Case Overview and Outcome
Dr. Charles S. Dehaan, was a licensed physician, practicing in Rockford, Illinois. He did home visits for patients who were too ill to leave their house, elderly, disabled and/or bedridden. He was charged in 2014 for sexual assault to one of his patients. There were more than a dozen patients of his that came forward and accused him of assaulting them too. His license to practice medicine were suspended in Illinois after these charges were filed, pending trial (Teegardin, Robbins, Ernsthausen, & Hart, 2016). The victims that came forward said he would threaten them if they told anyone about the abuse and that no one would believe them anyway because he was a well-respected physician (Bruscato, 2018).
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In March of 2015, Dehaan was also charged with health care fraud. He has been overbilling Medicare for patients that had been dead or for services that head never been done. He pleaded guilty to two fraud charged and was sentenced to 9 years in prison and ordered pay over 2.7 million dollars in restitution (Andrist, 2015). While still in prison for fraud, Dehaan was still going through trial for the sexual abuse charges. He plead guilty for three counts of Aggravated Battery to three different victims for the sexual abuse accusations. The sentencing trial was supposed to be September 2018, but there are no reports of that trial. Aggravated Battery to a victim over the age of 60 or handicapped is punishable by two to five years in prison (Bruscato, 2018). Since he plead guilty to three counts he could be sentenced for six to fifteen years in prison.
Report Card for Illinois
Each state is scored on how well it protects patients against sexually abusive physicians. These scores are reported in a report card and is separated into five different categories and then and overall average is calculated. The overall report card score for Illinois is 61 out of 100. The five categories measured in Illinois are: transparency, duty-to-report laws, board composition, criminal acts, and discipline laws (Teegardin, Robbins, Ernsthausen, & Hart, 2016).
This allows ample information to be found by the public on physicians. This includes if the physician has been disciplined for sexual abuse or other crimes. The best scores went to states that allowed information to be found going back as far as 15 years (Teegardin, Robbins, Ernsthausen, & Hart, 2016). To receive a good score the state must, according to Teegardin, Robbins, Ernsthausen, & Hart (2016), “detailed the acts that led to sanctions; avoided private orders, reprimands or letters; provided easy web access to clearly labeled doctor information including disciplinary documents; and listed any hospital sanctions, criminal convictions and out-of-state disciplinary actions for each physician” (para. 1). Illinois average score for transparency is 46 and scored the following in these areas:
- Penal orders are not visible. Score 4/20. The information listed on acts are unclear. Score 8/20. Information on physician disciplines will only go back to the last 10 years. Score 12/20. When a physician is searched, two or more links to information may appear. Score 18/20. The board can issue non-public letters of concern and non-disciplinary actions. Score 4/20 (Teegardin, Robbins, Ernsthausen, & Hart, 2016).
The best scoring states have laws that require all physicians and medical organizations to report regulators of possible violations. There are five different actions that are taken to evaluate these laws. Illinois average score for this category is 84.
- All medical facilities are required to report alleged misconduct. Illinois requires all health care facilities to report misconduct and also reports terminated or restricted privileges of a physician. Score 20/20. There is a deadline of 30 day to make any reports to regulators. Illinois deadline to make reports is 60 days. Score 12/20.
- If a report is not made there are substantial consequences. In Illinois, if there is a failure to report a misconduct, it is considered a misdemeanor. Score 20/20. Physicians are required to report fellow physicians of there is known or suspected misconduct. In Illinois, physicians are only required to report colleague physicians under certain situations. An example situation is if the colleague physician violates the Controlled Substance Act. Score 12/20.
- Law enforcement agencies are required to report regulators when a physician is convicted of a crime. In Illinois, the state’s attorney in every county must report a conviction of a crime within five days of the physician being convicted. Prosecutors must immediately report to regulators when a physician is charged with a sexual crime or violent offences (Teegardin, Robbins, Ernsthausen, & Hart, 2016).
A plan was constructed to be aware of the significance of having public members on the physician health care regulatory organizations. To evaluate the structure of these organizations, there are three measures taken, to make sure that majority of the burden is given to consumer representation. The average score for Illinois for board composition is 75. Top scores were given to states with the following:
- Public members of the board make up 40 percent of it. In Illinois, the health care penalizing board has six doctors, one chiropractor and four public members. Score 40/50
- Members of the board or their family members do not have any financial or professional connections to medicine. In Illinois, the public members of the board cannot be connected as providers of the medical field. Score 15/25. Women must hold at least 40 of the board’s positions. In Illinois, four of the eleven members of the board are women. Score 20/25 (Teegardin, Robbins, Ernsthausen, & Hart, 2016)
Medical regulators and law enforcement must be aware of physician’s criminal convictions. This helps protects patients from physicians who may be predators. There have been three main laws created in order to protect patients. Illinois average score for criminal acts is 36. This is a very low score. The states that receive high scores provide the following:
- Physicians must have criminal background checks, get fingerprinted when they apply for license and occasionally after receiving license. Illinois requires a criminal background check and fingerprints at the time of application. Score 24/40. Sexual contact by a physician to a patient is a criminal offense when the patient cannot give consent. Illinois, does not have an obligation if there is sexual contact. Score 4/20. Health care boards must notify the law if there is an alleged criminal conduct. Illinois has no laws for physicians if a crime is committed. Score 8/40 (Teegardin, Robbins, Ernsthausen, & Hart, 2016)
Physicians that abusive their patients can be protected by laws that may restrict the regulatory boards capability to investigate allegations and don’t have to entail permanent withdrawal of license. There are four laws that evaluate the legal situation for physician discipline. In order to get a high score states must require permanent withdrawal of physical license for some crimes. They must require physicians who have a felony or have lost their medical license, cannot obtain a license in other states and regulators must be able to obtain the information they need to investigate alleged abuse. There must be rational proof against the alleged physician, especially for sexual abuse (Teegardin, Robbins, Ernsthausen, & Hart, 2016). The following are the disciplinary laws in Illinois with an average score of 65 and the scores given for the above laws:
- Illinois permanently revokes of a physician’s license if there is a conviction of criminal battery, sexual abuse, or violent offences to a patient. Score 25/25. Illinois does not limit access to any information needed from the hospital to investigate but does limit access to review boards. Score 20/25. Physicians who are charged with violent offenses, criminal battery, and sexual abuse against a patient are banned from obtaining a medical license. Illinois law does not ban physicians from obtaining a medical license when they have had them suspended revoked in other states. Score 15/25. Illinois requires substantial evidence to prove a disciplinary case against a physician. Score 5/25 (Teegardin, Robbins, Ernsthausen, & Hart, 2016) .
Other medical professionals, such as, employers coworkers, or medical boards, have an ethical responsibility to report any suspected or known misconduct of another medical professional. Being a physician, they have a commitment to protect the safety of their patients and maintain a trust with the public. Reporting a fellow physician who was involved in dishonorable behavior or conduct is proposed to shield patients. It is also intended to help make sure fellow physicians to practice justly and carefully. Physicians who become suspect or are aware that a misconduct to a patient or something that may violate ethical principles, that physician need to report it to appropriate authorities as soon as possible. They must protect the privacy of that patient that was involved to best of their ability (American Medical Association, 2016). If the ethical principles non-maleficence, autonomy, beneficence, or justice are violated, these need to be reported as well. Physicians have an obligation to follow these ethical principles and have obligations to let patients make their own decisions, to do no harm to the patients, only use treatments that will benefit the patient, and treat each patient fairly (Saint Joseph's University, 2019).
- American Medical Association. (2016). Opinions of Professional Self-Regulation. Retrieved from American Medical Association: https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/code-of-medical-ethics-chapter-9.pdf
- Andrist, E. (2015, Novemeber 15). Dr. Charles Scott Dehaan. Retrieved from The Patient Safety League: https://4patientsafety.org/2015/11/20/dr-charles-scott-dehaan/
- Bruscato, J. (2018, August 9). Press Release-Charles Dehaan Plea. Retrieved from Winnebago County Illinois : https://wincoil.us/departments/states-attorney/department-news/press-release-charles-dehaan-plea/
- Saint Joseph's University. (2019). How the Four Principles of Health Care Ethics Improve Patient Care. Retrieved from Saint Joseph's University: https://online.sju.edu/graduate/masters-health-administration/resources/articles/four-principles-of-health-care-ethics-improve-patient-care
- Teegardin, C., Robbins, D., Ernsthausen, J., & Hart, A. (2016). Doctors & Sex Abuse. Retrieved from The Atlanta Journal-Constitution : http://doctors.ajc.com/states/illinois_sex_abuse/
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