Georgia has concluded a year-long review of physician sexual misconduct cases brought to light by The Atlanta Journal-Constitution with a vague plan that focuses on educating doctors instead of seeking new patient protections as some states have done.
An AJC investigation revealed that two-thirds of Georgia physicians disciplined for sexually violating patients were permitted to practice again by the Georgia Composite Medical Board. The board announced last year that it would review its handling of those cases.
But instead of producing a comprehensive report, the board earlier this month released a one-page statement with three bullet points.
The board said it would protect patients from Georgia doctors who “use coercion or power for sex” by educating doctors about the importance of reporting colleagues; investigate all allegations and involve law enforcement when appropriate; and discipline doctors with public consent orders and license revocations when allegations are proven.
The board did not call for any changes in its rules or in state law even though the state lacks key patient protection measures. Among the gaps, Georgia does not have a law requiring doctors to report possible violations by their fellow doctors, nor is the medical board legally required to notify law enforcement of potential criminal acts. And while the board said it would protect patients from doctors who coerce patients for sex, the medical profession has acknowledged that even ostensibly consensual sexual contact between a doctor and patient is forbidden because of the power imbalance between physicians and those who turn to them for care.
Dr. John Antalis, the board chairman, said doctors across the state would be notified through a mass mailing that complaints of sexual abuse or “boundary violations” involving patients will be investigated and taken seriously. Antalis, a Dalton family practitioner, acknowledged that the process isn’t significantly different than the approach taken by the board in recent years. But he said the board and the public are now more aware of the problem and that awareness will make a difference.
“We have a good system now to handle these things when they come up and hopefully by educating we can let these physicians know this won’t be tolerated by the board,” Antalis said.
In its series Doctors & Sex Abuse, the AJC exposed a system in which medical boards, hospitals and law enforcement across the nation have long tolerated sexual misconduct by physicians. In Georgia, the newspaper found, nearly 100 doctors have been publicly disciplined for sexual misconduct since 1999 and others have received private disciplinary orders. The newspaper also ranked Georgia 34th nationally for patient protection laws.
Bob Jeffery, the Georgia board’s executive director, said the board’s review of past cases, conducted by a special subcommittee, could not lead to an extensive public report because much of the material examined is confidential by law. As for the lack of specific changes in policy, he said the board believes it has set a course to handle all cases properly in the future.
“I’m actually very proud of the board for doing that,” Jeffery said. “It would have been so easy for them to just circle the wagons and say, `We’re not going to talk to the press.’ They said, `We want to learn what those cases entail. We want to see what we can learn from how they were handled,’ and I think that’s cool.”
But Helen Robinson, director of advocacy for YWCA of Greater Atlanta, said the board should consider a number of specific changes to better protect patients. Her recommendations included training for medical board members by a group that works with sexual assault victims as well as more transparency about the board’s use of private orders in sexual abuse cases.
Robinson also said the board should require doctors on probation for sexual misconduct to notify patients and to tell them if, as a result of infractions, a chaperone is required to be in the room.
Patients would also benefit, she said, if the governor’s office appointed a strong consumer advocate to the non-physician seat that has been vacant on the board for nearly a year. Robinson also called on the state legislature to increase the percentage of non-doctors on the medical board and require all those applying for a physician’s license in Georgia to undergo a criminal background check — something most states already demand.
In appointing the special subcommittee, the board focused its attention on two cases detailed by the AJC involving physicians practicing in the metro Atlanta area.
One involved Dr. William Almon, who remained licensed despite being brought before the board on three separate occasions for allegedly sexually violating extremely vulnerable female patients.
In one instance, while working at a WellStar clinic in Paulding County, Almon was indicted in 2002 on felony charges of child molestation involving a 14-year-old girl and misdemeanor sexual battery of a mentally ill woman. However, even with the felony indictment, the board never suspended Almon’s license. In fact, it took no action until he pleaded guilty to the sexual battery charge six years later.
The other case involved Dr. Jacob Ward, who received a private letter expressing “concern” from the board in 2007 after two female patients reported that he had molested them during exams.
Four years later, another female patient reported to Woodstock police that Ward had molested her in the same way, and the doctor eventually pleaded guilty to sexual battery. That victim appeared in court on the day of Ward’s sentencing and learned of the board’s previous private letter. Shaken, she delivered such an emotional impact statement that the judge refused to sentence the doctor as a first offender.
The woman, who has requested that the AJC not identify her by name, expressed outrage when she learned that the board had reviewed the Ward case and had not seen it as a reason to eliminate private orders for doctors who engage in sexual misconduct.
“That crappy order, they had no way of upholding it,” she said. “There was no way to check whether he had somebody in the room with him (when he examined a female patient), which I’m proof he did not. Now that they know that their crappy little orders don’t work, they should be willing to do more.”
One of Ward’s initial accusers also criticized the board for not eliminating private orders in sex abuse cases. The woman said she was unaware of the letter sent to Ward until the AJC disclosed its existence and that the board arrived at its conclusion without interviewing her at any length.
“It’s not right at all,” said the woman, who also asked that her name not be used.
The board’s deputy executive director, Karl Reimers, acknowledged that the board has not ruled out private orders. But he noted that the board’s third bullet point says proven allegations of sexual misconduct will result in public consent orders or license revocations, a fact, he said, that can be interpreted as the board moving away from private orders in sex abuse matters.
Action by other states
In contrast to Georgia, several states have responded to the AJC series by enacting legislation aimed at making their medical boards more aggressive in dealing with sexual misconduct and more transparent in making information available to the public.
In West Virginia, a measure enacted this year requires that its medical and osteopathic boards report possible criminal activity to the appropriate law enforcement authorities. The law also states that the medical board can refuse to reissue a license to anyone convicted of a felony.
The West Virginia legislature took up these and similar issues after closely reading the AJC’s stories, said Gary Howell, the state legislator who chairs the committee that oversees the two boards.
“We literally went line by line and came up with regulations on how to fix this stuff,” he said.
In Maryland, legislation signed into law requires health occupation boards to provide more complete data on sexual misconduct cases. In addition, the State Board of Physicians must submit a report by Oct. 1 stating whether it’s feasible to better describe acts of sexual misconduct in board orders.
The Maryland law was enacted after the state’s Department of Legislative Services cited the AJC series in a sunset review of the board.
The AJC’s stories also helped prompt some other state boards that did not post disciplinary orders on their websites to change that policy.
Lawmakers are still seeking changes in other states. In Oklahoma, a state senator introduced a bill that would make it a crime for psychiatrists and other mental health providers to have sexual contact with their patients. The lawmaker took action after the AJC and its television partner in Tulsa, Fox 23, detailed how an Oklahoma psychiatrist used talk of witchcraft to manipulate his patients into sex. The bill died in committee, but the sponsor, Sen. Josh Brecheen, said he plans to bring it back next year.
“I found that there was a tremendous amount of support, so, even though the bill didn’t go forward, I expect it to be successful next year,” Brecheen said.