Even as Hollywood moguls, elite journalists and top politicians have been pushed out of their jobs or resigned amid allegations of sexual misconduct, the world of medicine is more forgiving, according to an Associated Press investigation.
Even when doctors are disciplined, their punishment often consists of a short suspension paired with therapy that treats sexually abusive behavior as a symptom of an illness or addiction.
The first time that Dr. Anthony Bianchi came onto a patient, California's medical board alleged, the gynecologist placed a chair against the exam room door, put his fingers into the woman's vagina and exposed his erect penis.
The second time, the board claimed, he told a patient that he couldn't stop staring at her breasts and recounted a dream in which he performed oral sex on her in the office.
The third time, the board charged, he told a pregnant patient suffering from vaginal bleeding that she shouldn't shave her pubic hair before her next visit, as he was getting too excited.
These episodes led to disciplinary actions by the state's medical board in 2012 and in 2016. Bianchi agreed not contest the charges, and held onto his medical license. Under a settlement with California's medical board, he agreed to seek therapy and refrain from treating women during five years of probation.
Bianchi did not respond to telephone messages from The Associated Press left for him at the workers' compensation clinic in Fresno, California, where he now evaluates occupational health claims.
Decades of complaints that the physician disciplinary system is too lenient on sex-abusing doctors have produced little change in the practices of state medical boards. And the #MeToo campaign and the rapid push in recent months to increase accountability for sexual misconduct in American workplaces do not appear to have sparked a movement toward changing how medical boards deal with physicians who act out sexually against patients or staffers.
"There's been a failure of the medical community to take a stand against the issue," said Azza Abbudagga, a health services researcher with nonprofit advocacy organization Public Citizen.
She published a report recently detailing sexual misconduct among physicians. Its findings showed of the 253 doctors reported to the National Practitioner Data Bank for having been sanctioned by their respective hospitals or health care organizations for sexual misconduct, or paid a settlement that stemmed from such an allegation, 170 of them were not disciplined by state medical boards, even though all boards have access to the reports filed with the data bank.
Current guidelines from the Federation of State Physician Health Programs, which represents doctor rehab programs in 47 states, are largely silent on handling sexual misconduct treatment and describe sexual harassment as a "cause of impairment" in a doctor. Programs to treat doctor impairment are inherently supposed to be "non-disciplinary," per the federation's guidelines.
State-authorized programs that attempt to oversee the rehabilitation of doctors who have committed sexual misconduct aren't always forthcoming about their methods. In Florida, the Professional's Resource Network asked the AP to provide detailed questions and a list of sources before it would answer questions.
After the AP provided the head of the program, Alexis Polles, with basic questions about the program's approach to clearing doctors for return to work after instances of sexual abuse, she declined to answer any of them.
The lenience of penalties for sexually abusive doctors sometimes a source of frustration even for members of the medical board who administer the discipline, according to Jason Rosenberg, a former chairman of the Florida medical board.
"This is incredibly inappropriate," Rosenberg said during one 2013 meeting when Florida's medical board allowed James Yelton-Rossello, a psychiatrist alleged to have molested jailed psychiatric patients, to keep his license. The settlement with the Florida board of medicine did not require Yelton-Rossello to admit guilt.
"You can't do this and serve french fries," Rosenberg said at that meeting, citing some fast food restaurants' policies against hiring sex offenders. "I'm ashamed of what's going on here."
Yelton-Rossello's lawyer did not respond to telephone messages or an email request for comment.
In practice, even some lawyers who represent doctors find the physician health programs to be problematic. David Spicer, who has represented doctors facing medical board discipline in Florida, says the state's doctor rehabilitation program isn't well designed to evaluate or treat sexual misbehavior. The program's key component, he said, is a "one-size-fits-all" requirement that doctors engage in therapy sessions and not get into trouble for a specified period, generally five years.
Experts in the treatment of sexual misbehavior question whether the treatments mandated for doctors who molest patients are even appropriate for such misconduct.
"It's insufficient," said Rory Reid, a UCLA psychology professor who studies addiction and hypersexual behavior. "We have clinical trials for everything underneath the sun," Reid said. "But there's not one clinical trial that I'm aware of on the efficacy of treatment for doctors who have engaged in sexual misconduct."