The Atlanta Journal-Constitution
NO FOOLPROOF SAFEGUARDS
Restrictions imposed by boards vary, provide glimpse at pitfalls in how violations are sometimes handled.
How can a medical board determine whether a doctor who has sexually abused patients is safe to return to practice? Board members often rely on therapists’ assessments, although therapists will concede they can never know for sure.
Boards also typically impose various restrictions therapists recommend.
Critics say no restriction is foolproof and medical boards are bending over backward to keep unethical doctors in practice, minimizing the gravity of their violations.
These cases illustrate some typical restrictions and pitfalls:
In New Mexico, Dr. Jonathan Burg was ordered in 2001 to abstain from sexual contact with patients and use a chaperone when treating females. A few months later and again in 2003, the board found he hadn’t complied. New orders ensued. But after a hearing, the board devised a new plan. Because only female patients had complained, the board decided it would allow Burg to treat male patients only. Its order emphasized that he would not “offer to practice, attempt to practice, or be involved in any manner whatsoever with any female patient until further order of the board.” And he was only to communicate with female patients through office staff. Finally, in 2004, the board ordered him to surrender his license for at least four years after finding he had been entering another doctor’s office for no legitimate reason when female patients were present. Burg could not be reached for comment.
Utah allowed Dr. Howard Sidney Berk, who worked for the state health department, to keep his license but restricted him to research, education and reviewing documents about the care given by other medical practitioners. That order came after the board found he had engaged in behavior in July 2005 that if proven, would “adversely reflect on (his) ability to safely and competently practice as a physician and surgeon.” The board order notes he had been criminally charged with burglary and sexual battery for breaking into a home to “have sex with a boy” and that he told police he had entered a second child’s home to engage in inappropriate conduct. Berk told the board he suffered an illness that caused the conduct and he had obtained medical and psychiatric treatment for it. Berk is deceased.
After federal agents in 2009 asked New York cardiologist Frank T. Pollaro why his name appeared in the emails of a dealer of child pornography, they said he confessed: For years he had sent and received images of underaged girls and spent time in chat rooms trying to get girls to send him more. Pollaro pleaded guilty to possession of child pornography and was sentenced to probation. Rather than take away his license, the New York State Board for Professional Conduct had him evaluated in Atlanta at Behavioral Medicine Institute (BMI), then adopted its recommendations. He was to see a therapist. He couldn’t treat patients 18 or younger. But he could continue treating adult patients in their homes for community service, if he was accompanied by a chaperone. Pollaro told the AJC that he had never traded such images and never said he did. He added that he had never seen child patients, and that the order caused him to stop seeing patients in their homes because no qualified chaperone agreed to be on call for house calls.
North Carolina sanctioned Dr. Oscar Mauricio Gualteros in 2000 for inappropriate physical contact with three patients. In 2001 it sanctioned him for improperly touching a nurse. Strike three came in 2005, when the board found he had made an inappropriate sexual comment to a patient and tried to kiss her. Then the board heard from another female patient who claimed he crossed the line with her. He agreed to surrender his license, and the board gave him a month to close his practice. In 2010, he sought reinstatement, and his therapist, Dr. Gene Abel, advised that Gualteros could practice safely if he saw just male patients and “geriatric patients” of either gender. But Abel said Gualteros could still pose a threat to women 50 or younger. The board refused to reinstate him. Gualteros could not be reached for comment.
Dr. Alfredo Garcia came to the attention of New Jersey regulators as far back as 1989, when they ordered him to have a chaperone with female patients. That didn’t stop him. In 2000, he conducted what the State Board of Medical Examiners later described as a medically inappropriate exam when a chaperone wasn’t present. In 2004, another patient told police that while he was alone with her, he conducted an inappropriate exam. Still, the board gave him another chance. To resolve the matter without formal proceedings, its order said, he agreed that his license would be suspended for 150 days. Then, when he returned to practice, the board said he must “immediately cease and desist from examining female patients without the presence of an authorized third party.” In 2009, a court ordered him to stop practicing as criminal charges were pending. In 2010 he was indicted on 18 counts of sexual assault or sexual contact with nine patients, and in 2012, after he pleaded guilty, he was sentenced to seven years in a state treatment facility. A news report said he sexually abused patients during exams supervised by nurses by disguising his actions as part of the exam. The Record quoted a prosecutor as saying that after Garcia was arrested, he told a psychologist that “what excited him was the fact that he was ... getting away with it.”
Dr. Donald Taylor in Georgia lost his hospital job for a litany of sexual allegations, including improper rectal and vaginal examinations of a 16-year-old girl. A specialist treated Taylor, then devised a rigorous surveillance plan to safeguard patients as he returned to practice. The plan included soliciting a week’s worth of patient feedback forms periodically from every patient Taylor saw. Instead, Taylor surveyed only repeat patients, not those who came once and never returned. Called on his lapse, Taylor said it was a mistake. His specialist, BMI’s Dr. Gene Abel, agreed: “He didn’t understand what I wanted done,” Abel testified in 1999. Taylor’s monitoring was lifted in 2008 but he later re-offended, according to a 2014 board order. Abel said recently that monitoring of physicians should last five to 10 years. Taylor is back in practice. He did not answer telephone or email messages.
A startling finding about cases of doctor sexual misconduct in Georgia prompted The Atlanta Journal-Constitution to undertake a yearlong national examination of the issue.
As is often the case with investigative reporting, this series grew out of other work. Reporter Danny Robbins was examining orders by the Georgia Composite Medical Board for his 2015 stories on prison medical care. In doing so, he saw orders allowing doctors to continue practicing after a finding that they had sexually violated patients.
He compiled those orders, discovering about 70 cases clearly involving sexual misconduct. And in about two-thirds of those cases, he was shocked to find, doctors either didn’t lose their licenses or were reinstated after being sanctioned. That included doctors who had repeatedly crossed the line with patients.
To see if Georgia was an exception, the AJC hired a legal researcher to study laws governing medical practices in every state. Meanwhile, reporters gathered studies and looked for cases around the country, compiled from news reports and other public sources. That work raised questions about the pervasiveness of doctor sexual misconduct. The research, and periodic scrutiny from other news organizations, also suggested that doctors were treated differently from other sexual offenders.
So the AJC decided to examine the system that is supposed to protect patients from doctors who sexually abuse. At first we submitted public records requests to medical boards or other regulatory agencies in every state, seeking databases identifying doctors who had been disciplined and the reasons for their sanctions. Nearly all said they didn’t keep such data, and only a few provided other information addressing our requests.
At that point, our data journalism team wrote computer programs to “crawl” regulators’ websites — a process known as scraping — and obtain board orders. This required building about 50 such programs tailored to agencies across the country. The result: More than 100,000 board documents were collected.
To assist us in identifying those involving sexual misconduct, we then created a computer program based on “machine learning” to analyze each case and, based on keywords, give each a probability rating that it was related to a case of physician sexual misconduct.
We then read all the documents for more than 6,000 cases to determine the nature of each one and board action. We eliminated cases completed before 1999 and duplicate orders when a doctor was licensed in more than one state.
That work set the stage for additional reporting. Over the past year, the project team sought other records, interviewed victims, doctors, regulators and experts, and completed other research. The project team also attempted to contact every doctor named in this investigation.