Monday, November 26, 2012

Was the Massachusetts Board of Registration Too Harsh on this case of Doctor-Patient Sex?

The Boston Globe recently reported that the Massachusetts Board of Registration in Medicine revoked the license of Dr. Gary Brockington, a 54 year old primary care physician and cardiologist, for having had a sexual relationship with a patient.

I've not been able to get a copy of the report from the Division of Administrative Law Appeals, so I'm entirely dependent on the Boston Globe story, which has extensive quotes from Brockington's lawyer. The story, if accurate and complete, leads me to speculate that revocation of licensure may be too severe a penalty in this specific situation.

According to the Globe, Brockington experienced a Job-like series of events in 2006. He was newly divorced, bankrupt, and depressed. During the same stretch of time his sister (his only sibling) broke her neck and was left by her husband. Brockington became legal guardian for her two young children.

One of his patients, a married woman who was a technician at the hospital where Brockington practiced, and who had worked with him on procedures, invited him to stay in her basement. According to Brockington's lawyer he told her she would have to get another primary care physician. He did, however, renew some prescriptions for her. He stayed in her home for two months. Apparently the brief sexual relationship occurred during the last two weeks of his stay. He moved out in July, 2006. The woman did not herself register a complaint.

If, as Brockington's lawyer claims, the facts show that this was a single episode in an otherwise exemplary career, it's not clear that public safety requires permanent loss of license. In other posts I've strongly supported permanent loss of license when the pattern of facts was different, as in this case. In another case, I concluded that Rhode Island was correct when it reinstated the license of a physician who participated in an extensive rehabilitation program, and agreed to continue in ongoing psychotherapy and long term supervision of practice. (see here)

The spokesman for the Massachusetts Board of Registration is quoted as saying that "the board has zero tolerance for sexual misconduct between physicians and patients." I believe that "zero tolerance" is the correct stance, but don't believe that sexual misconduct always requires permanent loss of license. If the Boston Globe article is the full story, a case can be made that this was a single, out-of-character episode that occurred in extraordinarily stressful circumstances. If that is how the Board saw the situation, I believe it acted too harshly.

12 comments:

jamzo said...

i am curious as to the extent to which the "zero tolerance" attitude rules across the continuum of physician misbehavior

Anonymous said...

The Board is a joke. Only in Massachusetts would multiple regulatory agencies refuse to remove violent doctors, including those involved in intentional sexual assaults of patients. Protecting public health has never been the goal of the Board.

Massachusetts is a highly corrupt state where perpetrators are protected and victims silenced.

Joan said...

Yes The Board of Medicine was Definitely too Harsh. THis Doctor
Gary Brockington M.D. Is known for
being an Outstanding Medical Doctor.
All Persons in their life time can have major negative events in their lives Including the BORIM STAFF. In
My opinion The Patient they are referring to was very manipulative and deliberately with menance took a
Innocent doctor life away from him.
why Is n't this woman being prosecuted. ?

Jim Sabin said...

Dear Jamzo, Anonymous, & Joan -

Thank you for your comments. I'll respond in order.

Jamzo - you raise an excellent question as to whether the same "zero tolerance" is applied in other areas. I'm sorry that I don't know the answer, but if I have a better sense of it in the future I'll write another post.

Anonymous - I'd be shocked if the Board was not severe in its response to a physician who were violent and sexually assaultive. I hope your conclusion is wrong.

Joan - the letters in today's Boston Globe confirm your view that Dr. Brockington typically took excellent care of his patients. But even if your speculation about the woman involved in the relationship is 100% correct (which I doubt), it is the physician's responsibility to conduct himself in accord with well-established ethical norms. Your suggestion that the woman should be prosecuted is over the top. What would she be prosecuted for? You don't have to attack her to support your view (which I believe is correct) that Dr. Brockington took excellent care of his patients.

Best to all

Jim

Joan said...

Jim as you said you don't have all the facts , so therefore how can you say I was over the top about this female CO-Worker, I believe she deliberately coerced him and that being said why shouldn't she be prosecuted. Is It because Dr. Brockington Is " MALE" That He Is
supposed to be the stronger one! ?
Men can be sexually harassed by women as well. I Hope He appeals this Anarchic decision / unjustifiable decision.

Jim Sabin said...

Hi Joan -

I agree that sexual harassment can be carried out by women as well as by men. The reason a male physician should not enter into a relationship even if invited to do so is not because men are stronger (I think men and women are equally strong in terms of moral strength) but because professional ethics appropriately prohibits certain forms of relationship. That prohibition would apply to a female physician in relation to a male patient, and to same sex relationships.

Best

Jim

joan said...

Hi Jim.. This woman was a co-worker, and patient yes, however,
The Board of Medicine Is not giving all the facts to this case ,
The Truth Shall Prevail ! Did You ever consider DR. Brockington Is the victim here. ? DR. Brockington
spent two Hours discussing my mothers options with her and our family. I resent highly the slanderous and libilious statements made about Dr. Brockington .

Jim Sabin said...

Hi Joan -

Since your last note I've heard from some of Dr. Brockington's colleagues - they also think of him as a devoted physician. Apparently the kind of attention he gave to your mother was characteristic of the way he dealt with his patients. I hope you've expressed your respect and gratitude to him directly.

Best

Jim

Anonymous said...

Interestingly, you might recall the excellent PBS Series, 'The Making of a Doctor.' In Part 1 (of 2 Parts), the series follows a number of Harvard medical students, one of whom (who later became an anesthesiologist)-- related ASKING OUT(!) a woman--whom he saw as a patient (for a foot problem) at the MGH ED. They later married---and the Series even reported on their unfortunate divorce. The Series featured several video interviews with both spouses!
Apparently, the Board (whose chief on or about that time was convicted in Federal Court for lying to Federal Investigators re: his actions as V. P. of Bristol-Myers) took NO action against that apparently 'intolerable' marriage!
HMMD Boston

Jim Sabin said...

Dear Anonymous -

Thank you for the reference to the PBS program. I saw it at the time but had forgotten the student/patient story you described.

Earlier this year I wrote about a comment I'd received from a physician who'd married a woman he'd cared for as a patient during his internship and to whom he'd been happily married for 8 years. (http://healthcareorganizationalethics.blogspot.com/2012/03/is-this-doctor-patient-marriage.html) Human beings meet and are attracted to each other in all kinds of circumstances, including medical relationships.

I believe the current ethical standards that enjoin physicians to refrain from sexual relationships with present and - for some specialties like psychiatry - former patients, are correct. Certainly in my discipline the potential for harm to the patient is high and difficult to predict. But as I've argued recurrently in my posts, harm to public trust in the medical profession is inevitable.

Violating that standard, however, doesn't entail a single specific penalty like loss of license. In the court system we expect judges to consider factors specific to the convicted person in deciding on a sentence. The same should be true for the Board of Registration. In my view, IF the facts of Dr. Brockington's situation are as reported in the Boston Globe, revoking his license is an overly severe penalty.

Best

Jim

joan said...

Hi Jim .. Yes ofcourse my family
was greatful, and we thanked DR. Brockington . He Is the reason my Mother Is still Alive today. Dr. Brockington has always expressed thoroughness and got all medical history from the Patient and listened to My Family Members concerns and we voluntarily gave our medical history.

Anonymous said...

I am shocked by this! I knew Gary as a customer in a shop back in the late 90s. He provided free heatlhcare to staff there (it's a long story) and helped every person he came across... I believe he also tackled a gunman who was robbing a woman, over by Fenway, at about the same time.

Literally one of the nicest most caring guys I ever met.