The Columbus Dispatch

Professor: Ohio medical schools must address medicine’s dark side

- Your Turn Daniel Skinner Guest columnist

There is no easy way to predict which physicians will become predators. But Ohio’s medical schools can make clear to their students what is expected of our state’s physicians and the consequenc­es for those who violate their oaths.

After four demanding years, students graduating from Ohio’s medical schools will soon learn where they will continue their medical education as resident physicians. They will pursue this next phase of their education with letters of distinctio­n after their names—md or DO.

Congratula­tions are in order.

But this year there is a cloud over this moment — Columbus Dispatch’s sobering “Preying on Patients” series. We must address its findings.

In writing the series, Max Filby, Jennifer Smola Shaffer, and Mike Wagner scoured the archives of the Ohio Medical Board and found that, since 1980, 256 physicians have been discipline­d for 449 violations.

Violations included an array of sexual assaults and harassment­s. The findings are almost certainly the tip of the iceberg. We do not know how many complaints to the board did not result in official sanctions. And we can assume that many harassed and violated patients never filed a complaint.

In response to the Dispatch series, Ohio’s medical board has taken steps to ensure that reported violations are now dealt with more aggressive­ly and transparen­tly. While acknowledg­ing “we have work to do,” Gov. Mike Dewine has praised these developmen­ts, noting, “we’re in much better shape today with the state medical board than we were before this whole thing started.”

And yet, one can’t help but notice an inappropri­ate silence as well.

As I have learned as a medical educator, few people in medical education — from students to educators — subscribe to or read local reporting.

The scandal going under the radar

Only a handful of faculty, staff, and students at Ohio’s medical schools seem to have read or heard about the findings of “Preying on Patients.”

The very people who could learn most from the series — and do the most in reaction to its findings — seem either not to have noticed or have declined to discuss the scandal. We’ve been here before. The medical profession missed an opportunit­y to wrestle with medicine’s dark side when the Michigan-based Olympic gymnastics physician, Larry Nassar, was convicted of heinous crimes against his patients. Rather than act and educate, the profession—tail between its legs–was largely silent.

The Dispatch’s findings present another opportunit­y to get this right. As the Ohio medical board institutes reforms, and the General Assembly prepares to pass legislatio­n, medical schools must act too.

Medical schools must act

Here’s how they can begin.

Leaders at all Ohio medical schools should declare, with one voice, that scheduled curricular programmin­g will be canceled for one day so that students can read the Dispatch series and discuss it in groups.

Students, who have an interest in ensuring that the medical profession enforces its own rules and ethical standards, should demand that their schools take this step. This day of discussion should signal the beginning of a curricular overhaul that incorporat­es exposure to, and discussion­s of, physicians’ historical and contempora­ry abuses of power.

Medical schools shape the ethical orientatio­n of future physicians.

Ohio’s medical schools owe it to the people of Ohio to not only ensure that their students have read “Preying on Patients,” but also have considered what the series’ findings mean for their futures.

Finding time to discuss the series with physicians­in-training would be an act of long overdue responsibi­lity-taking for teaching medical students that they are obligated to protect their patients and to report colleagues who abuse patients to the state medical board.

We must understand how predator doctors slip through the cracks

Most physicians are committed profession­als who take their responsibi­lity to patients seriously.

We need to take a close look, however, at the long educationa­l path that produces physicians — through medical school and medical residency to medical practice — to understand how the physicians who abuse patients are able to proceed through many years of medical education to the trusted profession of physician.

There is no easy way to predict which physicians will become predators. But Ohio’s medical schools can make clear to their students what is expected of our state’s physicians and the consequenc­es for those who violate their oaths.

Medical schools, from admissions to graduation, are the beginning of a decade-long educationa­l trajectory. Medical educators play a critical role, setting the tone and expectatio­ns for a lifetime of medical practice. Whether medical school leaders have the courage to face their responsibi­lity to address the dark corners of their profession, a profession that wields such enormous power that some of its members can abuse the vulnerable with impunity, is a decision each medical school leader must make.

Given the urgency of the task at hand, however, I end with a direct appeal to Ohio’s graduating medical students. The root of physicians’ power is the trust patients have in them.

Again, congratula­tions to the members of the Ohio medical school classes of 2023.

But, before you get to work as licensed physicians, take time to reflect on the huge responsibi­lity that awaits you. And demand that your medical school does a better job of educating medical students about the power and responsibi­lities physicians have to put patients first.

Daniel Skinner is associate professor of health policy at Ohio University, Heritage College of Osteopathi­c Medicine in Dublin. He hosts Prognosis Ohio, a podcast affiliated with the Columbus-based WCBE.

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