A new bill making its way through the North Carolina Legislature seeks to ensure doctors are held accountable for sexually assaulting their patients. The bill is partly influenced by Larry Nassar, a former doctor and convicted serial sexual predator who, during his time at USA Gymnastics, molested hundreds of young girls and women.
The legislation, House Bill 228, cleared the House Health Committee on Tuesday and has been re-referred to the Committee on the Judiciary.
Rep. Greg Murphy (R), the legislature’s sole practicing doctor, sponsored the measure, which would make it a Class C felony for a doctor to communicate to a patient that sexual contact or penetration between them is necessary or would be beneficial to their health. It would also become a Class C felony for doctors to engage in sexual contact or penetration with a patient while the patient is incapacitated. In addition to this, doctors could be charged with other crimes for the same actions, such as rape.
The legislation would also require doctors to report suspected sexual violence and drug abuse by other doctors or risk losing their medical licenses.
Murphy’s office told ThinkProgress that although the bill was partly intended to update North Carolina Medicaid Board rules, Nassar’s crimes also motivated lawmakers to act.
Nassar was an osteopathic physician and associate professor at Michigan State University from 1997 to 2016, employment that overlapped with his role as the national medical coordinator for USA Gymnastics from 1996 to 2014. Over several decades, Nassar molested hundreds of young girls and women. In 2017, he was sentenced to 60 years in prison, in part due to the possession of 37,000 images of child pornography. In 2018, he was sentenced to an additional 40 to 125 years for 10 counts of sexual assault and 40 to 175 years in prison for seven counts of sexual assault, respectively.
Many, though not all, of his victims were abused under the guise of a legitimate medical procedure, which made it particularly difficult for victims to question his actions. He was a well-respected physician and his victims, who were girls and young women, were often not knowledgeable of their own bodies. He readily took advantage of these huge disparities in power.
“How was I supposed to know at the age of 13 what was medically acceptable and what the boundaries were?” Kara Johnson, one survivor of Nassar’s abuse, said in her statement.
Melissa Imrie said that in 1997, when she was 12 years old, Nassar said he needed to massage her muscles anally to treat a fractured tailbone. He then penetrated her vagina with his fingers.
“I just remember being in so much pain, tears streaming down my face, holding onto the table, just shaking, screaming, gritting my teeth,” she said of the experience.
A number of people in positions of authority enabled Nassar’s predation of gymnasts, including those on the U.S. Olympic Committee, as well as law enforcement. No one told the Michigan Medical Board about allegations against Nassar in time to prevent a slew of sexual assaults against gymnasts. In 2017, after an administrative complaint was filed by the state attorney general’s office, Nassar’s license was temporary revoked, and then permanently revoked in 2018.
The North Carolina bill seeks to address the issue of enablers within its reporting system. “If there is a process where someone is being accused, then the medical board needs to know about that and be able to track that,” Murphy told WRAL.
Research and media investigations on physician sexual violence suggests that major reforms are necessary to stop doctors from preying on patients for years without any accountability. In cases where medical boards have been alerted to sexual harassment and assault by doctors, many doctors have ended up keeping their licenses, a 2018 Associated Press investigation found. When doctors did experience some form of discipline, they were often given a short suspension and mandatory therapy. A 2016 Atlanta-Journal Constitution investigation revealed similar findings.
Azza Abbudagga, a health services researcher with Public Citizen, shared her report on sexual violations by physicians with the AP. Her report looked at 253 doctors reported to the National Practitioner Data Bank, a computer database run by the U.S. Department of Health and Human Services, who were sanctioned for sexual misconduct or paid a settlement due to a sexual misconduct allegation. Out of those 253 physicians, 170 were not disciplined by their state medical boards.
A 2017 study researching sexual abuse by doctors found that in the 101 sexual violation cases they studied, 69 percent of whistle-blowers were patients, 94 percent of cases involved investigations by medical boards, and 89 percent involved criminal prosecutors. In 87 percent of the cases, the perpetrator lost or surrendered their medical license. But the article notes that this loss was often temporary or restricted to one state.
The researchers couldn’t accurately estimate the prevalence of sexual violations in medicine but wrote that when it does occur, it is usually repeated behavior and physicians perpetrate these violations for years before they are stopped. Researchers recommended reform among state medical boards and the National Practitioner Data Bank and said the American Medical Association and Federation of State Medical Boards should provide more leadership on the issue, such as “developing policies and procedures to prevent the transfer rather than removal of perpetrators.”
Michigan recently reintroduced legislation inspired by the Nassar abuse case that would include coaches and trainers in the state’s mandatory reporter law, take steps to ban people in authority from interfering with sexual assault and harassment reports, and provide more options for judges to admit evidence of a defendant’s history of sexual assault. Last fall, then-California Gov. Jerry Brown (D) signed a law requiring doctors to tell patients if the state medical board put them on probation for sexual misconduct, drug abuse, or improper prescribing.