Doctors & Sex Abuse: License to Betray

July 8, 2016 2:59 PM

In a national investigation, The Atlanta Journal-Constitution examined documents that described disturbing acts of physician sexual abuse in all 50 US states. What they found was a broken system that forgives sexually abusive doctors. Everywhere.
(Some may find descriptions of abuse in the links in this post disturbing.)

* Table of Contents

Some Highlights:
* Doctor reputation no indicator of likelihood to offend
* Condemnation without Action: Medical profession condemns sexual abuse by doctors but resists solutions
* Why a national tracking system doesn't show the extent of physician sexual misconduct
* About the Project
* Resources for Patients.

posted by zarq (27 comments total)

Description, from the site:

"Last year an AJC investigative reporter detected something alarming about the way Georgia treats doctors who have been disciplined for sexual misconduct with their patients: Two-thirds were permitted to practice again.

Our findings made us wonder whether our state is unusual. We expanded our scope to the rest of the country, and analyzed more than 100,000 medical board orders relating to disciplinary action against doctors since 1999.

We found disturbing news: Georgia isn’t unusual – sexual abuse of patients by doctors occurs far more often than any of us would have expected. Moreover it is shrouded by a system that too often protects doctors from accountability, leaving patients vulnerable.

We uncovered these problems after many months of investigative reporting. Doctors & Sex Abuse is a multimedia project that shares what we’ve learned. Our goal for this project is that it will lead to solutions that benefit the public."

posted by zarq at 3:01 PM on July 8, 2016 [2 favorites]

Also:

* Staying Safe in Exam Rooms: For patients: What should you expect during doctor examinations
* Staying Safe in Breast Exams: For patients: What are the protocols for breast examinations?
posted by zarq at 3:07 PM on July 8, 2016 [3 favorites]

Surprise, surprise - the AMA is once again blocking oversight of doctors.
posted by NoxAeternum at 3:08 PM on July 8, 2016 [10 favorites]

And this is why, if we are to have a functioning society, we need real journalists and journalism.

By real I mean people and institutions that have the resources and time to go after long-form, non-splashy, hard, gruntwork-laden, investigative reporting.
posted by lalochezia at 3:10 PM on July 8, 2016 [51 favorites]

Please read the "About the project" that zarq linked to above to understand what I mean.

This is a hideous finding, looks to back up its broad claims with serious mounds of evidence, and exemplary fucking journalism.
posted by lalochezia at 3:14 PM on July 8, 2016 [6 favorites]

Given that my anesthesiologist just insisted on a handshake that was more like handholding, twice, I am now officially really creeped out to be getting doped up.
posted by corb at 3:29 PM on July 8, 2016 [10 favorites]

From the article Which doctors sexually abuse?:

The charm and clinical skills that win doctors the support of their communities also can allow them to manipulate and exploit patients. They may not even see themselves as offenders but as sexually desirable men – they’re almost always men — with a keen sense of patients’ needs.

When do we as a society stop valuing charisma and charm? They have been proven to be, at best, unreliable indicators of any individual's skill and trustworthiness. Can we just start calling charm and charisma out as 'manipulation'? Just lessons everyday, that someone who is trying to flatter and impress should be assumed to be trying to bypass one's good judgment.

I am just tired of reading about the apparent charms of abusive people. Fuck charm. It is a mask on malevolence.
posted by palindromic at 3:36 PM on July 8, 2016 [28 favorites]

It's called 'disarming' for a reason, right?
posted by Fantods at 3:38 PM on July 8, 2016 [5 favorites]

Charisma is a con job. It lures victims in, and distracts potential sources of accountability away. It is the gold leaf wrapping paper on a box full of shit.

Like corb, I am going under anesthesia for a procedure soon so my craw is particularly sticky at the moment.
posted by palindromic at 3:48 PM on July 8, 2016 [4 favorites]

As someone who is in training to become a physician this is heartbreaking on so many levels. The violation of trust and the doctor/patient relationship and basic decency, and then the ability to get away with it because of their status and reputation. It's sickening. And abhorrent. And despicable. Jesus.
posted by ghostpony at 4:08 PM on July 8, 2016 [8 favorites]

I agree about charisma and have been saying the same for years. Unfortunately, it seems to some people I come across as charming and charismatic, so I accidentally implicated myself! FWIW, I'm not up to anything sneaky, generally, other than trying to convince the world not to kill me and that I'm worth something because I have terrible imposter syndrome. But yeah, I might not go so far as to say anybody who's charming can't be trusted, but I'd agree that if you feel overly charmed by someone, proceed with caution until you've really gotten to know them.
posted by saulgoodman at 4:38 PM on July 8, 2016 [2 favorites]

When do we as a society stop valuing charisma and charm? They have been proven to be, at best, unreliable indicators of any individual's skill and trustworthiness.

We don't intend to value it. That's the nature of such things; beauty comes to mind, as well.
posted by clockzero at 5:00 PM on July 8, 2016 [5 favorites]

When do we as a society stop valuing charisma and charm?

I'm pretty sure that would require fundamentally changing human nature.
posted by Mitrovarr at 5:02 PM on July 8, 2016 [3 favorites]

Not everybody who's charming is trying to put something over on you, get something out of you, or abuse you.

However, it's prudent to notice the little red flags the crooked ones will have popping up here and there despite the charm.
posted by jenfullmoon at 5:40 PM on July 8, 2016 [9 favorites]

I'm pretty sure that would require fundamentally changing human nature.

I dunno shit about "human nature" with regard to particular behaviors but it does seem that by definition charisma and charm are those qualities which make a person likable without engaging rational circuits.
posted by atoxyl at 6:18 PM on July 8, 2016 [5 favorites]

I bet a friend that you basically have to either kill a lot of people or deal massive amounts of drugs to get your MD privileges revoked. After looking at the New York state disciplinary listing website (of course hidden behind an anti-indexing interface), we saw so many cases where the judgement was "ALLOWED TO PRACTICE DO NOT LET IN ROOM ALONE WITH WOMAN FOR 5 YEARS". The details leading up to that judgement were left to the imagination.
posted by benzenedream at 6:26 PM on July 8, 2016 [7 favorites]

This is part of larger patterns in the relationship between society and professionals, but I'm not sure if I'm smart enough right now to draw the picture. I just know that it reminds me of abuse by teachers and police officers and priests. They're all people who do complex jobs that can't be evaluated by simple metrics, they need extensive training, and having a group of them doing good work together creates benefits for society that go way beyond what they get paid. They get a lot of respect, and they mostly deserve it. But there's an apparently overwhelming temptation for some of them to take advantage of that respect and power in order to do nasty things. And when they do, the result is devastating. They can fuck people up, especially children, in ways that few other jobs can match.
posted by clawsoon at 7:01 PM on July 8, 2016 [15 favorites]

The husband used to work for a law office that did malpractice. One guy they would *not* take on was a Dr. Slade, whom they called Slade the Blade, because he had a propensity for doing unnecessary surgery and losing the subsequent lawsuits.

But of course, he was still practicing, just out in the sticks where they couldn't afford to be as picky. You can be so notorious you have a nickname and still not lose your license.

Much like cops, doctors are the beneficiaries of decades of TV-hero propaganda. We still have what, at least 2 or 3 Heroic Hospital Docs shows going on right now, along with the heroic cop shows. If you're raised on those, it's probably hard to believe that people you've always been told were noble, hardworking, altruistic might be the opposite. Especially when you interact with them while you're vulnerable, in pain, or even unconscious.
posted by emjaybee at 7:15 PM on July 8, 2016 [11 favorites]

Their overall job performance may not be simple to measure, but the "doesn't rape clients/patients" measure isn't complicated. Either they do or they don't. I'd be willing to err on the side of caution and say doctors shouldn't be having sex with their patients and teachers shouldn't have sex with their students, period.
posted by Anne Neville at 7:26 PM on July 8, 2016 [6 favorites]

Good lord, if you take away the charm and charisma I literally have nothing to offer as a physician. / not even kidding

I swear, I have never manipulated or abused anyone. My wife and I obsessively read the monthly WA Medical Quality Assurance Commission's reports on punitive actions taken against doctors and half of it is like "there but for the grace of God go I" and the other half are like "this person isn't in jail, and worse, may yet practice medicine again??!"

Every doc I know looks at these kind of cases and thinks about that one Vicodin refill that maybe wasn't so appropriate or that patient who gave you baseball tickets or that one that maybe held your hand a little too long and we realize we are in a profession where appropriate borders can be very difficult to see. Throw in the mix mental health issues (from patients and doctors, both of which have higher rates of mental illness than the general population), chemical dependency issues (ditto), a history of lax enforcement, and respect for the independently practicing physician and it's easy to see this happening. I've sat on committees that removed privileges from people over inappropriate behavior and it's hard because you can almost always see how the person meant well and got to the point that they did. In almost all of the really egregious cases (and we've had two now where jail time was served) it involved a provider who was working more or less independently with little opportunity for others to see what was going on. So I'm guessing this is far less likely in a group practice or a hospital setting. People going under anesthesia at a hospital or surgical center can rest assured that there's always going to be at least 2 other people present at all times. Not that that's a guarantee of safety but it should be somewhat reassuring.

In summary, these providers who abuse their power need immediate harsh and severe action because I'm not 100% sure I don't creep people out and I don't need them thinking it's easy for a true criminal to keep a license to practice medicine.
posted by Slarty Bartfast at 7:31 PM on July 8, 2016 [18 favorites]

The medical community decided surgery to be a cause of PTSD, now erases the patient's memory of what happened in the OR with drugs. Then some folks get into rape under anesthesia, and do this in their spare time too. Or some big city ER docs make a deal with drug seeking ladies, that spills over to injury victims. You can demand a chaperone.
posted by Oyéah at 7:33 PM on July 8, 2016

Ugh. I had a doc appt a few weeks ago that was a little odd. I wanted to ask "is it medically necessary to poke me there?" but ... that thing kicked in, the thing where you don't acknowledge that something might not be cool because you don't know what might happen if you acknowledge that something might not be cool.

I just didn't say anything and didn't go back.

And it might have been cool. I just don't know.
posted by bunderful at 7:49 PM on July 8, 2016 [4 favorites]

Anne Neville: Their overall job performance may not be simple to measure, but the "doesn't rape clients/patients" measure isn't complicated.

Oh, yes, 100%. The complexity of their jobs is more a part of why we give them respect, and why we generally let them self-govern as professions. And the self-government is another part of the problem. It makes sense when doctors are judging each other on questions of treatment A vs. treatment B - nobody else can properly make that judgment - but we let them self-govern on whether rapists should be allowed to practise, too, and that's crazy.
posted by clawsoon at 7:50 PM on July 8, 2016 [4 favorites]

Part of my job involves skimming through local small-town newspapers, and I make a note of ads from new doctors in the area, as well as those who are trying to drum up business. Most of them are pretty straightforward, talking about where they did their residency, what their particular areas of specialization are, things like that. And then there was one from an OB/GYN that came off more as a personalized valentine. I really couldn't put my finger on it, but there was just something about it.. I really wish I'd saved it, because a few years later, hey, guess what.
posted by Halloween Jack at 9:52 PM on July 8, 2016 [2 favorites]

People going under anesthesia at a hospital or surgical center can rest assured that there's always going to be at least 2 other people present at all times. Not that that's a guarantee of safety but it should be somewhat reassuring.

That reminds me of a local case where a surgeon got in trouble for literally hitting people who were under anesthesia while the anesthesiologist and nurses looked on. He was eventually fired from just about every hospital in the area. Recently I had to go to an orthopedic center that has a surgery wing and he strolled right past me wearing scrubs and a white coat.
posted by xyzzy at 10:13 PM on July 8, 2016 [5 favorites]

Thanks for posting! We use NPDB reports, like everybody else, and I'm fascinated to read a breakdown of ways in can fail to capture reasons a provider shouldn't be practicing.
posted by ThePinkSuperhero at 3:59 AM on July 9, 2016 [1 favorite]

as an anesthetist, this is why I am an indifferent jackass in preop holding.
posted by a robot made out of meat at 7:52 PM on July 9, 2016 [2 favorites]