From protector to predator: Physicians who sexually assault their patients
Key Takeaways
More than 2,400 doctors in the US have reportedly been publicly disciplined for sexual assault allegations from patients since 1999. Half of them retain their licenses.
Victims of physician sexual abuse may choose not to report their doctor due to feelings of confusion, intimidation, or embarrassment. Meanwhile, healthcare organizations often address allegations without notifying police or licensing agencies.
The AAFP encourages physicians who treat victims of sexual abuse to communicate with their patients by listening nonjudgmentally while offering appropriate resources.
The doctor’s office is a place where patients may expect to feel safe and cared for. After all, it is part of the Hippocratic oath to “do no harm.” For some patients, however, doctors’ offices and hospitals set the stage for sexual abuse by a trusted physician—many of whom are male, over 39, and see patients privately, according to authors of an article in the journal Sexual Abuse.[]
The authors note that it's difficult to accurately estimate the number of sexual assaults in medicine, as most patient-victims do not report their assailant; they note one study that estimates fewer than 1 in 10 victims choose to report it. This has led some news organizations to claim that the American medical system has yet to publicly prioritize the issue of sexual misconduct, unlike the organizations to which similar allegations have been drawn, such as the Roman Catholic Church, the Boy Scouts, and the US military.
Stories of sexual abuse from patients
To better support victims, physicians who treat patients with a history of sexual abuse can approach them nonjudgmentally and by using empowering and supportive language in the exam room, per the American Academy of Family Physicians (AAFP).[]
Sexual abuse by physicians is not a common issue, but the statistics may surprise you.
According to an investigative report from the Atlanta Journal-Constitution, over 2,400 doctors across the country have received some form of public discipline relating to sexual infractions from patients since 1999.[]
One doctor who falls under this category is Dr. Ashok Alur, who is reported to have placed his mouth on a female patient’s genitals during an abdominal exam in Kentucky.
Another is a psychiatrist in California, Dr. Mandeep Behniwal, who is reported to have put his hand down a patient’s blouse as she was leaving an appointment, he then reportedly exposed himself and ejaculated on the patient’s hand.
In both of these cases, the doctors involved maintained their licenses and returned to practice.
The same is true of two-thirds of physicians who’ve been publicly disciplined for sexual misconduct in Georgia, according to the Atlanta Journal-Constitution—a statistic based only on cases made known to the public.
Systemic failures create conditions for abuse
Why don't some doctors face legal ramifications after the occurrence of abuse? The Atlanta Journal-Constitution cites a number of factors contributing to this phenomenon.
For one, victims are often too confused, intimidated, or embarrassed to come forward. Compounding this is the silence of nurses and colleagues who may be close to the physician in question.
On top of that, hospitals and other healthcare organizations may dismiss sexual assault allegations pertaining to their staff, or quietly ask the offenders to leave before news gets out. "Hospitals or physician employers sometimes ignore reports of abuse or push for a resignation rather than reporting physicians to medical boards or law enforcement," wrote the authors of the Sexual Abuse article.
This silence extends to the systemic level: Medical boards dominated by physicians, the Atlanta Journal-Constitution reporters found, tend to grant offenders second chances, and prosecutors are quick to reduce charges or dismiss them altogether.
All of these dynamics effectively keep abusive doctors in practice and off sex offender registries.
Addressing the problem, as noted in an article published by the Journal of General Internal Medicine, will require education for physicians and the public about the issue.[] There should also be reporting mandates for doctors, penalties for those who fail to report, and other institutional changes that actionably condemn perpetrators while supporting victims.
In the meantime, you can take steps to communicate effectively with your patients about their experiences with sexual abuse.
Communication strategies to use with victims
According to the AAFP, physicians may at times encounter patients who disclose experiences of sexual abuse. If you find yourself hearing a disclosure of this nature, there are a few things you can do to effectively respond.
Sit instead of stand. Position yourself so that you can make eye contact with the patient as they speak. Avoid looking at the computer, too.
Practice nonjudgmental listening. When patients come forward about sexual assault, your job is to listen without judgment. You may express support, and you should know how to not retraumatize them.
Use language that empowers patients. Avoid using statements such as, “You should be over this by now,” or “Why don’t you remember everything that happened?” Instead, use a gentle and receptive tone, which can help patients feel more at ease during difficult conversations.
Avoid physical touch. You may feel as though you want to extend a nurturing pat on the back to your patient as they open up about a vulnerable topic. But this should be avoided. As the AAFP states, “By definition, sexual assault involves someone exerting control by violating someone else’s physical space and boundaries.” It’s best to instead rely on body language, words, and tone of voice to show support.
Have a list of resources ready. Get to know the resources available to survivors in your local community. You may also make brochures readily available in your waiting room for patients to read on their own.
What this means for you
Physician sexual abuse is an issue that has gone largely unaddressed by America’s medical system. Despite the toll it takes on patients, some physicians faced with sexual abuse allegations continue to practice medicine.
One way to approach victims of sexual abuse in the exam room is with nonjudgmental listening. Refrain from using touch as means of support, and instead rely on words that uplift and empower your patients. Finally, be prepared to offer resources that provide support to survivors.