Category Archives: psychiatry

Study concludes that psychiatrists almost four times as likely to be sanctioned for sexual misconduct

The new analysis of a decade of discipline cases across Canada more than confirmed anecdotal evidence and a previous study that suggested a problem with psychiatry, said Dr. Chaim Bell of Toronto’s Mt. Sinai Hospital, who co-authored the paper.

Psychiatrists are twice as likely as other Canadian doctors to face professional discipline generally and almost four times as apt to be sanctioned for sexual misconduct, concludes a new study that underscores long-held concerns about the speciality.

Experts blame the problem in part on psychiatrists’ unusually close and long relationships with their patients, compared to surgeons and some other specialists who often have relatively brief contact with the people they treat.

Past research has suggested many of the wayward therapists may also be “lovesick,” middle-aged men in isolated practices who fall for younger women, the study notes.

Regardless, the new analysis of a decade of discipline cases across Canada more than confirmed anecdotal evidence and a previous study that suggested a problem with psychiatry, said Dr. Chaim Bell of Toronto’s Mt. Sinai Hospital, who co-authored the paper.

“This is surprising in how consistent it is across the various provinces, how consistent it is in different years, and how consistent it is with penalties and fines,” he said. “It’s also consistent with the sort of sensational, one-type anecdotal coverage you might get…. The [discipline case] that gets the front page is often the psychiatrist.”

Just this month, in fact, at least two psychiatrists have been in the news for sexual-abuse allegations. A London doctor under investigation by the Ontario College of Physicians and Surgeons for allegedly masturbating and inappropriately videotaping female patients was charged by police with sexual assault and voyeurism. In Calgary, meanwhile, a psychiatrist is being tried on charges of sexually assaulting 10 male patients.

Dr. Bell, an internal-medicine specialist, stressed that it is still a small percentage of psychiatrists — about two per thousand — who get in trouble with their regulatory colleges. Given the “catastrophic” effect even rare cases of misconduct can have on patients and the public trust, however, psychiatry must do more to curb wrongdoing, the study’s authors say.

At the same time, the average psychiatrist who faced discipline over the 10-year study period had been practising for more than 30 years, perhaps reflecting a shrinking generation of practitioner, said Dr. Molyn Leszcz, Mt. Sinai’s chief of psychiatry.

Younger psychiatrists have been exposed to training on appropriate boundaries with patients, are more conscientious about their own emotional health and actually do their jobs differently, said Dr. Leszcz, who was not involved in the study. They are more likely to practise with groups of other doctors and spend less time in one-on-one psychotherapy sessions, he said.

“If you sit in your office and experience the kinds of strong feelings that get generated in psychotherapy all the time, in isolation, then it becomes harder to maintain professional perspective,” said Dr. Leszcz.

Still, the results from Dr. Bell’s study are “disappointing” in light of the measures taken to combat sexual abuse, said Dr. Donald Addington, chair of the Canadian Psychiatric Association.

“This kind of report makes us think about ‘What more could be done?’ and at this point, we don’t have a particular new plan or direction,” said the University of Calgary professor.

Dr. Bell said the regulatory colleges in each province do little tracking themselves of trends in discipline, so he and his colleagues developed a database of physicians punished for wrongdoing from 2000 to 2009, a total of just over 600 cases.

Psychiatrists made up 14% of that number, twice their percentage in the medical profession, concluded the study, just published in the journal Plos One. They were 3.62 times more likely than other physicians to be found guilty of sexual abuse of patients, had 2.32 times more chance of being convicted of fraud-related discipline offences, and were three times as apt to be found guilty of unprofessional conduct, the paper said.

Little research has been done on psychiatrists who “violate boundaries” with patients, but one 1989 study suggested a small number are actually psychotic, a somewhat larger group show antisocial or exploitative behaviour, and the largest category are the “lovesick” — typically neurotic, socially isolated middle-aged men who fall for much younger patients.

A 1997 Canadian study that followed a group of new psychiatrists over time concluded that the two who were eventually convicted of sexual abusing patients had identifiable personality problems even while still in training.

That raises the “ethically challenging” prospect of screening medical students for sexually exploitative tendencies before they are assigned to specialty training, the new study noted.

It is simply unclear, meanwhile, why a disproportionate number of psychiatrists are found guilty of fraud-related discipline charges, he said.

Source: Tom Blackwell, “Psychiatrists four times as likely as other Canadian doctors to be disciplined for sexual misconduct: study,” National Post, December 6, 2012.

University of Alberta head of psychiatry resigns over Ontario sexual misconduct allegation

The University of Alberta’s new head of psychiatry has resigned his position less than two weeks after CBC News revealed he faces an allegation of sexual misconduct involving a female patient in Ontario.

Dr. Claudio Soares resigned as head of the University of Alberta’s psychiatry department.Dr. Claudio Soares resigned as head of the University of Alberta’s psychiatry department. (McMaster University)

Dr. Claudio de Novaes Soares, incoming chair of the department of psychiatry, resigned effective immediately, according to a letter to university staff on Monday.

Soares was to assume the role of chair on September 1, but was placed on a leave.

Documents obtained by CBC News showed the Ontario College of Physicians and Surgeons is investigating an allegation that Soares had sexual relations with a woman who was a patient between November 2007 and May 2009. At that time, he was a professor at McMaster University in Hamilton.

A date for the hearing has not yet been scheduled and none of the claims have been proven by the Ontario college.

Soares’ departure was announced by the dean of the faculty of medicine and dentistry, Dr. D. Douglas Miller, in a letter to staff and colleagues Monday.

Dr. Glen Baker, currently director of the neurochemical research unit at the University of Alberta, has been appointed interim chair.

Baker served as department chair from 2000 to 2005 and acting chair from 2005 to 2006.

Source: “New U of A psychiatry chair quits amid sex allegations,” CBC News, September 24, 2012.

UK psych nurse accused of sexual assault of female patients

A male nursing assistant told a mental health patient that he would put her “in the book” if she did not allow him to sexually assault her, a court heard today.

Foday Chorr, 46, is accused of sexual assaulting two female patients at Eastbourne District General Hospital  between June 10 and 21 last year.

Opening the case at Lewes Crown Court, prosecutor Michael Riley described the two women as “vulnerable” and having “mental health issues”.

In one incident, the victim said Chorr walked into her room and asked her what relaxed her, Mr Riley said.

She answered that when she had been pregnant she liked to have her feet massaged and Chorr offered to do this for her.

Mr Riley told the jury: “(The victim) said she didn’t want him to, that she was just answering the question.

“He said he would put her ‘in the book’ and report her as being obstructive… if she didn’t let him do it.”

Mr Riley said Chorr, from Shropshire, then proceeded to massage her feet and move his hands up and down her legs.

He added: “She felt she had to comply with the threat… he was a nurse at the hospital, she was a mental patient. She froze, she was shocked.”

Chorr then kissed her before leaving.

The following night, a similar incident occurred except that, when he touched her legs, his hands moved further towards her thigh.

The victim reported the incident after she was discharged and was asked to fill out a questionnaire about her four-day stay at the hospital.

In a second case, the victim made her complaint hours after it happened, Mr Riley said. She was in her bed reading when Chorr came into her room late at night, the jury was told.

Chorr said he was going to tickle her and she said she did not want him to. He then tickled her feet and moved his hand up and down her leg before leaving.

Mr Riley said: “She said she felt scared and shocked.” Chorr then came back a second time and touched the victim on her thigh.

On his third visit that night, the victim awoke to find her covers off, her nightgown lifted up and Chorr standing at her bedside, while she had no underwear on.

He told her to “cover up”.

Mr Riley said on the third occasion, the victim claimed Chorr also touched her leg and pubic area.

“She was scared and didn’t think she could do anything about it before (Chorr) had left.”

Chorr, of Shorncliffe Drive, Shrewsbury, denies five counts of sexual assault on the two female patients while working as a psychiatric nursing assistant at the hospital.

The trial, before Judge Richard Haywood, continues.

Source: Eastbourne psychiatric nurse sexually assaulted two patients, court hears, The Argus, September 24, 2012.

State charges psychiatrist Richard J. Pines with sex abuse of children

The Idaho State Board of Medicine has filed a complaint against a Boise child and adolescent psychiatrist alleging he had improper sexual contact with four former patients or foster children and had a three-year affair with an adult patient to whom he was prescribing painkillers.

The complaint against Dr. Richard J. Pines was filed on June 28 and alleges abuses dating back to June 2001. He has denied the allegations in his response to the board. Pines’ attorney, David Cantrill, declined comment.

The board is seeking a hearing on whether Pines’ license should be suspended or revoked or if he should face other punishment. No criminal charges have been filed.

The board’s complaint alleges that in two cases Pines told young men he needed to practice giving massages to naked bodies to maintain his medical license and improperly touched them, including one who was 14.

Pines acknowledged taking naked pictures of another patient who was about 14 while they were at Pines’ cabin in Garden Valley and acknowledged taking money to that patient before Pines was interviewed by Boise police in March 2011, the board’s complaint alleges.

In January 2011, the board alleges Pines told a former foster child that he needed a “test patient” on whom to practice hernia exams and that he acknowledged giving that person $2,000 after the incident.

The board also alleges Pines prescribed controlled substances to an adult patient with whom he had a three-year affair without records showing that the patient needed the medication. The board said the last prescription, for acetaminophen and codeine, was filled in June 2010.

Pines has been licensed to practice medicine in Idaho since June 1997 and has worked at several places including Boise Public Schools and Saint Alphonsus Health System.

Source: “Medical board files complaint against Boise doctor,” Associated Press, August 27, 2012.

This would not be the first time a psychiatrist weasled his way into a patient’s business…or her undergarments

INSTEAD of hearing details of the intimate relationship between psychiatrist Ray Berard and patient Sylvia Ireland, the Health Professions Council of South Africa (HPCSA) heard reasons why the hearing should be postponed.

The professional conduct inquiry was expected to go ahead yesterday and today, but Berard’s representative, Graham van der Spuy, instead argued for a postponement to allow for more preparation time.

In July 2008 Ireland wrote to the HPCSA accusing her former psychiatrist of having used her therapy sessions, for more than two years, to have sex.

Her husband Stuart Ireland, a high-profile businessman in the beauty industry, was footing the bill for the sessions.

Stuart Ireland died two years ago while attempting to obtain a divorce, citing her affairs and lavish spending as reasons for the end of the marriage.

Sylvia Ireland said Berard used his position as her psychiatrist and marriage counsellor to prescribe her a number of drugs, blackmail her into having sex, control her marriage, and go into business with her husband.

According to the news magazine Noseweek, Stuart Ireland appointed Berard as a director of his company Prestige Cosmetics while the psychiatrist continued to send erotic SMSes to Sylvia Ireland.

Sylvia Ireland then confessed details of the affair to her husband, prompting Berard to resign as director.

Dressed all in black with a leopard print jacket, Ireland stared straight ahead throughout the hearing at the Belmont Conference Centre in Rondebosch, Cape Town, yesterday, avoiding eye contact with Berard.

According to the charge sheet, Berard was guilty of unprofessional conduct in that, during the period October 2005 until February 2008, he had a doctor-patient relationship with Ireland.

The charge sheet said Berard had “Misused the position of trust and confidence towards your patient by entering into an intimate physical relationship with her and/or having sexual intercourse with her.”

The hearing continues.

Source: Michelle Jones, “Bid to delay psychiatrist’s sex case,” Independent Online, URL: http://www.iol.co.za

French psychiatrist sentenced to eight years prison; told patients it was part of treatment

A former psychiatrist in the Loire-Atlantique region of France was sentenced to eight years in prison on Friday for raping three of his patients. Charles Caillé, 68, told female patients the abuse was part of their treatment.

He was tried for rapes committed against three women in his care between 1998 and 2000.

A fourth patient filed a complaint against Caillé in October 2009, but the case could not be brought to trial since the alleged rapes took place more than 10 years earlier.

“He’s a liar and a manipulator but also a pervert and predator,” said prosecuting attorney Yves Gambert. “He used his intelligence to satisfy his sexual desires.”

Caillé admitted “mistakes” but denied raping his patients, claiming that the sex was consensual.

“I ask my victims for forgiveness, I’m not proud of myself,” Caillé told the court, sobbing, as the jury prepared to deliberate its verdict. “I want to thank my patients for accusing me. It enabled me to see how far wrong I had gone.”

Source: “Former psychiatrist jailed for raping patients,” RFI, March 18, 2011.

California psychiatrist David Neal Glaser gets probation for “romantic-sexual relationship” with patient; prescribing without exams

On November 17, 2010, the Medical Board of California placed psychiatrist David Neal Glaser on probation for two years with terms and conditions.

The circumstances of this action involve charges of gross negligence and prescribing without appropriate examination and medical indication, among other things.

According to the Board’s documents, Glaser treated a female patient whom he met at a social gathering in December 2003 and with whom he carried on a romantic-sexual relationship for approximately a year.  Glaser did not treat the patient/girlfriend in his office and did not keep usual and customary treatment records on her, save for one which was “a compilation of information obtained over a period of ‘several months’.”

Glaser prescribed the patient a preparation used to prevent/terminate an unwanted pregnancy but did not have any records to support the use of this agent; no evidence of having performed a history or physical examination or even the use of a pregnancy test to substantiate the need for the agent, among other things.

Further, Glaser’s aforementioned single reatment note for the patient contains diagnoses in absence of documentation, substantiation, testing, etc.

The state’s document contains several other similar examples of Glaser’s negligent treatment of the patient in lieu of substantiation.

Source: Stipulated Settlement and Disciplinary Order and Accusation in the Matter of David Neal Glaser, M.D., Physician’s and Surgeon’s Certificate Number G 40041, Case No. 17-2007-184665, Medical Board of California Department of Consumer Affairs, filed December 14, 2009.