A recent case filed in a Maryland State Court underscores protectionism within the medical community and the potential ramifications of entities for not having the courage to report physician sexual misconduct.
Whenever I teach bioethics to medical students, we discuss the virtue of courage. Courage has different meanings in various factual scenarios. When it comes to sexual misconduct, it takes courage for another member of the medical community, whether it is a physician or a hospital administrator, to report the conduct of a physician both internally and externally (e.g., state medical board, law enforcement). In this scenario, courage aligns with the definition of fortitude – that is the ability to stand up and do the right thing, regardless of the backlash by other members of the medical community.
Having written on the subject before for the Nevada State Medical Board, a couple of related issues came to my mind. First, a physician's fundamental duty and an executive's fiduciary duty is to "do no harm to the patient." Second, most sexual assaults go unreported or are dismissed by institutions or practices that want to keep the topic hidden from the public. Third, the residual harm to the patient – both physical and emotional – can last a lifetime. Finally, failing to have the courage to take the right course of action can have greater consequences down the line for both the perpetrator and the hospital.
In 2016, The Atlanta Journal Constitution did a five-part series entitled Doctors & Sex Abuse. The results of scouring over 100,000 records nationally found profound evidence of hidden conduct existed as physicians hid behind the veil of the medical profession. Furthermore, it was disconcerting to learn that the victims could not find treatment from other physicians in the community. This type of conduct is what forms the basis of the recent class action case in Maryland.
In this case, multiple patients reported the physician to both the Maryland Board of Physicians and Kaiser Permanente. Moreover, a patient confronted both the physician assistant and the physician, as well as notifying Kaiser. Another patient notified their primary care physician, but to no avail. None of these persons took immediate action, despite having a legal, fiduciary, and ethical obligation to do so. In turn, more patients were subject to assault, battery and other conduct, which did not constitute informed consent.
These actions beg the question – what should physicians do to protect themselves, as well as reporting peers, who are outliers and disgrace the medical profession? First, common sense tells us that touching a patient sexually, sexting during surgery or office examinations and sexually assaulting a patient while under anesthesia is beyond reproach and flat out wrong. Second, physicians (whether male or female), should always have a staff member in the room with them at all times.
Finally, it is incumbent upon all members of the healthcare community to report these wrongs immediately. Battery and sexual assault constitute both civil and criminal wrongs, which can lead to fines, suspension or loss of one's medical license, and carry prison time. State medical boards are actively addressing this issue. If they do not know about the conduct, then no action can be taken. In sum, hopefully this topic serves as a reminder that the goal is to promote health and well-being – not traumatize a patient for the rest of his or her life.