How State Medical Boards/ Professional Associations Can Facilitate Patient Reporting of Sexual Misconduct 1 » Provide multiple channels (e.g., writing, phone, email, online form) » Clearly post process of state medical board websites » Ensure translation of complaint materials for complainants who do not speak English » Educate as to types of physician behaviors to expect » With exceptions for urgent, emergency, or same- day care, one should obtain patient consent well in advance with the understanding that patients are disadvantaged by the requirement to give quick decisions at the point of care. 1 If anesthesia (or the possibility of anesthesia) is involved, informed consent should include information about the effects, including the possibility of amnesia, with a view to preventing particular dangers of sexual misconduct in these patients. 1 If any photograph or video is to be taken, the patient must give consent that is then documented in the medical record. 13 All informed consent materials should be written in common language that is easily accessible to the lay public. If consent cannot be obtained (due to anesthesia or any other reason), only medically-necessary intimate examinations should be performed and never for purely educational reasons. 1 Patients capable of making decisions have the right to refuse any examination or procedure. 13
Best practices during intimate examinations include routine use of chaperones, obtaining patient consent, using the minimum amount of physical contact to inform diagnosis and treatment, and maintaining open, informative, and respectful communication. All physicians have a duty to report observed or credible suspicion of sexual misconduct by colleagues and superiors. Effectively addressing physician sexual misconduct will require widespread cultural and systemic changes and medical education across the practice continuum. 1
Educate as to types of physician behaviors that warrant complaint Educate on what to do if made uncomfortable by physician’s actions Educate on what actions would warrant direct report to law enforcement Ensure public anonymity of complainant (anonymity to board may not be possible)
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Conclusions The overwhelming majority of physicians who provide compassionate, competent care within professional boundaries risk compromise to the reputation of their profession from the “bad apples” within their ranks. Sexual misconduct by a physician is an abuse of power and is grounds for investigation, sanction, and, when warranted, criminal prosecution. Because offenders often repeat their misconduct, many patients can be affected over years or even decades. Sexual misconduct by physicians is properly and effectively addressed through standards and expectations of professionalism, preventive education, meaningful disciplinary action, law enforcement when required, traditional self- regulation, and the modern concept of shared regulation. 1
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