Doctor sex scandals: Should they be made public?

It's an ongoing debate in the medical profession: is full disclosure of doctors' sexual dalliances by medical regulatory bodies a good idea?

On one hand, transparency and openness are all the rage now in models of good governance these days. Probably most people wouldn't argue that transparency is a good policy in most situations. But some matters -- like, say, doctors' sex scandals -- might not be good candidates for such openness, some physicians are thinking now.

Several embarrassing cases over the past year or two, in which physicians became sexually involved with their patients or even their patients' mothers, have some doctors wondering whether airing the medical profession's dirty laundry is really so prudent.

DR GERALD PAUL DEMPSEY
Last year, the College of Physicians and Surgeons of Ontario (CPSO) held a hearing on alleged misconduct by Dr Dempsey, a pediatrician. Their finding (PDF) was that "sexual liaisons with the mothers of two of his pediatric patients had the potential to cloud his judgment and compromise his care of the children."

A response (PDF) to the announcement of Dr Dempsey's case, from Dr Robert Wagman, a Toronto physician, was published this April:

I am not convinced that Dr. Dempsey’s conduct necessarily “would reasonably be regarded by members as disgraceful, dishonorable or unprofessional.” Given total agreement with the zero-tolerance policy regarding sexual relationships with patients, I wonder if Dr. Dempsey’s conduct was just plainly stupid...

In the grand scheme of things in the world in general and in the medical community in Ontario in particular, unless there is more to this story than is being reported, I would suggest that it would have been more appropriate for the College to have published this case with the doctor’s name withheld. That way he would have been spared the public humiliation while the membership would still have been made aware of the issue and of the College’s policy on the matter.

The CPSO answered that in Dr Dempsey's case, because he was guilty (he admitted his guilt), the College was obligated by law to report his name.

DR CURTIS BELL
Last November, the College of Physicians and Surgeons of Alberta found Dr Curtis Bell guilty of "unbecoming conduct," including:

i) soliciting his patient to become involved in a sexual relationship with him;
ii) kissing and sexually fondling his patient on more than one occasion, including on June 6, 2006 during an appointment to see his patient’s daughter;
iii) discussing his sexual preferences with his patient;
iv) exposing himself to his patient;
v) suggesting sexual acts to his patient;
vi) conducting lengthy telephone conversations with his patient;
vii) sending numerous text messages to his patient that included discussions of his interest in having a sexual relationship with a patient.

Part of his punishment -- which consisted of a suspension held in abeyance, a $15,000 fee for hearing expenses, and mandatory training and boundary-violation lessons -- was the publication of his case in the College's newsletter (PDF). (As was true in Dr Dempsey's case as well, all the interactions Dr Bell had with his patient were consensual.)

In the August 2008 issue of that newsletter (PDF), called The Messenger, Dr Muriel Solomon wrote in to complain:

"[W]ho among us can fling the first stone? Sure, our colleagues made mistakes and are paying the price but this could have happened to any one of us. I think to myself “there, but for the grace of God, go I.”

"I take strong exception to the publication of names of our fallen colleagues. They know who they are. They are probably suffering for their misdemeanors. Need we rub it in?

"I was about to throw The Messenger into the recycling bin when I was stopped by the thought that this publication could very easily be read by anyone in the public. Transparency is good - it is the modern catchword - but must we hang out our dirty laundry for all to see? Where is our solidarity and empathy for one of our own who has fallen? After all, we are but human..."

Dr Karen Mazurek, the College's associate registrar of complaints, responded, "Medicine is a self-regulating profession, a privilege granted by the public. With this privilege comes certain responsibilities, including the need to be accountable to both the public and the profession." And that's not all. Dr Mazurek added that when the Alberta College is moved under the jurisdiction of the Health Professions Act -- a change which still has not come about yet -- all complaints will have to be made public by law, as opposed to only disclosing most of the guilty findings, as is the case in Alberta right now.

DISCLOSURE ETHICS
This September, another letter arrived in the mailbox of the CPSO. Dr John Sauret, a physician who left Ontario to practise in New York, wrote (PDF):

The CPSO seems to enjoy parading their disciplinary actions against physicians.

I don’t suppose there could be imposed any disciplinary action against the CPSO for the absolute debacle of health care in Ontario over the last two decades?

I am a licensed family physician in Ontario, and based on your actions and history I do not plan on returning anytime soon.

Is full disclosure alienating physicians from their regulators? Is it possible that what appears to be something of a backlash in several recent incidents might contribute to physicians' reluctance to report cases of colleagues' misconduct, because they believe the punishment is too harsh? These are important questions and, judging by the complaints above, there's growing frustration in the medical profession that those questions aren't being asked.

What do you think? Is airing the medical profession's filthy laundry -- undergarments and all -- appropriate, or does it cross the line?

Photo: Shutterstock (Yes, I recognize how outrageous that photo is. It's just a goofy, staged stock photo, of course.)

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