Article Figures & Data
Figures
Figure 1. Characterization of records related to unprofessional sexual misconduct referrals. a The types or names of monitoring agreements (contracts) available varied over the course of the 35 years included in the chart review. Some individuals received more than one type of contract, typically if they had multiple presenting concerns or were rereferred to the program at a later date for a different concern. PHP, professional health monitoring program; PSM, professional sexual misconduct.
Tables
Variables Levels Total Sample (N = 570) Monitored Group (n = 232) Unmonitored Group (n = 338) df t χ2 p Cramer’s V Cohen’s d Age — 47.95 ± 10.08 46.84 ± 9.42 49.17 ± 10.66 410.93 −2.39 — .0172 — .231 Gendera Male 546 (96.6%) 222 (95.7%) 324 (97.3%) 1.00 — .65 .4205 .044 — Female 19 (3.4%) 10 (4.3%) 9 (2.7%) Other 0 (.0%) 0 (.0%) 0 (.0%) Sexual orientationb Heterosexual or straight 319 (91.7%) 205 (91.9%) 114 (91.2%) — — — .6537 .094 — Gay or lesbian 20 (5.7%) 12 (5.4%) 8 (6.4%) Bisexual 6 (1.7%) 4 (1.8%) 2 (1.6%) Asexual 1 (.3%) 0 (.0%) 1 (.8%) Other 2 (.6%) 2 (.9%) 0 (.0%) Relationship statusb Single 39 (10.3%) 23 (10.0%) 16 (10.8%) — — — .4524 .105 — First Marriage 190 (50.4%) 113 (49.3%) 77 (52.0%) Remarried 70 (18.6%) 43 (18.8%) 27 (18.2%) Divorced 76 (20.2%) 50 (21.8%) 26 (17.6%) Widowed 2 (.5%) 0 (.0%) 2 (1.4%) Racea Caucasian or white 275 (73.5%) 168 (76.4%) 107 (69.5%) 1.00 — 1.87 .172 .077 — Other and multiracial 99 (26.5%) 52 (23.6%) 47 (30.5%) Ethnicitya Hispanic and Latine 55 (30.6%) 27 (25.7%) 28 (37.3%) 1.00 — 2.26 .1325 .124 — Not Hispanic or non-Latine 125 (69.4%) 78 (74.3%) 47 (62.7%) Country or region of birthb United States 201 (70.3%) 146 (73.0%) 55 (64.0%) — — — .4719 .162 — Southeast Asian 24 (8.4%) 15 (7.5%) 9 (10.5%) Latin American 20 (7.0%) 12 (6.0%) 8 (9.3%) Caribbean 15 (5.2%) 9 (4.5%) 6 (7.0%) Middle Eastern or North African 11 (3.8%) 6 (3.0%) 5 (5.8%) Europe 7 (2.4%) 6 (3.0%) 1 (1.2%) Sub-Saharan African 4 (1.4%) 2 (1.0%) 2 (2.3%) East Asian 3 (1.0%) 3 (1.5%) 0 (.0%) Canada 1 (.3%) 1 (.5%) 0 (.0%) Religious affiliationb Catholic 25 (31.6%) 20 (32.3%) 5 (29.4%) — — — .7227 .301 — Protestant 27 (34.2%) 21 (33.9%) 6 (35.3%) Jewish 10 (12.7%) 8 (12.9%) 2 (11.8%) Muslim 5 (6.3%) 3 (4.8%) 2 (11.8%) Evangelical Christian 3 (3.8%) 3 (4.8%) 0 (.0%) Hindu 2 (2.5%) 2 (3.2%) 0 (.0%) Buddhist 1 (1.3%) 0 (.0%) 1 (5.9%) Agnostic 1 (1.3%) 1 (1.6%) 0 (.0%) Atheist 0 (.0%) 0 (.0%) 0 (.0%) None 3 (3.8%) 2 (3.2%) 1 (5.9%) Other 2 (2.5%) 2 (3.2%) 0 (.0%) Occupationb Physician 348 (64.4%) 156 (67.2%) 192 (56.8%) — — — .0725 .158 — Adult primary care 111 (20.9%) 52 (23.4%) 59 (19.2%) Psychiatry 48 (9.1%) 24 (10.8%) 24 (7.8%) Obstetrician or gynecologist 26 (4.9%) 9 (4.1%) 17 (5.5%) Pediatrician 6 (1.1%) 2 (.9%) 4 (1.3%) Other physician 157 (29.6%) 69 (31.1%) 88 (28.6%) Physician assistant 17 (3.2%) 11 (5.0%) 6 (1.9%) Massage therapist 11 (2.1%) 2 (.9%) 9 (2.9%) Other 154 (29.1%) 53 (23.9%) 101 (32.8%) - Table 2
Addictive and Psychiatric Disorder Diagnoses among Professionals Monitored by the PHP
Diagnoses Monitored Group (n = 232) Addictive Disorders No addictive disorder 101 (43.5%) Compulsive sexual behavior or “sexual addiction” 9 (3.9%) Alcohol use disorder 25 (10.8%) Drug use disorder 26 (11.2%) Psychiatric Disorders No psychiatric disorder 37 (15.9%) Impulse control disorder 7 (3.0%) Mood disorder 41 (17.7%) Anxiety disorder 11 (4.7%) Trauma-related disorder 7 (3.0%) Adjustment disorder 22 (9.5%) Attention-deficit and hyperactivity disorder 2 (0.9%) Personality disorder 56 (24.1%) Eating disorder (not including “food addiction”) 1 (0.4%) Paraphilia or other sexual disorder 28 (12.1%) Other 20 (8.6%) Some individuals received multiple diagnoses. PHP, professional health monitoring program
- Table 3
Unprofessional Sexual Behavior Exhibited by Healthcare Professionals Recommended for PHP Monitoring
Variables Levels Total Sample (N = 570) Monitored Group (n = 232) Unmonitored Group (n = 338) df χ2 p Cramer’s V Workplace and Patient Involvement Work environment: no patient involvementa No 452 (79.3%) 168 (72.4%) 284 (84.0%) 1.00 10.60 .0011 .141 Yes 118 (20.7%) 64 (27.6%) 54 (16.0%) Work environment: involving patient(s)a No 190 (33.3%) 56 (24.1%) 134 (39.6%) 1.00 14.20 .0002 .162 Yes 380 (66.7%) 176 (75.9%) 204 (60.4%) Outside workplace environmenta No 444 (77.9%) 176 (75.9%) 268 (79.3%) 1.00 .75 .3864 .041 Yes 126 (22.1%) 56 (24.1%) 70 (20.7%) Characterization of Violation(s) Purported “consensual” sexual behavior between adultsa No 517 (90.7%) 197 (84.9%) 320 (94.7%) 1.00 14.41 .0001 .165 Yes 53 (9.3%) 35 (15.1%) 18 (5.3%) Sexual behavior with possibility or likelihood of coerciona No 344 (60.4%) 103 (44.4%) 241 (71.3%) 1.00 40.50 <.0001 .270 Yes 226 (39.6%) 129 (55.6%) 97 (28.7%) Unwanted or offensive attention or communicationa No 352 (61.8%) 139 (59.9%) 213 (63.0%) 1.00 .44 .5083 .031 Yes 218 (38.2%) 93 (40.1%) 125 (37.0%) Unwanted physical or sexual contact without penetrationa No 341 (59.8%) 138 (59.5%) 203 (60.1%) 1.00 .00 .9594 .006 Yes 229 (40.2%) 94 (40.5%) 135 (39.9%) Unwanted sexual contact involving penetrationa No 459 (80.5%) 198 (85.3%) 261 (77.2%) 1.00 5.29 .0215 .101 Yes 111 (19.5%) 34 (14.7%) 77 (22.8%) Other (e.g., problematic pornography use; exhibitionism)a No 517 (90.7%) 204 (87.9%) 313 (92.6%) 1.00 3.03 .0818 .079 Yes 53 (9.3%) 28 (12.1%) 25 (7.4%) Age Characterization of Victim(s) Prepubescent minor(s)a No 526 (92.3%) 215 (92.7%) 311 (92.0%) 1.00 .02 .8961 .012 Yes 44 (7.7%) 17 (7.3%) 27 (8.0%) Postpubescent minor(s)a No 476 (83.5%) 196 (84.5%) 280 (82.8%) 1.00 .16 .686 .022 Yes 94 (16.5%) 36 (15.5%) 58 (17.2%) Adult(s)a No 135 (23.7%) 32 (13.8%) 103 (30.5%) 1.00 20.26 <.0001 .193 Yes 435 (76.3%) 200 (86.2%) 235 (69.5%) Gender Characterization of Victim(s) Malea No 509 (89.3%) 204 (87.9%) 305 (90.2%) 1.00 .54 .4612 .037 Yes 61 (10.7%) 28 (12.1%) 33 (9.8%) Femalea No 130 (22.8%) 35 (15.1%) 95 (28.1%) 1.00 12.52 .0004 .153 Yes 440 (77.2%) 197 (84.9%) 243 (71.9%) Botha No 556 (97.5%) 226 (97.4%) 330 (97.6%) 1.00 .00 1 .007 Yes 14 (2.5%) 6 (2.6%) 8 (2.4%) PHP, professional health monitoring program
↵a Pearson’s chi-squared test.
Variables Levels Total Sample (N = 570) Monitored Group (n = 232) Unmonitored Group (n = 338) df χ2 p Cramer’s V Criminal or Legal Involvement Any legal or disciplinary consequencesa No 201 (35.3%) 99 (42.7%) 102 (30.2%) 1.00 8.87 .0029 .129 Yes 369 (64.7%) 133 (57.3%) 236 (69.8%) Civil settlement outside of court (no criminal charges)a No 501 (87.9%) 188 (81.0%) 313 (92.6%) 1.00 16.24 .0001 .174 Yes 69 (12.1%) 44 (19.0%) 25 (7.4%) Ordered to pay damages in civil court proceedingsb No 563 (98.8%) 229 (98.7%) 334 (98.8%) — — 1 .005 Yes 7 (1.2%) 3 (1.3%) 4 (1.2%) Criminal charges filed but droppeda No 536 (94.0%) 216 (93.1%) 320 (94.7%) 1.00 .36 .5498 .033 Yes 34 (6.0%) 16 (6.9%) 18 (5.3%) Found “not guilty” of criminal behavior in courtb No 559 (98.1%) 229 (98.7%) 330 (97.6%) — — .5381 .038 Yes 11 (1.9%) 3 (1.3%) 8 (2.4%) Agreed to plea bargain involving lesser chargeb No 562 (98.6%) 229 (98.7%) 333 (98.5%) — — 1 .008 Yes 8 (1.4%) 3 (1.3%) 5 (1.5%) Found “guilty” of crime with no jail or prison sentencea No 484 (84.9%) 184 (79.3%) 300 (88.8%) 1.00 8.86 .0029 .130 Yes 86 (15.1%) 48 (20.7%) 38 (11.2%) Found “guilty” of crime and sent to jail or prisona No 527 (92.5%) 218 (94.0%) 309 (91.4%) 1.00 0.94 .3325 .047 Yes 43 (7.5%) 14 (6.0%) 29 (8.6%) Criminal charges still pendingb No 568 (99.6%) 231 (99.6%) 337 (99.7%) — — 1 .011 Yes 2 (0.4%) 1 (0.4%) 1 (.3%) Criminal or legal involvement with unknown outcomea No 513 (90.0%) 218 (94.0%) 295 (87.3%) 1.00 6.11 .0134 .110 Yes 57 (10.0%) 14 (6.0%) 43 (12.7%) Impact on Professional Licensure Disciplined by licensing board, but ability to practice not affecteda Never 283 (62.2%) 106 (47.7%) 177 (76.0%) 1.00 37.31 <.0001 .291 Temporarily 172 (37.8%) 116 (52.3%) 56 (24.0%) Permanently 0 (.0%) 0 (.0%) 0 (.0%) Voluntary license relinquishmentb Neverc 350 (79.2%) 182 (84.7%) 168 (74.0%) — — .0122 .135 Temporarily 6 (1.4%) 3 (1.4%) 3 (1.3%) Permanentlyc 86 (19.5%) 30 (14.0%) 56 (24.7%) Involuntary license restriction (able to practice under restrictions)a Neverc 313 (71.3%) 126 (58.3%) 187 (83.9%) 1.00 36.07 <.0001 .287 Temporarilyc 100 (22.8%) 69 (31.9%) 31 (13.9%) Permanentlyc 26 (5.9%) 21 (9.7%) 5 (2.2%) Involuntary license suspensionb Never 290 (64.6%) 137 (63.1%) 153 (65.9%) — — .7763 .029 Temporarily 157 (35.0%) 79 (36.4%) 78 (33.6%) Permanently 2 (.4%) 1 (.5%) 1 (.4%) License revokeda Neverc 362 (83.2%) 194 (91.5%) 168 (75.3%) 1.00 — <.0001 .225 Temporarily 6 (1.4%) 3 (1.4%) 3 (1.3%) Permanentlyc 67 (15.4%) 15 (7.1%) 52 (23.3%) Outcome Levels Total Sample (N = 570) Monitored Group (n = 232) Unmonitored Group (n = 338) p Cramer’s V Outcome of PHP participationa Still under initial monitoring agreementb 28 (4.9%) 28 (12.1%) 0 (0.0%) .0005 .877 Successfully completed monitoring without relapseb 105 (18.4%) 105 (45.3%) 0 (0.0%) Successfully completed extended monitoring agreementb 23 (4.0%) 23 (9.9%) 0 (0.0%) Completed initial monitoring but rereferred to PHP 3 (.5%) 3 (1.3%) 0 (0.0%) Discontinued PHP involvement against recommendation (relinquished license) 68 (11.9%) 27 (11.6%) 41 (12.1%) Turned over to licensing board for noncompliance with PHP recommendations 50 (8.8%) 22 (9.5%) 28 (8.3%) No monitoring agreement signed because licensing board took action firstb 44 (7.7%) 0 (0.0%) 44 (13.0%) Licensing board denied or revoked license during monitoring periodb 8 (1.4%) 8 (3.4%) 0 (0.0%) PHP monitoring was not appropriateb 221 (38.8%) 0 (0.0%) 221 (65.4%) Otherb,c 20 (3.5%) 16 (6.9%) 4 (1.2%) Monitoring Success Levels Total Sample (N = 570) Monitored Group (n = 232) Evaluated in terms of meeting the dual missions of assisting professionals with potentially impairing conditions and protecting patient safetya,d Very unsuccessful 11 (1.9%) 11 (4.7%) Unsuccessful 21 (3.7%) 21 (9.1%) Neutral 27 (4.7%) 27 (11.6%) Successful 59 (10.4%) 59 (25.4%) Very successful 114 (20.0%) 114 (49.1%) No monitoring agreement (contract) 338 (59.3%) 0 (0.0%)
