Currently, 47 of 50 states have professional health monitoring programs (PHPs) that provide confidential support services for physicians and sometimes other health care professionals with potentially impairing conditions such as a substance use disorder (SUD) and who may be facing disciplinary action. Potential components of a PHP contract are tailored to individual needs but may include psychiatric and/or SUD treatment, a worksite monitor, chaperone reports, polygraph testing, drug testing, participation in mutual support meetings, and courses on workplace professionalism.
Alexandria G. Polles, M.D., of the Professionals Resource Network, in Fernandina Beach, Florida, and colleagues combed the Florida PHP database between 1982 and 2018, identifying 570 cases in which a physician or other health clinician engaged in unprofessional sexual behavior. Of these, 232 individuals were referred to take part in a PHP, while the rest were deemed ineligible and handled by the licensing board, legal system, or other entities.
Most clinicians referred to the monitoring program for sexual misconduct were married, middle-aged, heterosexual men; 67% were physicians; and consistent with previous studies, the three most common physician specialties involved were adult primary care (23%), psychiatry (11%), and obstetrics-gynecology (4%). Among the monitored group, personality, mood, paraphilias/other sexual, drug use, and alcohol use disorders were most common. The majority of sexual misconduct was directed to current or former patients, and 23% of all incidents involved minors.
Overall, three-quarters of the cases involving monitoring were deemed “very successful” (the individual completed the monitoring contract and there was no further aberrant behavior) or “successful” (completed the monitoring with modification of or extension to the requirements). Only 12% discontinued monitoring against recommendation and relinquished their license, while just 3% were denied licensure or had their license revoked. Compared with health professionals not eligible for a PHP, those with monitoring were less likely to face legal involvement and have their license restricted, relinquished, or revoked.
“Unprofessional sexual behavior by licensed health care professionals is a serious offense that merits full investigation and appropriate consequences. In cases where evaluation results and treatment response suggest that the practitioner would be successful returning to practice without recurrent [unprofessional sexual behavior], referral … may be beneficial,” the researchers wrote. Program “monitoring agreement parameters provide additional safeguards to protect the public from harm while supporting licensed health care practitioners in their return to practice and overall wellbeing.”
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