A task force formed by the Washington Department of Health has recommended taking faster action on sexual misconduct cases against health care professionals, according to a draft report reviewed by The Seattle Times.
The Patient Safety Improvement Task Force is also weighing whether to make information public about such cases earlier in the process. The group was created in response to a Times investigation, published in November, that revealed delays in disciplining providers for sexual misconduct. DOH shared draft recommendations with some professional associations earlier this month.
The report highlights obstacles to swiftly acting on sexual misconduct — from the difficulty of obtaining outside experts to the department's unwieldy system of paper files — and a variety of ways to accelerate the process.
Among the ideas considered by the task force: establishing earlier deadlines for phases of a case, setting limits on how long attorneys for DOH have for settlement discussions, creating specialized teams to investigate complaints of sexual misconduct, and more frequently using existing power to immediately suspend a health care provider's license "to be more assertive in protecting patients."
The task force also floated the possibility of disclosing when providers are under investigation on its online portal but has concluded more research is needed.
DOH is finalizing recommendations for agency executives to consider. "It is too early for us to predict the time frame for making those decisions," said Katie Pope, a DOH spokesperson.
Some of the task force's recommendations would require additional resources, such as adding staff and digitizing their paper records. The report didn't estimate how much such measures might cost.
The Times reviewed 628 cases of sexual misconduct since 2009, finding 45% took longer than a year to discipline a provider, while 10% took more than two years. In 18 cases, patients alleged they were harmed by a provider who was already being investigated for sexual misconduct and who ultimately was disciplined.
The most disciplinary actions were taken against massage therapists and nursing assistants, followed by doctors.
The number of complaints of all types against licensed providers more than doubled from 2009 to 2019, as the number of licensed health care professionals increased by 45%, to nearly 500,000.
But the number of complaints that resulted in discipline slightly declined over that time, according to a Times analysis of DOH data.
The Washington State Chiropractic Association and the Washington State Medical Association, which reviewed the recommendations, have endorsed faster resolutions for sexual misconduct cases, while expressing reservations about disclosing details of cases before disciplinary charges are filed.
"Shortening timeframes will help all parties involved by more quickly protecting patients and their safety without compromising the due process rights of physicians" and others who are the subject of complaints, Jeb Shepard, the medical association's policy director, wrote in a March 16 letter to DOH.
As for making information public earlier in the process, he wrote, "Unless DOH can ensure that a complaint is legitimate and substantiated before disclosure, posting information about an investigation before charges are filed will undoubtedly cause harm" to physicians and other health care professionals.
Setting the pace of disciplinary cases presents a delicate balance for DOH and state licensing boards and commissions, which weigh the need to build a solid case, the urgency of protecting patients and the rights of the health care professionals who are accused.
In one of the longest delays examined by The Times, DOH investigators in 2016 found a sexual misconduct complaint against a chiropractor to be credible and offered to settle the matter. Such a deal would have shown up on DOH's online portal for licensed providers, but the chiropractor rejected it, maintaining he did nothing wrong.
Ultimately, DOH gathered complaints from nine patients about the chiropractor — including two who claimed they were harmed while regulators were building their case — and suspended his license for at least 42 months in August. That ruling that came 2,016 days after the initial complaint.
The Washington State Chiropractic Association voiced concern about regulators posting details of an investigation earlier, pointing out that complaints can be inaccurate or incomplete. "Please do not 'rush to judgment' on these cases," according to a letter to DOH signed by the association's president and legislative chair.
The association backed the goal of shortening the time it takes to resolve sexual misconduct cases. "Patient safety, especially related to sexual misconduct, is critical," the association officials wrote.
