By Rhoda Feng
Despite the #MeToo and #TimesUp movements reverberating across U.S. workplaces — from the entertainment and media industries to Congress — insufficient attention has been given to physician sexual abuse of patients.
Public Citizen is shining a light on this important public health problem and – which were published in the July issue of the Journal of General Internal Medicine – that institutions can take to guard against it.
Extent of physician sexual abuse
Public Citizen’s recommendations build on groundbreaking research the organization published in 2016. That research documented that state medical boards – which are supposed to stop dangerous doctors from practicing – too often failing to protect the public from doctors already known to have committed sexual misconduct.
Between 2003 and 2013, 70% of U.S. physicians who were reported to National Practitioner Data Bank (a national database for flagging potentially dangerous doctors) because of sexual misconduct that led to sanctions by hospitals or other health care organizations or a malpractice payment were not disciplined by state medical boards for their unethical behavior, Public Citizen found. Over the decade, only about 1,000 physicians were reported for sexual misconduct to this database. Notably, “sexual misconduct” is the term used by U.S. medical community for this problem, although Public Citizen calls for using the term “sexual abuse” instead when referring to sexual conduct of physicians towards their patients.
“The U.S. medical community and state legislatures must adopt and enforce an explicit zero tolerance standard against all forms of physician sexual abuse of patients,” said Azza AbuDagga, health services researcher for Public Citizen’s Health Research Group and co-author of the journal article. “Our recommendations are commonsense policies that can make a major difference in patients’ lives and ensuring their safety.”
Factors behind persistence of abuse
Why is sexual abuse of patients at the hands of their physicians such a persistent problem in the U.S.?
First, many of these cases are never reported by patients because they may be shocked and consumed by feelings of disbelief, guilt or shame; may be fearful that they will not be believed; or may be unwilling to publicly disclose the abuse.
Additionally, victims may not know how to file a complaint with the state medical board or hospital. Even when they do, victims can be further traumatized by the investigation and legal procedures, which may lead them to withdraw their complaints.
Importantly, physicians often are unwilling to report their impaired or incompetent colleagues to relevant authorities, likely due in part to the absence of enforceable legal mandates for such reporting.
Public Citizen’s Recommendations
State medical boards should, among other things:
- Educate the public about how to prevent, recognize and report physician sexual abuse;
- Discipline and report to authorities physicians who are found to have engaged in any form of sexual abuse of patients; and
- Disclose on their websites complete information concerning all disciplinary actions against sexually abusive physicians.
Additionally, the medical community including medical boards and health care organizations, should:
- Educate physicians about the enormity of sexual abuse of patients, how to avoid it and how to seek help if they are struggling with their boundaries with patients;
- Mandate reporting by physicians and other professionals of any witnessed or suspected abuse;
- Encourage and facilitate reporting by patients and their families of all forms of abuse by a physician;
- Investigate thoroughly each complaint of alleged physician sexual abuse of patients;
- Provide trained chaperones to act as “practice monitors” during body exams; and
- Establish and fund programs to provide subsidized psychological counseling for all victims of such abuse.