How health care systems can protect patients from sexual assault by providers

Health care providers have a sacrosanct relationship with patients. That unique position of trust also puts them in a position of power over their patients. Far too often — as exemplified by the recent case involving a New York doctor accused of drugging and assaulting his patients, or the former pediatrician facing more than 100 lawsuits by former patients — predators are able to exploit that power to sexually abuse patients.

But by enacting simple protocols, the institutions we trust with our health and our lives can end the pattern of enabling sexual abuse of patients. In particular, health care systems and offices should mandate that two health care professionals are in the room during sensitive exams.

A 2021 study done by the National Institute of Health revealed almost 5% of women and 2% of men have experienced sexual misconduct by health care professionals. Throughout my career as an attorney representing survivors of sexual abuse, I’ve witnessed firsthand the traumatic impact of sexual abuse in health care and how institutions consistently fail to protect patients and hold abusers accountable. For instance, there was a culture of silence in U.S. women’s gymnastics that led to hundreds of young women and girls being abused by sports medicine physician Larry Nassar. (I represented many of these gymnasts in litigation against Michigan State University, USA Gymnastics, and the U.S. Olympic Committee.) Survivors told people about their experiences with Nassar, but USA Gymnastics and other institutions failed to act appropriately, enabling his abuse for years.

My experience working with survivors has also allowed me to identify patterns in these situations of medical abuse. In particular, minors’ comments are regularly ignored, cultures of silence are upheld, and institutions fail to record or follow up on patient complaints. This is unfortunately a widespread issue, and while there is a pattern of young girls and women being victimized, this abuse is not limited to any demographic.

One of the reasons that medical professionals can exploit patients is they are routinely alone and initiate the abuse under the guise of treatment. George Tyndall, a campus gynecologist at the University of Southern California, reportedly abused hundreds of women, but many were unsure if they were violated due to the complex nature of medical care and an unfortunate culture where women and girls often question themselves. (He recently pleaded not guilty to dozens of charges.)

When sexual abuse of patients occurs, many victims remain silent due to a combination of power dynamics, personal vulnerability, and what can feel like a gray area between what is medically necessary and what constitutes sexual abuse. That feeling of a gray area often results from an abuser’s exploitation of a patient’s unfamiliarity with certain medical procedures.

Adding to the tragedy of sexual assault by health care professionals, victims often experience long-term trauma and are wary of receiving care for the rest of their lives due to this horrific exploitation of trust. As a result, a health problem that may have been easily treated becomes life-altering and impacts their health and well-being for the rest of their lives.

To combat this widespread issue, systematic changes and proactive measures to prevent sexual abuse are necessary. First, all medical professionals should be required to complete comprehensive training programs about appropriate boundaries and patient rights before they can be involved in exams of a sensitive nature. Before sensitive exams, patients should also be educated on appropriate boundaries and procedures.

Perhaps most importantly, we must mandate that two health care professionals are present in the room for any sensitive exams — including gynecological procedures, exams that require the patient to be in a state of undress, and procedures that involve physical contact of sensitive areas by a medical professional — and that there is a verbal explanation of any physical contact that will occur. This is especially vital for minor patients, who are especially vulnerable.

These important mandates must be implemented and carried out at the institutional level. This would require training of all patient-facing staff to ensure the protocols put into action at all levels, which health care organizations could protest given the associated cost. If cost is the only excuse holding organizations back from better protecting their patients, an argument could easily made that it would save the organization money in the long run by reducing the lawsuits that can ensue after sexual assaults.

Mandating this preventative measure would be a huge step in the right direction, but it’s important to note that it would likely not prevent all abuse. Therefore, when abuse is reported, institutions must immediately respond with a thorough investigation to prevent any further abuse and get a full understanding of what took place. Developing robust reporting and disciplinary systems can also encourage colleagues to report any misconduct without fear of retaliation. And, importantly, institutions should collaborate to track complaints and detect patterns of misconduct, catching repeat offenders earlier on.

As a patient, if you are sexually abused in a medical context, you should immediately report it to law enforcement if you are able to do so. If you are unsure if what occurred was abuse, reaching out to a trusted medical professional, a rape crisis center, or a survivor advocate trained in recognizing abuse can also be a good first step. Importantly, by reporting your experience, you could prevent the abuser from causing further harm.

The prevalence of abuse within the medical field is an alarming reality that demands our immediate attention and action. Health care institutions, medical professionals, and society at large have a responsibility to address this problem. Implementing the above solutions would be a step in the right direction to help resolve this issue that unfortunately affects so many. Only through collective efforts can we build a medical field that deserves the trust placed in it.

Michelle Simpson Tuegel is a sexual abuse survivor advocate and attorney who has represented survivors in cases such as the Larry Nassar litigation against Michigan State University, USA Gymnastics and the U.S. Olympic Committee, sexual assault survivors at the University of Southern California and University of Michigan, female students in Title IX lawsuits around the country, and clergy abuse survivors nationwide.