No report, no justice: AJC investigation shows how doctors get away with sex abuse

AJC investigation shows how doctors get away with sex abuse

Doctor tile
Doctor tile

ATLANTA - Her doctor was making her uncomfortable. He wouldn't explain why she needed a breast exam. He didn't give her a gown. He just told her to lie back and lift up her blouse.

In minutes, her physician became her abuser. He felt her breasts under her bra repeatedly, making a sound of pleasure and saying they felt "excellent." When he backed away, she could see a bulge in his pants. "It made me feel so dirty," the woman recalled later.

Yet nothing in the Maryland medical board's public records shows it did anything to stop Raafat Y. Girgis when it got the complaint. Nor did the agency inform law enforcement about a possible sexual offense.

Medical regulators say they have an ethical duty, and some have a legal requirement, to alert law enforcement when a doctor may have committed a sex crime against an adult patient.

But The Atlanta Journal-Constitution's examination of thousands of cases found that regulators failed to consistently live up to that responsibility.

Instead, regulatory agencies, often dominated by physicians, can and do find reasons to avoid notifying police.

The result is that some abusive doctors can continue practicing and harm other patients, and others are allowed to quietly retire, without a full investigation into whether they committed crimes that could mean jail time for those in other walks of life.

"Too often, I think, it's cronyism," said Pauline Trumpi, whose book, "Doctors Who Rape: Malpractice and Misogyny," describes how her psychiatrist drugged and raped her in 1963. "It takes a lot of money and it takes a long time to become a doctor. So they feel empathy for the doctor rather than the victim."

In case after case, medical panels can decide that a doctor won't offend again if he gets rehabilitation and refresher courses. That if a victim doesn't want to talk to police, there's no point in letting police know what's been alleged. That there's nothing in criminal law that covers what the doctor did. That a case can't be pursued because it's only a he said/she said.

"The last thing we want to do is unjustly accuse a physician of something," Wyoming Board of Medicine Executive Director Kevin Bohnenblust said. "We'll certainly go after them if they screw up, but we don't want to perpetuate something if it's really, truly a miscommunication or something like that."

It's impossible to know how many crimes by doctors go unreported because many cases are handled privately. But the AJC's investigation revealed alarming cases in which medical agencies were aware of possible misdemeanor or felony sexual offenses, with trails of victims, yet never passed along the information to law enforcement.

That left accused doctors free to keep their doors open to other patients, such as the ones who kept going to Girgis in Catonsville, Md.

A second patient eventually came forward, alleging that in back-to-back appointments the doctor rubbed his groin against her, kissed her and fondled her breast. "I was kind of numb," she would testify years later. "It (took) a while to realize what happened."

The medical board still didn't act.

Then a third woman reported Girgis fondled her during an exam for a skin rash. The medical board finally revoked his license.

Girgis never faced so much as a police interrogation. He is now retired in Florida. In a brief conversation with the AJC, he said the allegations were false and called the medical board "a bunch of animals."

Across the country, it is legal for medical panels to act as gatekeepers. Thirty-nine states and the District of Columbia do not have laws requiring medical regulators to notify police or prosecutors about potential criminal acts against adults, the AJC found. Georgia is among them. Nationally, laws requiring reporting of child abuse are nearly universal.

Even in states that require reporting of adult victims, regulators still hold back. Maryland has such a law but didn't follow it in Girgis' case, the AJC found.

"It's deplorable, for heaven's sake," said John Banja, a medical ethicist at Emory University's Center for Ethics. "One of the things that you're going up against here is the historical, traditional sensibility of doctors to protect one another - to give their peers an excessive benefit of the doubt."

One jailed, one not reported

When doctors are reported to police, the investigation may differ dramatically.

While it took the Maryland medical board six years to take action against Girgis, it took Louisville, Ky., police just hours to have neurologist Ghias Arar in handcuffs after Tara Batrice reported him.

Batrice, who suffers from a degenerative bone disease, was attacked the first time she saw Arar. First, the doctor moved her walker to another part of the room, stranding her on an exam table. Then, as she tried to fight him off, he ripped off her bra, kissed her breasts, fondled her, masturbated and ejaculated on her.

She left the office terrified, driving aimlessly until she called her parents and pulled into a shopping center. Her stepfather called a rape crisis center, and a victim advocate met her at the hospital. Arar's DNA was still on her sweatshirt.

Two days later, Batrice told her story to a TV news station and made a plea for any other victims to speak out. Within a week, four other patients told police they were victimized.

Arar is now serving a three-year sentence and will have to register as a sex offender.

"I knew he'd done it before," Batrice said. "I was willing to do everything I could in my power to make sure this doctor never ever touched another victim, ever."

While Kentucky prosecutors put Arar in prison, the Kentucky Board of Medical Licensure allowed Mitchell E. Simons to continue as a pain management doctor after allegations he fondled patients.

Simons still practices in the Cincinnati area on both sides of the Ohio River. He did not respond to phone messages or certified letters seeking comment.

While he told the Kentucky board he denied the allegations, he agreed to an order requiring him to have a chaperone with female patients and to take a boundaries class. Ohio also required chaperones.

No law enforcement agency or prosecutor's office with jurisdiction in either state said they'd ever been informed about the accusations, the AJC found. The Kentucky board's executive director, Michael Rodman, said he could not offer an explanation because the case is so old.

Closing the loophole

Some states have decided reporting shouldn't be optional.

In Delaware, it took a public outcry. State Rep. Helene Keeley and Sen. Patricia Blevins tried to get a mandatory reporting law passed after being tipped that doctors who committed heinous sex crimes were only being reprimanded. But Keeley said resistance from the Medical Society of Delaware killed the legislation.

That changed after the arrest of pediatrician Earl Bradley, estimated to have assaulted as many as 1,000 young patients in Delaware and Pennsylvania.

Delaware now requires its Board of Medical Licensure and Discipline to report possible crimes "upon receiving a complaint." Keeley said every state should do the same.

"Because you don't know whether or not that person is going to end up being an Earl Bradley or not," Keeley said, "and you're better off being safe than sorry."

Not all laws are airtight.

In Maryland, where Girgis practiced, the board is required to report after it determines that information in a record concerns possible criminal activity.

Reporting an unsubstantiated allegation, a spokeswoman said, would be premature. But citing confidentiality, she would not explain why law enforcement agencies said they received no report on Girgis even after the board found he had sexually abused three patients.

Law enforcement authorities should at least have a chance to try, said Boston attorney Stan Spero, president of AdvocateWeb, a nonprofit online resource for sexual abuse victims.

"Historically, doctors and therapists were held in high regard and protected in general," he said. "And so to start bringing them into the criminal system, there's a lot of resistance."

An ethical duty

Board representatives said the most egregious cases do get handled by police because victims or their family members report the crimes.

If police aren't aware, most medical boards told the AJC that they inform law enforcement, as an ethical duty.

"All boards have an obligation to, whether it's in statute or not," said Susan Strout, executive secretary of the Maine Board of Osteopathic Licensure.

But there are exceptions, such as when boards believe the victim doesn't want police involved. Or they may say it's the victim's responsibility to go to police.

"We can't file a criminal complaint on behalf of a citizen," said Larry Dixon, executive director of the Alabama medical board. "What if this woman doesn't want anybody else to know, and we've told the local police and all of a sudden a cop comes to see her? She'd be outraged."

David LaBahn of the Association of Prosecuting Attorneys said medical regulators shouldn't make such delicate decisions. Police and prosecutors often have specially trained counselors who can help victims, increasing the likelihood they will pursue a criminal case.

"We can get them some services," LaBahn said, "and have a better determination as to whether they'll cooperate or not cooperate."

Some medical regulators say it is punishment enough for a doctor to be put on probation, suspended or lose a license. "The obligation of ours is to get him out of business," Dixon, of the Alabama board, said.

Agencies may even pull the plug on their investigation if the doctor agrees to step aside.

That means any evidence of violations is hidden from the public. Doctors can return to their communities with their reputations intact. A medical board censure won't put a doctor on the local sex offender registry.

Robert Jeffery, executive director of the Georgia board, wouldn't comment on specific cases, but said that when complaints can't be substantiated, turning them over to police would be illogical.

"Does the board look at everything and say, 'This might possibly be a crime?' Probably not," he said.

LaBahn, with the prosecuting attorneys association, said that kind of scrutiny should be the norm.

"The moment they open that investigation, I see no downside that the criminal investigation ought to open at the same time," he said. "They're looking at the licensing aspects. We're looking into if a crime occurred."

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