Patients violated, doctors rehabilitated

Doctor tile
Doctor tile

ATLANTA - After medical regulators said he fondled patients, exposed himself and traded drugs for sex, Dr. David Pavlakovic easily could have lost his license. Law enforcement thought his acts were criminal.

Instead of losing his job, Pavlakovic was placed in therapy. He was allowed to return to practice. And he didn't even have to tell his patients.

The way Alabama handled Pavlakovic's case reflects a growing trend across the nation: Medical regulators are viewing sexual misconduct by doctors as the symptom of an impairment rather than cause for punishment.

Doctors who abuse, regulators and therapists say, can be evaluated and managed - sometimes with as little as a three-day course on appropriate doctor-patient "boundaries," other times with inpatient mental health treatment that may include yoga and massage.

Society has become intolerant of most sex offenders, placing some on lifelong public registries and banishing others from their professions or volunteer activities. But medical regulators have embraced the idea of rehabilitation for physicians accused of sexual misconduct, a national investigation by The Atlanta Journal-Constitution found.

Increasingly, it is left to private therapists, rather than police investigators, to unearth the extent of a doctor's transgressions. There is little pretense of the check and balance of public scrutiny. Instead, some in the medical profession have discouraged public input, concerned it could trigger outrage that disrupts important work.

Even doctors with egregious violations are allowed to redeem themselves through education and treatment centers, which have quietly proliferated over the past two decades.

In Pavlakovic's case, regulators sent him for evaluation by Atlanta-based Behavioral Medicine Institute. The Alabama Medical Licensure Commission suspended him for just under a year - most of that time while its investigation was pending - fined him $10,000 and imposed other conditions.

Prosecutors dropped the criminal charges. The commission lifted its requirements in less than two years.

Pavlakovic and his attorney declined to comment.

These education and treatment programs are being used by regulators in virtually every state. In its review of public disciplinary orders for 2,400 physicians accused of sexual misconduct with patients since 1999, the AJC found that, with rare exceptions, all of the 1,200 who are still licensed were ordered to undergo treatment, training or both.

Public detractors must not halt the work of rehabilitating physicians, said Bradley Hall, incoming president of the Federation of State Physician Health Program.

"I don't think there's a wrong time to do the right thing," Hall said.

Patients who have experienced sex abuse by doctors are skeptical.

"The damage they do to a family, or a woman, going on to the rest of her life, is just irreparable," said Marilyn Nowak, who said she was abused by her psychiatrist decades ago.

"If you send these doctors for rehabilitation - I'm sorry but that's not enough for what they do to you," she said. "They should pay for that."

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