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MeToo has little impact on American medical world

Updated April 17, 2018

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WASHINGTON: Even as Hollywood moguls, elite journalists and top politicians have been pushed out of their jobs or resigned amid allegations of sexual misconduct, the world of medicine in the US is more forgiving, according to an Associated Press investigation.

Even when doctors are disciplined, their punishment often consists of a short suspension paired with therapy that treats sexually abusive behaviour as a symptom of an illness or addiction.

The first time that Dr Anthony Bianchi came onto a patient, California’s medical board alleged, the gynaecologist placed a chair against the exam room door, put his fingers into the woman’s vagina and exposed his erect penis.

The second time, the board claimed, he told a patient that he couldn’t stop staring at her breasts and recounted a dream in which he performed oral sex on her in the office.

The third time, the board charged, he told a pregnant patient suffering from vaginal bleeding that she shouldn’t shave her pubic hair before her next visit, as he was getting too excited.

These episodes led to disciplinary actions by the state’s medical board in 2012 and in 2016. Bianchi agreed not to contest the charges, and held onto his medical license. Under a settlement with California’s medical board, he agreed to seek therapy and refrain from treating women during five years of probation.

Examples of problematic behaviour are easy to find in states across the US. In Arkansas, Dr Robert Rook was allowed to keep his family practice open, so long as he’s chaperoned, despite facing multiple criminal charges for rape. Prosecutors subsequently downgraded the charges to more than 20 counts of sexual assault in the second- and third-degree, charges for which Rook says he is innocent. Rook did not return phone messages left with a secretary at his Conway office. He is set to face trial later this year.

Decades of complaints that the physician disciplinary system is too lenient on sex-abusing doctors have produced little change in the practices of state medical boards. And the #MeToo campaign and the rapid push in recent months to increase accountability for sexual misconduct in American workplaces do not appear to have sparked a movement towards changing how medical boards deal with physicians who act out sexually against patients or staffers.

Azza Abbudagga, a health services researcher with non-profit advocacy organisation Public Citizen, recently published a report detailing sexual misconduct among physicians. Its findings showed of the 253 doctors reported to the National Practitioner Data Bank for sexual misconduct, or paid a settlement that stemmed from such an allegation, 170 of them were not disciplined by state medical boards.

Current guidelines from the Federation of State Physician Health Programmes are largely silent on handling sexual misconduct treatment and describe sexual harassment as a “cause of impairment” in a doctor.

State-authorised programmes that attempt to oversee the rehabilitation of doctors who have committed sexual misconduct aren’t always forthcoming about their methods.

The lenience of penalties for sexually abusive doctors is sometimes a source of frustration even for members of the medical board who administer the discipline, according to Jason Rosenberg, a former chairman of the Florida medical board.

In practise, even some lawyers who represent doctors find the physician health programmes to be problematic. David Spicer, who has represented doctors facing medical board discipline in Florida, says the state’s doctor rehabilitation programme isn’t well designed to evaluate or treat sexual misbehaviour. The program’s key component, he said, is a “one-size-fits-all” requirement that doctors engage in therapy sessions and not get into trouble for a specified period, generally five years.

Experts in the treatment of sexual misbehaviour question whether the treatments mandated for doctors who molest patients are even appropriate for such misconduct.

“It’s insufficient,” said Rory Reid, a UCLA psychology professor who studies addiction and hypersexual behaviour. “We have clinical trials for everything underneath the sun,” Reid said. “But there’s not one clinical trial that I’m aware of on the efficacy of treatment for doctors who have engaged in sexual misconduct.”

Published in Dawn, April 17th, 2018