The first time I heard about a doctor raping a patient was during my third year of medical school. It was a Friday night and I was taking calls coming in to the Boston Area Rape Crisis Center hotline. The woman on the other end of the phone spoke hesitantly at first, explaining that she was “having trouble sleeping.” Then her story tumbled out, her voice cracking with sobs under the weight of profound trauma.
Emily (not her real name) was raped by her surgeon 30 years ago after a routine hernia repair. She had avoided medical care ever since. That Friday afternoon, giving into her aging body’s needs, she had bitten the proverbial bullet and stepped into a doctor’s office for the first time since her rape. That simple act forced her to relive that traumatizing experience.
Doctor’s offices, with their cold, sterile exam rooms and flimsy patient gowns that expose both bodies and vulnerability, are uncomfortable spaces for most of us, seemingly the antithesis of sex. But I was shocked to learn that they could both trigger memories of rape and be the actual venues of it.
The medical field, like popular culture, reinforces the physician-as-hero trope. Having answered their “life’s calling,” physicians are trustworthy, objective, selfless — even godlike. Doctors certainly do not rape, assault, or molest their patients.
But they do. The harrowing experiences of several hundred gymnasts who exposed Dr. Larry Nassar’s history of molestation under the guise of medical treatment demonstrates how he was able to sexually assault these young women because he was a doctor — using his trusted position and the safe confines of a doctor’s exam room.
Other doctors enabled Nassar’s predatory behavior. There was Dr. Gary Stollak, a clinical psychologist who heard about Nassar’s abuse from a former victim 14 years ago but did not report it; Dr. William Strampel, dean of the Michigan State University College of Osteopathic Medicine, who imposed protocols for Nassar — including wearing gloves and having a chaperone for sensitive exams — but failed to enforce them; and Dr. Brooke Lemmen, who resigned from Michigan State after failing to tell the university that Nassar had informed her he was under investigation by USA Gymnastics.
I’m a physician now. The outrage I felt hearing these stories was accompanied by flashbacks to conversations with survivors like Emily. Sadly, women like her had not been able to garner national attention to punish the physicians who sexually violated them and the other health care professionals who were complicit in these heinous acts.
And they are not alone. An Atlanta Journal-Constitution investigation in 2016 identified more than 2,400 cases of doctors across the country who had sexually assaulted their patients. The investigation found that half of these physicians were still licensed to practice medicine. One pediatrician assaulted as many as 1,000 young patients before being sent to prison.
The medical profession has failed these victims, too. Hospitals ignored reports of sexual assaults and encouraged offending physicians to resign rather than reporting them to medical boards or law enforcement. State medical boards aren’t always a good solution — they are often run by physicians who support their peers without oversight from nonphysician members to help ensure independent accountability.
Physicians’ disciplinary records are not always posted publically. And when they are, they commonly fail to describe the serious nature of sexual assault, using vague language like “boundary violation” or “unprofessional conduct.” In one case, a male physician who purposely did not wear gloves while conducting a rectal and vaginal exam of a female patient was reported for an “infection-control violation.”
Physicians, hospitals, and state medical boards can and should do more to protect patients from sexual assault. On a daily basis, patients allow doctors to invade their privacy, whether by placing a stethoscope on a naked chest, palpating a mass on a breast, or conducting a testicular exam. This should come with awareness of our privileged role and the incredible responsibility we have to uphold our pledge to “do no harm.”
We must confront the culture of medicine that dissuades physicians from reporting our colleague’s “bad behavior,” including conduct much less egregious than sexual assault. We must also advocate for independence in systems that hold physicians accountable.
At the same time, we must be respectful of survivors of sexual assault by strengthening our training around caring for them and ensuring that they feel comfortable seeking care in an environment that may have previously betrayed their trust. Whether or not the sexual abuse was committed by a physician, many practices and procedures performed in medical offices like gynecological exams — or even the removal of clothing — can trigger a post-traumatic reaction in a survivor of sexual assault. Health care providers should be equipped to offer support in these cases, acting as trauma-sensitive, trauma-responsive, and trauma-informed providers.
But as Olympic gold medalist Aly Raisman said in her victim’s statement, “Talk is cheap.” I hope we can heed her words, and that our collective outrage over Nassar’s conduct leads to instrumental changes in the health care profession.
Altaf Saadi, M.D. is a first-year fellow at the National Clinical Scholars Program at UCLA.
A former ob/gyn at NewYork Presbyterian/Columbia University medical center seems to have been treated somewhat leniently by the Manhattan D.A. (Cyrus Vance Jr.).
https://www.dailymail.co.uk/news/article-6966591/Pervert-gynecologist-pictured-outside-home-revealed-women-come-forward.html
I’m not from the east coast but Cyrus Vance Jr. doesn’t seem to have a very good reputation.
The defense attorney appears to have listed the lenient disposition of the case as an achievement or selling point on her webpage.
“– Obtained a favorable result for a doctor accused of sexually abusing multiple patients.”
http://www.clayro.com/professional/isabelle-a-kirshner/
I’m not a fan of the amoral aspect of the justice system. Defendants are not expected to tell the truth. They are encouraged to try to evade responsibility for their actions.
Talk is cheap indeed. Nothing has changed and it won’t unless the government steps in and goes relentlessly after those people ..
This article is about a controversy surrounding pelvic exams performed on unconscious female patients by medical students.
https://www.apnews.com/c309d388b10b4fe582753e3b1f768f94
This article says that HMS starting getting patients’ consent after students questioned the propriety of what they were doing. The article also has an alternate viewpoint from a Johns Hopkins professor.
https://www.cbsnews.com/news/pelvic-exams-without-permission/
New York state became either the sixth or the ninth state to enact a law concerning pelvic exams on unconscious female patients, depending on which article you read. Physicians won’t do the right thing unless legally compelled to or compelled to by publicity. I don’t think they know what the right thing is. That was not a joke.
Actually it’s not clear how informed the consent is at HMS. Generally when the medical schools are questioned about this their responses seem to be vague and evasive.
I don’t know if medical schools have a required class on Medical Ethics. If they do it has to be very short, like less than an hour.
This is why it’s wise for women to avoid male doctors for intimate procedures. Check out the video, History of Gynecology & How Women Can Prevent Sexual Abuse in Medical Settings at https://www.youtube.com/watch?v=nZg69V0sVTQ&t=163s.
Thank you for writing about this. I was assaulted at Stanford Hospital by a pediatrician when I was in hard labor with my son. It has been 26 years and I do not go to any doctor. I never will.
A professor in the Yale medical school who previously committed sexual harassment had his endowed chair revoked after members of the Yale community protested against it. The leadership of Yale University have developed a perverse reputation for tolerating sexual harassment. A Yale professor went on record calling them bullies, or something similar. That is as unusual as it sounds. I have to conclude that the board of trustees, or equivalent body that is ultimately responsible for the governance of the university, consists of pod people.
http://www.latimes.com/local/lanow/la-me-ln-medical-board-claim-huntington-20181001-story.html
This article is about a Pasadena (CA) obstetrician who has had a number of complaints lodged against him over the years. The newspaper submitted a number of questions to the state medical board and the hospital where he works but the responses they provided were vague and evasive.
https://www.latimes.com/local/lanow/la-me-huntington-doctor-misconduct-allegations-20181209-story.html
This long article describes a number of complaints that have been lodged against Dr. Sutton, many alleging improper medical care. Dr. Sutton agreed to be interviewed by the newspaper, and from what I recall he denied each allegation. The state medical board and the hospital where he worked, last time, provided vague and evasive responses to the newspaper’s questions, as I mentioned above. This time, they refused to respond. I think an argument could be made that they owe an explanation to the patients, and to the community.
A state senator in Texas, who is also a physician, was accused of sending an unsolicited picture of male genitalia to a female student who requested career advice. In response to media inquiries the senator’s spokesperson issued a statement that was vague and evasive. The senator subsequently hired an attorney who issued another statement that is more categorical, but lacks explanation. To my knowledge the senator has not responded directly to the complaint (i.e. not through an intermediary).
https://www.statesman.com/news/state–regional-govt–politics/investigating-sen-charles-schwertner-after-sexual-misconduct-claim/asnidSImg1fcb2FNBZ8iCO/
https://www.statesman.com/news/crime–law/senator-strongly-denies-sending-texts-new-statement/sr10HvBEaLjQNpayQgam5I/
The U. of Texas apparently concluded its investigation with an inconclusive result. It appears the senator gave his login information to a third party, who the senator refused to identify, and it may have been the third party who sent the lewd message to the student. The senator refused to answer some of the university’s questions, and because it was not a criminal investigation he was not legally required to. I assume he wishes to protect the third party, presumably a friend or family member. I’m not sure if he or the third party has apologized to the student.
A female physician has stated that the recently departed head of CBS Television behaved inappropriately when he was her patient 19 years ago. She stated further that when she reported the incident to her superiors at UCLA, she was discouraged from reporting the incident to the police, for dubious sounding reasons. The article has reprinted a statement issued by a spokesperson for UCLA.
https://www.vanityfair.com/news/2018/09/les-moonves-admits-to-unwanted-kissing-of-his-doctor-19-years-ago
State medical board calls former County-USC doctor a ‘sexual predator,’ suspends his license
http://www.latimes.com/local/lanow/la-me-ln-medical-board-usc-doctor-20180531-story.html
This article concerns a fellow at the LA County+USC Medical Center who was accused of molesting a resident. The article is kind of long and rambling but the underlying formula is standard. I can list some of the elements of the formula, from memory:
1. After complaint is filed the accused is put on leave for some period of time then returns to work.
2. Accused subsequently moves to another hospital.
3. Lawsuit is filed alleging the complaint was mishandled.
4. More victims are found.
5. New hospital announces they had no knowledge of the complaint(s) against the accused when they hired him.
6. Original complainant states she was retaliated against by her superiors, and the retaliation got worse after a story appeared in the LA Times. Complainant goes on medical leave.
While I can’t claim to predict the future, I will be surprised if the Medical Center admin takes positive steps to counteract the perception that complainants are retaliated against. To the contrary, they *want* people to think twice before filing a complaint.