Doctors & Sex Abuse: Investigation shows how cases are concealed

A regulatory system that's supposed to punish doctors who sexually abuse patients often shields them from public shame, a national investigation by The Atlanta Journal-Constitution found.

Secret penalties levied by state medical boards, vague language in their public orders and diversion programs through which offenders avoid punishment all make determining the scope of physician sexual misconduct impossible, the Journal-Constitution found.

But the newspaper's review of more than 100,000 medical board orders and other documents shows a broad phenomenon of doctors in every state preying on vulnerable patients.

The Journal-Constitution identified more than 3,100 physicians sanctioned after being accused of sexual misconduct since 1999. More than 2,400 of those cases involved patients.

Neither number is close to all-encompassing.

Medical boards in many states issue private letters of concern or confidential agreements when they determine a doctor has committed a sexual violation. In select cases, the Journal-Constitution became aware of such secret documents when doctors’ subsequent transgressions resulted in a public disciplinary action.

Some medical boards remove public orders from their websites after just a few years. North Dakota, for example, provides public disciplinary documents issued only since 2012; Hawaii, only orders issued in the past five years; New Mexico, only those since 2011.

Boards sometimes let doctors avoid disciplinary action by entering an “impaired physician” program. Such programs originally were created for doctors who had drug or alcohol addictions, but now are also used to rehabilitate physicians who sexually abuse patients.

In some states, licensing panels simply drop their investigations into physician sexual misconduct if a doctor voluntarily surrenders his license.

The website for Alabama’s medical board gives no reason for Dr. Cris Cole’s decision to surrender his license in 2004. But law enforcement records show the pediatrician was arrested on charges of sexually abusing two minors while he was medical director of a children’s hospital. He later pleaded guilty to sodomy.

Ohio’s medical board publicly acknowledges only that Dr. Samuel J. Bracken Jr. gave up his license. A board order in another state where Bracken was licensed gives the reason: He had been charged with sexual assault of a 15-year-old. He pleaded no contest.

Even when boards issue public orders, they often use vague descriptions of doctors’ misdeeds – “boundary violations” and “inappropriate contact,” among others.

When Michigan’s board suspended Dr. Kassem Hallak in 2011, it said only that an administrative complaint had been filed. But the board acted as criminal charges were being brought alleging Hallak molested women and girls at his clinic. He was later sentenced to prison for sexual assault.

In all but a few states, medical boards – typically, dominated by doctors – have no legal obligation to tell law enforcement when physicians sexually violate adult patients. Most boards say they learn about offending doctors from the police and that the reverse is rarely true.

Sometimes, boards are left in the dark even after a doctor has been accused of sexual misconduct.

The Journal-Constitution found instances in which hospitals, clinics and doctors overlook state laws requiring them to report sexual offenses by doctors to state regulators. This can allow doctors to abuse patients in multiple locations before they’re finally stopped.

Dr. Michael Roy Sharpe was able to get a job in Alabama even after three Tennessee hospitals fired him, two for sexual misconduct. None of the hospitals reported him to Tennessee’s medical board. In Alabama, Sharpe was arrested for raping a teenage patient. He was later sentenced to prison.

The difficulty in getting a complete picture of physician sexual misconduct reflects the insular culture of the medical profession, the Journal-Constitution found.

The American Medical Association has spent three decades fighting to keep confidential a government database of doctors who sexually abused patients or violated other medical or ethical standards. Concerned about the effect of strict behavior standards might have on medical malpractice cases, AMA members took eight years to update their ethics code. It still contains only "opinions," not rules.

“People outside of us and not friendly to us” could turn the code against the medical profession, one physician said during the annual meeting of the AMA’s legislative body, the House of Delegates. “We do not need a noose to hang us with.”

Patient advocates say the AMA and other medical organizations have shown reluctance to confront the scope and impact of sexual misconduct, further exacerbating the problem.

“At some point the profession has to take responsibility to accept that there are things that need to be done in regard to protecting patients,” said Lisa McGiffert, manager of the Safe Patient Project for the advocacy group Consumers Union. “It’s always been puzzling to me that doctors don’t collectively say, ‘We don’t want these bad apples in our profession. They give us a bad name.’”

“It’s a pretty tight club, being a doctor,” McGiffert said. “They protect their own.”

This story was compiled by Alan Judd and reported by the project team. For the full series, visit doctors.ajc.com.

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