Physician sexual exploitation: Wisconsin in the 1980s

Several factors make 1980s Wisconsin a useful window on the social changes now shaping the response by psychiatry and other medical specialties to patients who accuse physicians of sexual misconduct. The state medical board disciplined 19 such physicians in the 1980s, in contrast to 1 each in the two prior decades, as the state weathered several highly publicized cases in which multiple complainants accused prominent psychiatrists. Wisconsin was one of the first states to enact criminalization (1984) and mandatory reporting (1988) laws. Also, the relatively high number of physicians (3% of the state's psychiatrists) disciplined in the 1980s allows a beginning look at the epidemiology of this problem. Several patterns emerged: 1) Lone complainants who are psychiatric patients face many pressures. Fewer than 25% of successful cases against psychiatrists involved a lone complainant, while all the nonpsychiatrists were disciplined on the basis of a single patient's complaint. 2) More than half of disciplined psychiatrists had regained licensure by decade's end. Neither multiple sexual complainants nor multiple types of complaints seemed to deter relicensure. However, no physician with a criminal conviction has been relicensed. 3) Surprisingly, several connections were noted among offenders, including mentorships, friendships, and therapy relationships. Three disciplined psychiatrists were past presidents of local psychiatric societies. Psychiatrists who had been disciplined were significantly more likely to have been trained under one of the eminent sexual abusers than were other male psychiatrists in the state.