Exclusive: After sex therapy, sanctioned doctors returned to practice

Since 1999, 48 Ohio doctors disciplined for sexual misconduct were given a chance to regain their licenses.

Dozens of Ohio doctors sanctioned for sexual misconduct involving their patients have been allowed to continue practicing medicine after completing confidential counseling and therapy that even their counselors say is ineffective in many cases.

And the number of those eligible for reinstatement continues to grow as sanctioned doctors meet the terms and conditions that allow them to return to practice while their patients in many cases remain unaware of their past transgressions.

Dr. Craig Whitaker Johnson, a Miami Valley pediatrician whose license was suspended in 2014 for sexual misconduct, can reapply for an Ohio medical license this fall after completing courses on personal and professional ethics approved by the State Medical Board of Ohio.

Johnson’s suspension resulted from a January 2012 incident in which he asked a then 23-year-old female patient during a job interview to disrobe for a physical exam as part of her screening for a clerical position at his now closed Middletown office, where he had practiced since 1985.

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Johnson is one of at least 48 Ohio doctors since 1999 who were referred for treatment by the state medical board as part of a sanction for sexual misconduct, according to an investigation this newspaper did of Ohio medical board records compiled by the Atlanta Journal-Constitution as part of a national study.

An investigation by this newspaper last month found that several Ohio doctors were allowed to continue practicing even though they were sanctioned for sexual misconduct by medical boards here and in other states.

Between 1999 and 2015 the Ohio board received 75,584 complaints about doctors, including 1,360 that involved sexual misconduct allegations, the newspaper’s investigation found. About 17 percent of the sexual misconduct complaints resulted in disciplinary action, according to the board.

Ohio Medical Board officials say they refer all criminal cases to law enforcement. But when a physician’s actions “do not violate the law but are not just not appropriate,” they are referred instead to mandatory therapy or “a personal/professional boundaries and ethics course,” said Tessie Pollock, a spokeswoman for the state medical board.

Pollock said cases of doctors needing therapy for sexual misconduct are rare. Advocates also say the system protects patients by instituting monitoring and reporting requirements while allowing physicians who cross ethical boundaries to get help.

But victim advocates say more protections are needed to safeguard patients from doctors who struggle with sexual disorders. In Ohio, patients may not know about a doctor’s previous history when entering an examination room because state law does not require physicians to notify patients when administrative discipline is imposed.

Doctors ordered to undergo treatment are referred by the medical board to a handful of state-approved facilities or to individual psychiatric counselors. Typically the treatment is used as a condition for having their license reinstated.

The Columbus-based Ohio Physicians Health Program, which evaluates and assists doctors in finding treatment for a wide range of conditions — from stress to substance and sexual abuse — said the program’s goal is “to inspire physicians and other health care professionals to seek treatment and monitoring for their illnesses in order to ensure patient care and safety,” according to the organization’s website.

Dr. Craig Whitaker Johnson

The 23-year-old woman told a medical board hearing examiner that Johnson said she was to strip naked and wait for his return during the January 2012 visit to his office in Middletown. She said she was scared and vulnerable, mainly because Johnson had been her doctor since she was two months old.

“I would say he was more of a family friend,” she said when asked to describe her relationship with Johnson. “He came to my high school graduation. We trusted him with everything.”

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In his testimony, Johnson said the suspension of his license was the result of a misunderstanding. He said the woman misinterpreted his directions, and that he only wanted her to remove a heavy sweater so he could take her blood pressure.

But the woman, who is not identified in the transcript, testified that the doctor’s instructions were clear. She said she asked him if he wanted her to “take everything off” and he replied, “Yes, everything.” He then walked out of the exam room without offering her a gown.

She was so suspicious of his motives she said she formulated an “escape plan” just in case the doctor tried to touch her.

“I was hoping I was going to be getting a gown, but I also in my…in the back of my head was thinking ‘how am I going to get out of this?’” she testified.

Johnson could not be reached for comment.

The doctor told the medical board he was “shocked” to find the woman sitting naked on the exam table when he returned. But he did not ask her to cover herself when he later directed her to walk down a hallway to another room to be weighed as part of the physical, which he admitted he never completed or had given to any other applicant for a clerical position.

When they returned from the weigh-in, the woman asked Johnson if she could get dressed. She said the doctor agreed but remained in the room while she put her clothes on, and then said, “I know this is embarrassing, but if you asked me to do it, I would. Go ahead and ask me.”

The woman testified that she interpreted his comments to mean “that if I wanted him to take everything off, then he would.”

She reported the incident to her parents and to Middletown police, the woman said, but the police did not arrest Johnson. She later filed a lawsuit against the doctor, eventually settling out of court, according to state medical board records.

After reviewing the testimony, the hearing examiner determined the doctor was not credible, writing, “His explanation of events defied common sense,” and recommended his license be permanently revoked.

However, the board, comprised predominantly of medical doctors, rejected the recommendation and instead voted to suspend his license for two years and specified conditions for reinstatement, including taking a course on maintaining doctor-patient boundaries.

>>>EXCLUSIVE: Ohio doctors kept practicing after sexual misconduct

Such programs are not designed to treat doctors who may have serious sexual disorders, said William Swiggart, a psychotherapist at the Vanderbilt University Center for Professional Health — one of the handful of medical board-approved programs that handle referrals from Ohio.

“My program is an educational program, so it’s really not treatment,” Swiggart said. “I know the public gets upset, and should, at some of the egregious behavior by doctors, including some things that amount to rape or abuse. For those people, I don’t think our course is appropriate. It’s not designed to stop that, nor does it.”

The Vanderbilt Center’s three-day program hosts about 50 doctors a year for what it calls sexual-boundary training, which includes a 30-minute instructional video: “Hazardous Affairs: A Course on Practicing Smart.” The video is intended to “raise awareness of behaviors that can start you on the slippery slope to sexual misconduct,” according to the center’s website.

Sometimes physicians who complete treatment are allowed to return to practice under strict limitations.

Dr. Laurence I. Kleiner, a neurosurgeon at Dayton Children’s Hospital, was required to seek treatment and counseling after he was reprimanded in 1999 by the board of directors of Carilion Medical Center in Roanoke, Va., for conduct toward staff members that was deemed to constitute sexual harassment, according to medical board records from Ohio, where Kleiner received a probationary medical license in 2002.

Kleiner, who declined comment when reached at Dayton Children’s, participated in a treatment program from May 1999 to January 2001 that included therapy and medication for issues related to “depression and anxiety,” according to Ohio medical board records.

Kleiner signed a consent agreement with the medical board that required him to limit his work hours, practice with a monitoring physician and continue psychiatric treatment.

The Ohio board records show that Kleiner in 2001 was diagnosed by a medical team at a Chicago-area health care facility with a “history of adjustment disorder” and a personality disorder with “narcissistic features.” The consent agreement stated that the adjustment disorder with “mixed depression and anxiety,” was resolved.

His probation was lifted by the medical board in March 2007.

Swiggart said many physicians are unaware of when they’ve crossed a line into inappropriate behavior.

“We talk about what the rules are, why they are there, and we also talk about boundary issues that are not unethical but could lead to, at minimum, the perception of unethical or sexual misconduct. We discuss things like going out, and having dinner with a patient,” he said. “Dinner itself is not unethical, it’s just not smart. We refer to that as a boundary crossing, not a boundary violation.”

Sexual misconduct can range from flirtatious comments from doctors toward patients to inappropriate touching to rape, said Swiggart.

“To some degree, we depend on the medical boards to screen folks who need treatment as opposed to folks who need education,” he said.

Dr. Rick St. Onge

The West Virginia Board of Medicine in 2009 revoked the medical license of Dr. Rick St. Onge, who exposed his genitals to a female patient in 2008 and allowed her to take a picture of them with her cell phone.

But St. Onge received more lenient treatment from the State Medical Board of Ohio, which suspended his license but left room for him to return to practice if he sought treatment and met conditions for reinstatement.

St. Onge worked in the obstetrics and gynecology department at the Holzer Clinic, which has offices in West Virginia and Ohio. He admitted exposing himself to his patient in his testimony to the Ohio board, saying he became aroused after she first exposed herself to him.

“It was, you know, I showed you mine; you show me yours sort of thing,” testified St. Onge, who worked in the clinic’s offices in Gallipolis and Jackson, Ohio. “You know, it was just insane and I did it.”

The Ohio board records also show that after she inquired about nude beaches in Florida, he shared information with her about a particular beach in Miami, along with directions on how to get there. He never saw her outside his office, he said, but engaged in behavior that he acknowledged was inappropriate.

“We never had sex. We never had intercourse. We never had oral sex,” he told the board. “It was mutual fondling.”

Medical ethicists say even consensual contact between doctors and patients is forbidden because of the patients’ vulnerability and the inherent power physicians have over their patients.

St. Onge admitted to the board that he was “impaired in his ability to practice” during the state’s investigation of the case.

During a vote to suspend St. Onge’s medical license, one board member voiced concerns about the possibility of St. Onge returning to practice as an OB/GYN and moved for a vote on permanent suspension of the doctor’s license.

The board instead allowed for reinstatement under certain conditions. After two years of therapy and psychiatric treatment, St. Onge in 2012 was granted permission to practice again in Ohio.

St. Onge is now the medical director at Columbus Aesthetics & Women’s Health in Gahanna, a Columbus suburb. Several messages seeking comment were left at the office.

According to his Ohio medical board records, St. Onge must have a witness when he is alone with any patient. He is still undergoing psychotherapy sessions, but in January of this year the board granted his request to reduce those sessions to once a month.

Dr. Arlan Marcus Gustilo-Ashby

A Miami Valley doctor whose Ohio license was suspended in 2006 had it reinstated under probation in 2007. After participating in a sexual addiction recovery program, his probation was lifted in 2010.

Dr. Arlan Gustilo-Ashby (Marc Ashby) is a licensed OBGYN currently working with the Kettering Physicians Network in Centerville.

The medical board suspended Ashby’s license when it came to light he had an improper sexual relationship with a patient while working on a Navajo Indian Reservation in northern Arizona.

Ashby, who did not return messages seeking comment left with his administrative assistant, told the Ohio medical board the relationship with the patient lasted for about a year. It ended when he moved to Cleveland in 2004, he said.

The patient filed a lawsuit against the federal government because he was a government employee, Ashby told the board.

“He settled the suit with her, and then sought an evaluation for sexual addiction because he realized that what he had done was wrong,” Ohio medical board records show.

The medical board and Ashby entered into a consent agreement that required him to continue counseling, have his work monitored by another physician and participate in a sexual addiction recovery program.

A requirement of the program was that he complete more than 100 weekly therapy sessions at the The Cleveland Clinic Foundation and attend at least two meetings of Sex and Love Addicts Anonymous per week for two years, the medical board records show.

The medical board voted in August 2010 to release him from the requirements.

Recovery is not guaranteed for many people diagnosed with sex addiction — even after years of therapy, said Dr. Jerald Kay, former professor and chair of the Department of Psychiatry at the Wright State University Boonshoft School of Medicine.

>>> COMPLETE SERIES: Find the entire AJC investigation

“The problem with sexual addiction is there is no short-term fix for it,” said Kay, a psychiatric counselor approved by the state to treat doctors sanctioned for sexual misconduct. “It requires really intensive in-depth psychotherapy. It’s not something that can be fixed in 12 sessions. The people that I have had success with are people who I have been seeing on a weekly basis for three, four or five years, and never really crossed that line.”

Kay said he believes many instances of sexual misconduct go undetected because most doctors who cross the line have a “deep-lying personal deficit or enduring psychological problem” that’s only discovered when their behavior has been exposed and they’re forced to seek treatment.

“It’s important to note that people who do this, they continue to do it with multiple patients, ” he said. “Many of these cases are only brought to attention when another patient finds out about it and other people come forward.”

Staff Writer Josh Sweigart contributed to this report.

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