State's lax rules let doctors practice despite complaints
Monday, April 24, 2006 7:05 AM PDT
By Associated Press
Printable version
E-mail this articleSEATTLE (AP) -- Hundreds of doctors and counselors in Washington state have been allowed to keep working despite complaints from patients of sexual misconduct, according to a newspaper report.
The Seattle Times investigation found the state Department of Health repeatedly failed to adequately investigate and penalize offenders -- including doctors, nurses, chiropractors and counselors.
Since 1995, the department has dismissed 461 sexual-misconduct complaints -- about a third of the nearly 1,500 received -- without making an inquiry. Fewer than 1 percent of all health-care providers have been disciplined for sexual misconduct over the past decade.
"This is a big, big problem," said psychologist Scott Stacy of Kansas-based Acumen Assessments, who has treated 600 practitioners accused of sexual transgressions. "It's much larger than most of us realize, and it's getting worse."
The Health Department licenses 57 kinds of health-care practitioners, most regulated by governor-appointed boards and commissions.
The Medical Quality Assurance Commission, which regulates the state's 20,000 physicians, meets about seven times a year. Board members frequently wait until disciplinary hearings are under way to read the thick investigative files, leaving scant time for meaningful examination.
When the state does intervene, offenders are often allowed to keep working under dubious safeguards, their sexual abuse of patients treated as a lapse in judgment.
Following the newspaper's findings, the Health Department said it has moved toward reform. Last month, it issued eight emergency suspensions for health-care professionals charged with sexual misconduct. That compares to a total of seven in 2005.
Professional associations make clear that sexual contact with a patient or client is unethical and forbidden.
But in some cases, access and power result in exploitation of patients.
"Doctors tell you to take off all your clothes, kneel on this table and bend over," said Dr. Steven Altchuler of the Mayo Clinic in Minnesota, one of the nation's leading authorities on the problem of sexual misconduct by doctors. "You do it without question. Why? Because we trust them like no other person."
In June 2001, Lyubov Veselkov, 32, notified the state Health Department that Vancouver family practitioner Huong T. Luu had taken photos of her during a pelvic exam.
Department investigators recovered 136 photos from Luu's office computer, most showing Luu inapparopriately touching women patients, often with an ungloved hand.
Luu's license was suspended, but at his hearing in Seattle that fall Veselkov was told her testimony would not be needed. The hearing was not open to the public.
Closed-door settlements often result in the characterization of sexual misconduct cases as consensual -- confirming sexual contact took place but the state is not revoking or suspending a license. In such cases, practitioners agree to watered-down charges, which is what the public sees on the state Health Department Web site when a practitioner is disciplined.
In Luu's case, he was barred from performing gynecological exams for three years, required to wear surgical gloves and to have a female chaperone in the exam room at all times.
Officials never identified the other women Luu had photos of. His patients, most of them women, didn't know of his misconduct, The Times said.
Luu was permitted to edit the state's disciplinary order. He removed some details, such as that he was touching Veselkov in one photograph, and evidence that he had tried to erase the digital photos. His claim of innocence was added.
In the past decade, 197 practitioners who were subject to sexual complaints have been allowed to return to work, more than half under "practice restrictions," such as requiring a chaperone when examining patients.
State officials contend state courts consider a health-care license the property of its holder, and that regulators must start with the "least restrictive" discipline, according to case law.
Among the deals the state has approved:
• A Kirkland psychologist who had sex with female patients was told he could continue to treat women -- but only those older than 50.
• A Bellevue dentist, charged with molesting patients, was allowed back into practice -- on condition that he install a video camera in his office so regulators could randomly review the tapes.
• A Puyallup physician accused of fondling a woman's breasts was ordered to attend a refresher class on how to conduct breast exams. Today, he stands accused of fondling other patients.
State health officials defend such settlements as a way to discipline practitioners and still protect the public. But experts say the penalties are too lax, and that officials should treat sexual misconduct as an indicator of deep-seated problems and a predictor of future offenses.
In Washington, sexual misconduct is one of the leading disciplinary problems in health care. The Times used Health Department files and court records to identify 399 caregivers disciplined for sexual misconduct offenses since 1995.
Most were men exploiting women. About half still are licensed to practice.
In Washington, at least one out of 10 practitioners disciplined for sexual misconduct later exploited more patients or violated terms of their practice restrictions, The Times found.
Rep. Tom Campbell, R-Roy, vice chairman of the House Health Care Committee and a chiropractor himself, wants tougher penalties.
"It's simply ludicrous," he said. "When you look at the punishment or the remedial actions taken, it's pathetic. I've been shocked by the repetitive nature of offenses by some providers, and they're still out there."
Last year, he sponsored an unsuccessful bill that mandated revoking health-care licenses for repeat offenders. Lobbyists for the physicians' trade group said the discipline system was working adequately.
Copyright 2006 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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