Preventing Sexual Misconduct in Medical Environments

It’s time again for that dreaded yearly checkup appointment with your gynecologist. Or you’re a young woman who is getting married and it’s your first time for THAT appointment. You trust your doctor because you were referred to him by someone you know, you’ve seen him many times, or he delivered your baby.

You’re not worried; just anxious.

Anxiety should be a tool to help you focus as you prepare to enter the exam room. Unfortunately, sexual assault happens in doctor’s offices so being aware of that despicable fact can help you discern anything inappropriate that might happen. The Code of Professional Ethics of the American College of Obstetrics and Gynecology, Code of Conduct, Patient-Physician Relationship, reads:

Sexual misconduct on the part of the obstetrician–gynecologist is an abuse of professional power and a violation of patient trust. Sexual contact or a romantic relationship between a physician and a current patient is always unethical.

Predatory Behavior in Medical Settings

It’s unthinkable to have to be on the lookout for potential predatory behavior of medical professionals when you need to see a doctor for a sore throat, a bout with the flu, or yearly gynecological exam. However there are medical professionals who use their professional power over their patients for sexual purposes. The Federation of State Medical Boards (FSMB), in a May 2020 Report of Workgroup on Physician Sexual Misconduct, states that “The relationship between a physician and patient is inherently imbalanced. The knowledge, skills and training statutorily required of all physicians puts them in a position of power in relation to the patient. The patient, in turn, often enters the therapeutic relationship from a position of vulnerability due to illness, suffering, and a need to divulge deeply personal information and subject themselves to an intimate physical examination. This vulnerability is further heightened in light of the patient’s trust in their physician, who has been granted the power to deliver care, prescribe needed treatment, and refer for appropriate specialty consultation.”

Predatory Behaviors

Potential predatory behaviors of which young women should be aware can be:

Verbal or physical — inappropriate comments or touch, gestures that are of a sexual nature, sexual humor;
Grooming — gift giving, special treatment, or sharing of personal information;
Lack of respect for sexual boundaries between the doctor and patient. Professional boundaries are the spaces between the doctor’s power and the patient’s vulnerability.
Examining or touching the genital area without gloves;
Requesting details of sexual history and likes and dislikes during sex;
Refusal to allow family or friends or a nurse in the room;
Refusal to listen to a patient’s concerns. A predatory doctor may interrupt the patient as she is talking.

Not Limited to One Case

Predatory behaviors are not limited to just one individual or case but rather a systemic issue with the medical industry. Unfortunately, claims of Physician Sexual Misconduct (PSM)are not rare. An article from Missouri Medicine reports that “a confidential survey found that 8% of physicians admitted committing some degree of PSM with one or more patients, and most physicians acknowledge they’ve been tempted.”

In Every State in America

CNN reported on a yearlong investigation conducted by the Atlanta Journal-Constitution newspaper that uncovered thousands of cases of physician sexual abuse spread across every state in America. “The results are very concerning,” said Laura Palumbo, a spokeswoman for the National Sexual Violence Resource Center. “It is astounding that, at the systemic level, there seem to be conditions where sexual abuse is allowed to happen and physicians aren’t held accountable.”

Positions of Power

Doctors and other medical professionals can use their positions of power to exploit or manipulate patients. Because of their superior knowledge about medical conditions and treatment, some doctors may use this knowledge to coerce their patients to do something sexually that they might not normally do. Two cases that involve OBGYNs who violated the trust of their patients are Dr. David Broadbent and Dr. Fabio Ortega. Dr. Broadbent assaulted women in routine exams for decades. Women coming forward say he groped their breasts with his hands and performed aggressive vaginal and rectal exams. Dr. Ortega was imprisoned for aggravated sexual assault. There are multiple civil lawsuits against him, accusing him of sexually assaulting women under the guise of medical care. Unfortunately, sexual assault of women is prevalent in society and the statistics are alarming.

How to Protect Yourself During Medical Procedures

Informed Consent

Women and young women often feel powerless in medical settings. They can be intimidated by the doctor and feel that he has power over them. They can feel pressured to consent to treatment due to the unequal power relationship and perceived authority between themselves and their doctor. Therefore, discussions between the patient and the doctor about any medically appropriate option of treatment must be forthcoming by the doctor so that the patient can give “informed consent.” In other words the patient needs to be able to understand the doctor’s treatment plan in order to give consent to the medical treatment.

According to The American Medical Association’s Code of Medical Ethics, Chapter 2.1.1 Informed Consent, “Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.” The process of informed consent occurs when communication between a patient and physician results in the patient’s authorization or agreement to undergo a specific medical intervention.

Shared Responsibility

In practice, informed consent is a shared responsibility between you and your healthcare provider. They’re obliged to inform you in the best way they know how.

Tips

Before you sign the Informed Consent form, make sure your doctor has discussed with you:

•Your diagnosis;
•The proposed treatment plan;
•The risks and benefits of the plan;
•What happens if you do nothing.

You might also ask the doctor who will be performing the different aspects of your procedure, for example, the anesthesiologist. And maybe bring a family member or a friend who can help you understand what you are being told.

Advocate for Yourself

Do not hesitate to ask your doctor questions about the procedure. You need to know why it is necessary and what you can expect, from the diagnosis to the completion of the procedure. SPEAK UP if you feel uncomfortable in the presence of the doctor or have any concerns at all about the procedure.

Bring a Trusted Friend or Family Member to Your Appointment

Having an appointment with the doctor can be very stressful. You might have a list of questions in your mind that you want to ask the doctor, but when you get before the doctor, the list goes out of your mind. A good idea would be to bring a trusted friend or family member with you to provide support and help ask questions.

Request a Same-Gender Medical Professional

Women can request a same-gender medical professional for certain procedures, such as pelvic exams or breast exams, if they feel more comfortable. [link to “Appropriate and Inappropriate Ways to Help Young People Navigate Visits to the OB/GYN” when published

According to the American Journal of Obstetrics & Gynecology, patients may request care from a woman obstetrician-gynecologist for various reasons, including privacy concerns, religious or cultural reasons, and in some cases, a history of abuse. They should be given the opportunity to voice their reasons for requesting a woman obstetrician-gynecologist but should not be compelled to do so. Respect for patient autonomy is a compelling reason to consider honoring a patient’s gender-based request.

Document Everything

You have finally made an appointment with a doctor in regard to a medical problem. Before you head out the door, make sure you bring with you a notepad for documentation purposes. Write the date and time of your appointment, the name of the doctor you see, and what the doctor tells you. If any procedure is done, document any information about the procedure, too. You will have a record in case you need to refer to it later.

Seek Support and Speak Out

Experiencing predatory behavior in a medical setting or being the victim of sexual assault can be traumatizing, There is a national network of community-based crisis centers and local organizations who support the needs of sexual assault survivors. These centers exist across the United States to provide supportive services to victims of sexual assault.

Resources

The following resources will help you as you seek help:

RAINN

https://www.rainn.org

National Sexual Violence Resource Center (NSVRC)

https://nsvrc.org

Sexual Assault Kit Initiative (SAKI)

https://www.sakitta

Joyful Heart Foundation

https://www.joyfulheartfoundation.org

Planned Parenthood

https://www.plannedparenthood.org

National Domestic Violence Hotline

https://www.thehotline.org

The 988 Suicide and Crisis Hotline

https://988lifeline.org

Remember, always be aware of potential predatory behavior of medical professionals (or anyone, for that matter); and if you recognize predatory behavior, SPEAK UP and GET HELP.

What Girls and Young Women Should Know to Protect Themselves in a Medical Environment