State medical boards are failing to protect the public from many doctors already known to have committed sexual misconduct, according to a recent report from Public Citizen, a non-profit, consumer rights advocacy group and think tank based in Washington, DC.
Seventy percent of U.S. physicians — 177 out of 253 — who had engaged in sexual misconduct that led to sanctions by hospitals or other healthcare organizations or malpractice payments were not disciplined by state medical boards for their unethical behavior, according to the research. The study is the first published one that used information on physician sexual misconduct from the National Practitioner Data Bank (NPDB).
“It’s clear that medical boards are allowing some doctors with evidence of sexual misconduct to continue endangering patients and staff,” said Azza AbuDagga, MD, health services researcher for Public Citizen’s Health Research Group and lead author of the study.
Public Citizen for years has pushed state medical boards to do a better job of disciplining problem doctors. “These boards must pay more attention to sexual misconduct that leads to health care organizations cracking down or to lawsuits,” AbuDagga said.
AbuDagga co-authored the study with Sidney Wolfe, MD, founder and senior adviser of Public Citizen’s Health Research Group; Michael Carome, MD, director of Public Citizen’s Health Research Group; and Robert Oshel, MD, retired NPDB associate director for research and disputes.
When state medical boards do act on sexual misconduct, though, they take severe measures in the vast majority of cases. For the 974 NPDB reports of medical boards disciplining physicians in response to physician sexual misconduct, the boards took serious licensure actions — such as revoking, suspending, or restricting the medical license — in 89% of cases. In contrast, state medical boards took such severe actions in only approximately two-thirds of cases involving other types of misconduct.
“These numbers show that when state medical boards take action, the action rightly tends to be much more severe for physicians who engaged in sexual misconduct than other offenses,” Wolfe said. “Now, the medical boards need to pay increased attention to sexual misconduct that led to health care organizations cracking down or to lawsuits. State medical boards have full access to the NPDB data. The boards must protect the public.”
Public Citizen examined physician reports in the NPDB from Jan. 1, 2003, through Sept. 30, 2013. The study focused on sexual misconduct-related licensure, clinical privileges, and malpractice payment reports for physicians, including medical doctors, osteopathic doctors, and intern/resident physicians. A “licensure” sanction refers to an action, such as revocation or restriction of a doctor’s medical license, taken by a medical board. A “clinical privileges” sanction refers to actions such as revocation or denial of clinical privileges, voluntary surrender of privileges, and restrictions on a doctor’s ability to practice. These actions are taken by hospitals, nursing homes, or managed care organizations.
The analysis found that 1,039 physicians had one or more sexual misconduct-related reports, and of these, 786 (76%) had been disciplined only by a medical board. The study also revealed that the remaining 253 physicians had one or more clinical privilege reports or malpractice payment reports related to sexual misconduct, but 177 did not have a report of state medical board licensure action for such misconduct.
While the study provides important new information, it likely highlights a possible overall underreporting or inaction related to physician sexual misconduct. The authors caution that because sexual misconduct-related reports accounted for only 1% of the total reports in the NPDB, their study “represents only the tip of the iceberg of physician sexual misconduct in the U.S.”
The full report is available online at http://tinyurl.com/z4ft236.
