said at that meeting, citing some fast food restaurants’ policies against hiring sex offenders. “I’m ashamed of what’s going on here.”

Yelton-Rossello’s lawyer did not respond to telephone messages or an email request for comment.

In practice, even some lawyers who represent doctors find the physician health programs to be problematic. David Spicer, who has represented doctors facing medical board discipline in Florida, says the state’s doctor rehabilitation program isn’t well-designed to evaluate or treat sexual misbehavior. The program’s key component is a “one-size-fits-all” requirement that doctors engage in therapy sessions and not get into trouble for a specified period, generally five years, he said.

Experts in the treatment of sexual misbehavior question whether the treatments mandated for doctors who molest patients are even appropriate for such misconduct.

‘’It’s insufficient,” said Rory Reid, a UCLA psychology professor who studies addiction and hypersexual behavior. “We have clinical trials for everything underneath the sun,” Reid said. “But there’s not one clinical trial that I’m aware of on the efficacy of treatment for doctors who have engaged in sexual misconduct.”


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