Decades of doctor-patient sexual assault raise questions of transparency

Seven out of 10 sexual assaults are committed by someone known to the victim according to the Rape, Abuse and Incest National Network (RAINN). A relative. A spouse. A date.

A doctor?

A 2016 investigation conducted by the Atlanta Journal Constitution analyzed public records from the last two decades and found more than 3,100 doctors nationwide had been publicly disciplined after accusations of sexual misconduct. It also found many violations were never reported publicly or uncovered by state medical boards.

RAINN and Women’s Health Magazine surveyed nearly 500 women and found reports of sexual misconduct by a doctor — reported by 27 percent of the women — ranged from inappropriate touching and sexual comments to masturbation during an exam and rape.

The Daily Tar Heel conducted a local investigation and found no physicians in Orange or Durham counties with public sexual misconduct violations on their record. But due to underreporting and private records, records may not give the whole story.

Bethany Wichman-Buescher, client services director at Orange County Rape Crisis Center, said in ten years she has met several survivors who experienced sexual violence at the hands of the medical professional.

“Sexual assault is a crime of power and control,” Wichman-Buescher said. “I think it happens a lot that the perpetrator is in a position of power.”

In December 2015, a family care physician in Charlotte was charged with three counts of second-degree sexual assault.

In November 2016, the North Carolina Medical Board suspended a medical resident in Winston-Salem who was found to have inappropriately touched and exchanged explicit messages on social media with a patient.

In November 2015, a physician assistant surrendered his license in Wake County following allegations that he took photos of a patient’s body.

In all three cases, the N.C. Medical Board conducted investigations that resulted in revocations of the professionals’ medical licenses. But in the interim, there is no way for patients to know if their doctor is being investigated.

“By law, the board can’t take action based on allegations alone,” said medical board spokesperson Jean Brinkley. “The board has to take action based on evidence. And evidence takes time to collect.”

Several investigations in North Carolina were resolved within six months.

Brinkley said in certain circumstances, the board may suspend a doctor or physician assistant’s license before an investigation is complete.

“In cases like that there does have to be rock solid evidence. Like they would have to say, ‘Yes I sexually assaulted these patients, and I’m glad I did it,’” said Brinkley.

Brinkley said in many cases, board action is not required to prevent a physician accused of sexual misconduct from practicing.

Depending on the allegations, UNC Health Care will put employees accused of sexual assault on administrative leave or reassign them until an investigation is complete, spokesperson Tom Hughes said in an email.

Little information

According to a 2015 ethics report by the American Medical Association, 42 licensed physicians in the United States were disciplined for sexual misconduct in 1989; in 1996 the number jumped to 147. Current numbers from the AMA are unavailable.

In 2000, Rep. Tom Bliley, R-Va., sponsored a bill to allow public access to the National Practitioner Data Bank, a federal database of physicians’ disciplinary histories originally intended to be open but later exempted from the Freedom of Information Act. Bliley’s bill to make the data public failed, in part due to AMA lobbying to keep the disciplinary information sealed.

“The AMA strongly opposes sexual misconduct in the practice of medicine,” said AMA spokesperson R.J. Mills in an email, noting that professionalism in medicine is regulated by a state-run system, not the AMA.

The N.C. Medical Board’s website ranked in the top five by Consumer Reports based on transparency and ease of use.

However, in some cases the medical board can issue private letters of concern, which would not show up on a physician’s record. Several other states, including Texas and Minnesota, make public all orders, reprimands and letters of concern regarding physician conduct.

“There are some cases where the board reviews a matter and they don’t have sufficient evidence to proceed with public action,” Brinkley said.

Protecting patients

The N.C. Medical Board requires that all physicians undergo background checks at the time of licensure. Several other states utilize recurring background checks for long-term practice.

Background checks are also required by many employers, including UNC Health Care.

To further protect patients, Hughes said it is standard to have a chaperone present during pelvic and rectal exams.

Wichman-Buescher said above all, education surrounding sexual assault is key.

To search a doctor or PA’s record, use the NC Medical Board website.

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