Doctors & Sex Abuse: Reporting we hope will spur change

It was May of last year and some of the AJC’s best journalists had a big decision to make.

Over previous months, they’d been digging around on sexual misconduct by doctors. This curiosity had its roots in a series of stories by the AJC’s Danny Robbins.

You might recall articles by Robbins about Yvon Nazaire, a troubled doctor who left New York under a cloud and was promptly put in charge of medical care at women's prisons in Georgia. Robbins showed that inmates died after they received poor or no care. Nazaire was finally fired.

All that work of digging into a troubled doctor’s past meant that Robbins reviewed lots of records kept by the Georgia Composite Medical Board.

In his digging, he noticed that doctors in Georgia with sexual violations were allowed to continue to practice. And cases of sexual misconduct did not seem to be coming to attention of police.

The record in Georgia for protecting patients did not look good. Robbins was on to another story, but was convinced there was more investigating to do.

Deputy Managing Editor Shawn McIntosh, who oversees our investigative work, suggested we do some wider digging to figure out where Georgia stood in relation to other states.

So we hired a freelance legal researcher to tell us how the law works across states. We wanted to know whether medical boards had to report sexual abuse to police, and if the records were required to be public.

Lois Norder, an investigations team leader, started digging as well to determine what was known about doctor sex abuse.

A pattern began to emerge. In many states, the system, typically supervised by fellow physicians, had limited transparency and little accountability. When the sexual abuse involved an adult, regulators didn’t even have a legal obligation to report it to law enforcement in most states.

In between his other work, Robbins put together a spreadsheet on those Georgia doctors that had sexual violations. Two-thirds of them were still practicing.

Was this true in other states? Norder checked on Alabama and Illinois, as a test of the theory. Similar numbers.

And so, around May, it was decision time. Should The Atlanta Journal-Constitution pursue the story beyond Georgia? It seemed to be a national problem, but a complex issue, in part because each state licenses doctors under its own rules.

The investigative team knew versions of the story had been told by other news organizations in other states. But the problem appeared bigger than any single state. It seemed to relate more to the way the medical profession views doctor sex abuse than any set of regulations.

A national investigation into why doctors get away with sexual abuse would require examining records and cases in every state. They started gathering material and hit roadblocks at every turn. States did not know the extent of the problem and could not provide records. States had poor records, and medical boards weren’t enthusiastic about providing them. Databases were unavailable or not even maintained.

And the work you see in today’s newspaper, and online at shows they were right to insist on pursuing the story.

The persistence, ingenuity and dedication of a group of AJC journalists brought to light one of our country’s most troubling sexual abuse scandals.

It’s an important story that needed to be told. The challenge? How to get it done without burrowing into a hole so deep that the reporters might never come out with a story.

Enter Jeff Ernsthausen, another AJC journalist.

Ernsthausen and a colleague wrote a computer program to “scrape” disciplinary records from medical regulator web sites in all 50 states. The team read a few thousand and determined they could never finish because the work was so arduous. Ernsthausen then devised a machine-learning program to analyze all of the documents to eliminate the ones that were not likely to relate to sexual misconduct and flag those that reporters should carefully review. It narrowed the work from more than 100,000 disciplinary records to some 6,000 to read.

And for months, Norder, Robbins, Ernsthausen, McIntosh, Carrie Teegardin and Ariel Hart and others read the documents, developing deep knowledge of cases and ultimately interviewing victims and others.

They identified more than 2,400 doctors who had been disciplined after allegations of sexual misconduct. That is a small number of the more than 900,000 licensed doctors in America. Yet it's unlikely that number represents the extent of the problem, because doctor sex abuse is shrouded in secrecy by a system that is designed, in large part, to protect doctors.

At a time when a deeper understanding of sexual abuse has reshaped policies in the church, youth organizations, the military and other institutions, the medical community has yet to take steps to fully protect the vulnerable people in its care.

These finding are upsetting; the victims’ stories are difficult to hear and read about. And the victims most powerfully illustrate why this story needed to be told. As we’ve published the stories over the last week, our determined journalists have heard from more victims, who want their stories told, or who now understand better what happened to them.

There is no more inspiring affirmation of a story well done.

But great journalism is never enough. We hope this work leads to important changes that need to be made in how sexual abuse by doctors is handled by the medical profession.

RELATED: Reaction to Doctors series: Experts say Medical boards must get tough to curb ‘mind-boggling’ scope of problem