Keep Quiet, Lose Your License? Physicians’ Duty to Report a Colleague’s Sexual Misconduct

New York Gov. Andrew Cuomo is just the latest in a long and infamous line of high-profile individuals to find their careers and reputations threatened by allegations of sexual harassment and misconduct. In most of these cases, from Larry Nasser to Harvey Weinstein to Jeffrey Epstein to countless others, the focus is justifiably on the alleged perpetrators of these abhorrent actions. But in the wake of the #metoo movement, many organizations and professions have come under scrutiny for their tacit complicity in allowing such conduct to go unchecked or unreported.  

Specifically, others who may have been aware of misconduct turned away or failed to take action which could have prevented further abuses and spared other victims. For physicians and other medical professionals who learn of a colleague’s misconduct  – sexual or otherwise – the failure to report such wrongdoing is not just a moral failure. It can be a breach of professional ethics that threatens their professional licenses as well.

Ethical Obligation to Report Misconduct

The duty to report misconduct within the medical profession is often the only way such transgressions can get the attention of professional licensing boards such as the Illinois Department of Professional Regulation (IDFPR) as well as law enforcement. As the Federation of State Medical Boards (FSMB) put it in its sweeping 2020 Report and Recommendations on Physician Sexual Misconduct:

“In a complaint-based medical regulatory system, it is… essential that patients, physicians and everyone involved in healthcare speak up whenever something unusual, unsafe or inappropriate occurs. All members of the healthcare team, as well as institutions, including state medical boards, hospitals and private medical clinics have a legal as well as an ethical duty to report instances of sexual misconduct and other serious patient safety issues and events. This duty extends beyond physician-patient encounters to reporting inappropriate behavior in interactions with other members of the healthcare team, and in the learning environment.”

Similarly, the Council on Ethical and Judicial Affairs of the American Medical Association (AMA) admonishes that, “A physician should expose, without fear or favor, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.”

However, while the Illinois Medical Practice Act allows for physician reporting of a colleague’s unethical behavior, it neither requires it nor makes a failure to report a basis for disciplinary action.  It provides that licensed physicians “may report to the Disciplinary Board any information the physician… may have that appears to show that a physician is or may be in violation of any of the Act’s provisions.”

But just because reporting sexual misconduct is not mandated under the Act doesn’t mean that failing to report physician sexual misconduct isn’t an ethical violation. “The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in… the ethical standards of the profession,” according to the AMA.

The FMSB was more strident in its 2020 report, concluding that the failure to report sexual misconduct should result in disciplinary action: “Physicians who fail to report known instances of sexual misconduct should be liable for sanction by their state medical board for the breach of their professional duty to report.”

AMA Reporting Guidelines

The AMA has set forth guidelines for how physicians should respond to and report information about a fellow doctor’s patient misconduct. Physicians who become aware of or strongly suspect that conduct threatens patient welfare or otherwise appears to violate ethical or legal standards should:

  • Report the conduct to appropriate clinical authorities in the first instance so that the possible impact on patient welfare can be assessed and remedial action taken.
  • Report directly to the state licensing board when the conduct in question poses an immediate threat to patients’ health and safety or violates state licensing provisions.
  • Report to a higher authority if the conduct continues unchanged despite initial reporting.
  • Protect the privacy of any patients who may be involved to the greatest extent possible, consistent with due process.
  • Report the suspected violation to appropriate authorities.

Regardless of the language contained or not contained in licensing statutes, professionals of all stripes should seize the moment and no longer remain silent when they become aware of harassment or misconduct. While the damage done to victims of sexual misconduct is exponentially greater, the damage to your professional reputation and career could be catastrophic if it is discovered that you were tacitly complicit in allowing such misconduct to continue. 

Louis Fine: Chicago Physician License Defense Attorney

As a former Chief Prosecuting Attorney and administrative law judge for IDFPR, I have seen the serious consequences that an adverse enforcement decision can have on professionals who suddenly find their future in disarray. I understand how and why the Department decides to pursue investigations against physicians, how it handles negotiations, and how to approach formal proceedings in a way that gives my clients the best possible chance of a positive and expeditious outcome.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. Together, we will get you back to your clients and your career.

Discredit Check: What CPAs Need To Know About Career-Threatening “Acts Discreditable To The Profession”

Certified Public Accountants have countless ethical responsibilities to their clients. The American Institute of Certified Public Accountants (AICPA) Code of Professional Conduct is almost 200 pages long, containing detailed and dense descriptions of the many ways in which CPAs can put themselves in danger of losing their professional license and their career. But one of the most dangerous provisions in the code for CPAs is one that can encompass a wide range of professional – and personal – indiscretions: “acts discreditable to the profession.”

Such acts are prohibited in Section 400.1 of the AICPA Code of Professional Conduct. Similarly, an “act discreditable to the public accounting profession” is considered unprofessional conduct under the Illinois Public Accounting Act that could subject a CPA to disciplinary action by the Illinois Department of Financial and Professional Regulation (IDFPR).

But what kind of acts bring discredit to the accounting profession? Are they limited to a CPA’s performance of their professional engagements, or can they extend into private decisions or actions that do not directly relate to the services they provide clients? These open questions, and the broad contours of the rule, should give every CPA pause as they evaluate their conduct in all spheres of their life.

Personal Choices, Professional Consequences

The AICPA Code does not clearly define what constitutes “acts discreditable.” However, it does provide specific examples of such conduct, most of which are relatively obvious and baseline ethical violations that relate to work performed for clients or their professional interactions with the public generally, such as:

  • Negligence in the preparation of financial statements or records.
  • Failure to respond or comply with requests or obligations imposed by governmental bodies, commissions, and regulatory agencies.
  • Failure to follow specified government standards, guides, procedures, statutes, rules, and regulations in conducting a governmental audit.
  • Unauthorized disclosure of an employer’s confidential information.
  • Unauthorized removal or use of client files.
  • False, misleading, or deceptive acts in marketing or promoting their professional services.

But Section 400.1 of the code also specifically identifies proscribed conduct that does not directly relate to their services for or interactions with clients, government bodies, or the general public. Instead, they involve personal choices and behaviors that, according to the AICPA, reflect poorly on – and bring discredit – to the profession as a whole:

  • Discrimination and harassment in employment practices.
  • Failure to file a personal tax return or pay a tax liability.
  • Cheating on the CPA exam.

Disciplinary Action For “Social Crimes”

These specified personal transgressions seem like no-brainers in terms of exposing a CPA to licensing and ethics trouble. The problem is that AICPA has left the door open for the possibility that other personal conduct could constitute an “act discreditable.” And state licensing bodies have shown that they have no problem walking through that door.

A 2016 study looked at how “social crimes,” that is, those that do not directly involve a CPA’s performance of their professional duties, are often the basis for disciplinary action. Such acts include driving under the influence, nonpayment of child support, and drug possession. These violations comprised 10.3 percent of the disciplinary action taken by state boards of accountancy in California, Illinois, New York, Texas between 2008–2014.

Other federal or state convictions, including financial felonies and misdemeanors unrelated to professional engagements, make up 27% of the disciplinary actions. These include such things as money laundering, drug dealing, immigration fraud, and assault.

But if something like driving under the influence, as serious a transgression as it may be, brings “discredit” to the accounting profession, it raises the possibility that other conduct equally unrelated to the actual work of a CPA could be the basis of professional discipline. For example, if a CPA was involved in the attempted coup and terrorist attack at the Capitol on Jan. 6, would that be a “discreditable act” regardless of any criminal charges? Even the possibility of such blowback should make CPAs think long and hard about their actions, even when they are off the clock.

Louis Fine: Chicago CPA License Defense Attorney

If you are a CPA, the moment the IDFPR contacts you is the moment you should contact me. I will immediately begin communicating with IDFPR prosecutors and work with you to develop the strategy best suited to achieving the goal of an efficient, cost-effective outcome that avoids any adverse action. Together, we will get you back to your clients and your career.

Please give me a call at (312) 236-2433 or fill out my online form to arrange for your free initial consultation. I look forward to meeting with you.

Your Choice of a Lawyer Matters. Here are Four Qualities to Look For.

What-To-Look-For-in-a-LawyerI meet with new clients and potential new clients on an almost daily basis. When I do, I know that the reason they are in my office is because they have important issues that need to be addressed; issues that can have a profound impact on their career, family, and future.

I also know that the decision as to which attorney they hire to assist them is one that they don’t, and shouldn’t, take lightly. There is no question that the quality and competence of an attorney can play a significant role in the outcome of a given matter, and how that attorney approaches his practice and relationship with clients can make the difference between peace of mind and constant worry.

Based on my experience, here are some qualities you should consider if you are in the process of looking for an attorney:

  • Knowledge of the Law. It goes without saying that your lawyer should know what he’s doing, and that includes keeping up to date on new developments and approaches. The law is constantly changing; new legislation, court decisions, rules, and guidelines come out all the time. It is crucial to hire a lawyer who not only understands the law as it is but who is aware and alert to the impact of changes which may take place.
  • Experience. So much of what happens in a legal matter is not based on things that can be found in books; knowing the nuances of both the law and the reality of practice is crucial to obtaining successful results. Look for a lawyer who knows their way around the courthouse, hearing room, or conference room. Look for a layer who knows how things work, and knows how things get done. Sound judgment and insight isn’t learned at a seminar. That is something that only comes from years of experience.
  • Communication. You no doubt have many questions about your situation, what may happen next, and what the plan should be going forward. Throughout your case, you’ll want to know that when questions and concerns come up, your attorney will be there, available and ready to answer and resolve them. You also want a lawyer who will actually listen to you and who will take the time to understand your needs and goals.
  • Empathy and Trust. When you meet with a lawyer, you are not there necessarily to discuss a case or a file; you are talking about your life. You want an understanding and compassionate lawyer who you can speak to about your concerns and issues and you want to feel as if they truly care and understand what is at stake. Choose an attorney who makes you comfortable, who is trustworthy and ethical, who you feel will truly expend all necessary efforts on your behalf, and who gives you a feeling of peace of mind every time you leave his office or hang up the phone after speaking with him or her.

The attorney-client relationship is a unique and important one, and the trust you place in your lawyer is something he or she should value and work every day to earn.