Despite efforts to raise awareness and make change, #metoo has not yet disrupted the doctor’s office
Last week, 45 former patients of Darius Paduch, M.D., requested The New York State Department of Health investigate the hospitals where Dr. Paduch, a urologist, worked, claiming he was allowed to practice medicine for years after patients made allegations of sexual abuse.
The male fertility specialist, 56, was arrested and had his medical license suspended in April. More than 58 victims have since come forward with allegations of rape, sexual assault and sexual harassment that spanned many years.
A lawsuit brought in September by several former patients alleges that Dr. Paduch’s employers, including New York-Presbyterian/Weill Cornell Medical Center, Northwell Health and Long Island Jewish Medical Center knew of his sexual misconduct for at least six years without reporting it to the Office of Professional Medical Conduct (OPMC).
“I foolishly assumed that these institutions put patient safety above all else,” David Sonneborn, one of Dr. Paduch’s former patients, tells The Messenger.
“Instead, it appears that their reputation and profits were prioritized above the care of their patients, even those who were minors. I sincerely hope my words give strength to other victims and help them find the courage to come forward. The truth must be brought into the light, for every victim of every age,” Sonneborn says.
In response to the allegations that it was complicit in Dr. Paduch’s misconduct, Northwell Health said in a statement to The Messenger, “We take these allegations very seriously. Dr. Paduch is no longer working at Northwell. We will cooperate with the appropriate authorities as they conduct their investigation.”
Dr. Paduch violated hundreds of patients and employees, some of them underage boys, “under the guise of medical care and treatment,” the complaint states, and the patients’ allegations were made directly to the hospital’s medical ethics committee, but no crime “was too big or too terrible for the corporate defendants to cover up.”
Dr. Paduch “groomed and manipulated” patients “into trusting that what he was doing had some basis in legitimate medical care,” the complaint reads. The defendants knew of Dr. Paduch’s “prolific sexual predation of boys and men dating back to 2010, and did nothing to stop his abuse of patients,” it claims.
New York-Presbyterian/Weill Cornell said in a statement to The Messenger: “The conduct described in these suits is extremely disturbing, and we feel deeply for all those involved. No patient who entrusts us with their care should ever experience such appalling behavior. We continue to cooperate fully with law enforcement and are committed to maintaining the highest professional and ethical standards.”
There's a tremendous amount of deference to physicians both in the law and in practice, both from patients and from legislators. And when you have that level of deference, there's not a lot of accountability.
Dr. Paduch has pleaded not guilty and will go on trial in April 2024. His attorney provided The Messenger with the following statement:
"Not only has Dr. Paduch been a well-respected physician for 20 years, he has authored or co-authored over 80 scholarly publications in his field and served our country honorably as a Captain in the Army Reserve Medical Corps. We will defend this case to the fullest extent of the law."
Allegations like those against Dr. Paduch have been made against many, many other prominent physicians.
Earlier this year, Robert Hadden, M.D., a gynecologist at Columbia University Medical Center and New York-Presbyterian Hospital, was convicted of sexually assaulting patients and sentenced to 20 years in prison.
Six years prior to that conviction, Dr. Hadden admitted to assaulting other patients. He pled guilty to a felony count of a criminal sexual act in the third degree and a misdemeanor count of forcible touching in order to avoid prison. That deal also allowed him to avoid being in an online list of offenders.
While this analysis focuses on doctors and processes in New York, sexual abuse within the medical field is a widespread, nationwide issue.
Sexual misconduct by physicians is difficult to uncover
Despite efforts by sexual assault survivors’ advocate groups and media to expose sexual misconduct by physicians, the systems that allow abuse to take place for years have not evolved enough to protect patients.
Between 2016-2018, the Atlanta Journal Constitution did exhaustive reporting in its “Doctors and Sexual Abuse” series, analyzing public records from every state to find 3,100 doctors accused of sexual misconduct, with more than 2,400 of them involving patients.
These figures represent only a fraction of sexual abuse incidents since clinics and hospitals often fail to report doctors to regulators, AJC found. The Federation of State Medical Boards has also heard complaints that hospitals and clinics “regularly ignore” reporting requirements.
When doctors are reported, many state medical boards do not notify the public and may refuse information to patients and press who inquire about a physician under investigation.
Physicians who do make it in front of the state board and are found culpable by them are often allowed in some states to avoid discipline entirely if they agree to enter a private addiction recovery program.
The health care industry is slow to change
While the AJC investigation raised awareness (and was even a finalist for a Pulitzer in 2017), many of the systemic problems it uncovered have not been reformed.
“I don't know that there's been that much change, frankly,” Stefan Turkheimer, interim vice president of public policy at the Rape, Abuse and Incest National Network (RAINN) tells The Messenger.
“There's a tremendous amount of deference to physicians both in the law and in practice, both from patients and from legislators. And when you have that level of deference, there's not a lot of accountability,” Turkheimer, who worked with the AJC on their investigation into doctors and sexual abuse, says.
“The patient has very little power in that relationship, both individually with the doctor, but also structurally, and that leads to a lot of these problems,” he says.
Hospitals do not often report misconduct
In another criminal case, Zhi Alan Cheng, M.D., was charged with drugging and raping patients and filming the assaults.
One of accusers is suing New York-Presbyterian Hospital in Queens, alleging employees knew about the assault and failed to call police, suppressed evidence and continued to employ him for a full year following the assault.
A spokesperson for New York-Presbyterian denies the hospital was aware of the abuse prior to Cheng’s arrest.
“As soon as the District Attorney made us aware of allegations of sexual abuse against this individual, he was immediately placed off duty, banned from hospital property and terminated” the spokesperson said to The Messenger.
Although health care facilities in New York are required to report any assault to the OPMC, there is no penalty specified when they don’t comply. And in most states, you can’t research a physician to see if any abuse complaints have been made against them.
“It's very difficult to figure out if a complaint has been made about a particular doctor at all. And it’s then even harder to determine what the nature of those complaints were, especially if they weren't found to have merit or if they didn't result in a malpractice judgment,” Turkheimer says.
On a national level, The National Practitioner Data Bank (NPDB) established by Congress in 1986 was created to prevent practitioners from moving from state to state without disclosing any sort of malpractice — but the public can’t view the records. Only hospitals can request documentation when making hiring decisions, and they must keep the information confidential or are subject to a $10,000 fine.
Reported misconduct does not often result in discipline
A 2021 investigation into the reporting and disciplinary process in New York found the Department of Health was reluctant to penalize physicians for any violations, and the OPMC process involves physician input at every step. As a result, just 4% of all complaints (not just sexual misconduct cases) between 2007 and 2018 resulted in board action.
Sources in that investigation said “the vast majority” of sexual misconduct cases, which are not identified in the state data reports, were closed without any disciplinary action.
“If I were a person who was violated and I knew that system, I would never go in and tell my story,” a former OPMC investigator said in 2021. “Never, never.”
In 2020 and 2021, reforms to the OPMC were proposed in the New York state legislature, but did not pass after a physician advocacy group lobbied against it.
The OPMC did not respond to a request for information and comment.
Doctors are protected by their peers
State medical boards that are responsible for disciplining doctors are often made up of other doctors. The Federation of State Medical Boards recommends that boards be made up of at least 25% non-physicians.
According to the latest numbers in the NPDB, 1,662 physicians from 2003 to 2021 were reported for sexual misconduct, Azza AbuDagga, Ph.D., a health researcher from Public Citizen’s Health Research Group tells The Messenger.
But Dr. AbuDagga says these numbers represent “the tip of the iceberg” of sexual assault cases. Not only do many victims stay silent, but physicians are unlikely to report sexual misconduct by a colleague, and those who are reported may never have their case filed by a state board or logged in the NPDB.
In addition, researchers have found that hospitals and clinics “have utilized a number of strategies to evade reporting requirements to the NPDB.”
How to feel safe in the doctor’s office
RAINN has a guide for what to expect when you go to see a medical professional, and your rights as a patient:
- End the exam at any time. If anything about the exam makes you feel uncomfortable, you can let the person examining you know and they should stop right away.
- Ask to have someone in the room. If you want to have someone else in the exam room with you, you can ask for a nurse, friend, or family member to stay with you.
- Privacy. The exam should be in a private room or have a curtain drawn. You should also have a private place to change your clothes before and after the exam.
- Undress to your comfort. You should only need to undress the parts of your body that are being examined, and you shouldn’t need to stay undressed for long before or after the exam.
- Ask for an examiner of a different gender. You can ask to be seen by someone of another gender if that makes you more comfortable (but this might require picking a new doctor and might not be possible if it’s an emergency).
- Have your questions answered. If you ask the person examining you about what they’re doing or why they’re doing it, they should answer you truthfully and right away.
- Respect for your religion. You should be able to continue to wear religious jewelry or garments, unless they stop you from getting care.
- Get information in the language you speak. Medical caregivers should make every effort to give you information in the language you speak. If they don’t speak your language, ask them to make arrangements to have someone interpret either on-site or through a language access line. You can also bring along a trusted friend or family member who can interpret for you.
- Have your pain taken seriously. The person examining you should let you know if something will be painful. If you tell them it hurts and you want them to stop, they should stop right away.
What is okay and not okay during a pelvic, vaginal, breast, rectal or teste exam?
Sometimes an exam of private areas of your body is needed to stay healthy, but it should be limited to steps that are absolutely medically necessary. Here are some things that are normal and not normal during an exam of private parts of your body.
It’s okay for the examiner to:
- Explain each part of the exam to you before and while it is happening.
- Use gloves.
- Encourage you to tell them if something feels wrong or uncomfortable.
- Is the same sex as you, if you have asked.
- Only ask you to undress the part of your body being examined.
It’s NOT okay for the examiner to:
- Refuse to answer your questions or tell you to be quiet.
- Examine private parts without gloves.
- Refuse to tell you what they are doing or why they are doing it.
- Decline to have another person in the room with you.
- Insist that you undress parts of your body they are not examining.
- Ask you questions about your sexual activity that make you uncomfortable.
If you or someone you know has been a victim of sexual assault, help is available 24 hours a day through RAINN's National Sexual Assault Hotline at 1-800-656-4673.