Politics

11.29.12

Scott DesJarlais Crossed the Line by Having Sex With Patients

The ‘family values,’ anti-abortion GOP congressman has tried to explain away his affairs and alleged suggestions that one or two sex partners have an abortion, but his sleeping with patients is unacceptable—and tars all physicians, says Dr. Kent Sepkowitz.

Tea Party darling Scott DesJarlais, a family-practice physician and Republican congressman from Jasper, Tenn., is in a bit of a pickle just now. It seems all that jawing he had done regarding abortion (he’s strongly anti) didn’t quite square with some admitted “mistakes” he made a few years earlier when he encouraged his wife, and maybe a girlfriend, too, to go ahead and end their pregnancies, according to sworn testimony from DesJarlais in his divorce case.

And then there is the little issue of the many women, none of them his wife at the time, he had been sleeping with along the path to his marriage’s conclusion, according to the testimony. Not a good pro-marriage strategy. But that’s his and his wife’s business, not really for us nosy people who live for this sort of scandal.

And what about the donors to his campaign? According to the Washington Times and OpenSecrets.org, he’s got lots of un-health-conscious PAC buddies, including the American Beverage Industry, National Beer Wholesalers Association, and American Crystal Sugar Company, as well as PAC doctor pals who ponied up the max: the American Association of Orthopaedic Surgeons, American College of Radiology, American College of Cardiology, American Society of Anesthesiologists, and the American Association of Neurologic Surgeons. Pretty impressive lineup.

Sex with willing women; abortions when they are convenient; friends in high places—that’s all part of someone’s American dream. Maybe appalling, but hey, live and let live. He’s really just another politician who is a hypocrite—nothing to see there. Plus, please note that Dr. DesJarlais isn’t letting a humiliating scandal get him down: as he says with an odd mashup of Dr. Phil and Dr. Seuss, “I’m ashamed of things that have happened, I’m moving on, and I’ll be fine.”

Given all of this, it is worth noting that he seems like a decent doctor. According to Tennessee state records, Dr. DesJarlais is licensed to practice medicine. He graduated medical school in 1991 and completed a single-year internship in obstetrics and gynecology, finishing in 1992. It seems he has not had additional medical training, and is not eligible for any specialty board certification. (Licensure is granted by states, whereas certification is granted by specialty boards to denote those who have satisfied additional requirements). For example, the required duration of training to become eligible to take certifying boards in obstetrics and gynecology is four years—three years longer than Dr. DesJarlais studied this discipline.

As a general practitioner, Dr. DesJarlais also apparently chose not to pursue formal specialization in the field of family medicine, which requires a three-year period of training. “Family practitioners” and “specialists in family medicine” are often confused, since their titles sound alike and they see a similar range of patients. 

Some might consider his one-year-and-out approach a shortcut, but surely longer training doesn’t guarantee a better doctor—Dr. DesJarlais seems well-liked by those patients who have rated him, 77 percent of whom would recommend him to family and friends. And to his credit, Dr. DesJarlais chose to practice in an underserved rural area—Jasper had a population of 3,279 in 2010—and responded to a dire need in American medicine.

(Note office bonus: Yiddish is spoken in his office.)

There is a line however, that Dr. DesJarlais has crossed that separates him from the standard-issue pond scum that runs for Congress and parties hard with the young ladies and behaves unfortunately, something all the back-pedaling and backslapping simply can’t paper over: he has had sex with patients, according to his sworn testimony in his divorce case. At least two patients—one of whom did (or did not) become pregnant from his seed.

Doctors over the last 2,500 years have been a varied lot who occupy just about every square inch of the human grid. In all that time, probably the only thing we have agreed upon is this: sleeping with patients is verboten. Hippocrates himself wrote: “In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or men, be they free or slaves.”

There are a few medical articles that address the issue of doctors who have sex with their patients. The literature is not vast, but it is consistent.

Family-practice doctors ( Dr. DesJarlais’s area of practice), along with psychiatrists and obstetricians, show up at the top of every list of physician-predators. According to these reports, the involved doctor usually is an older male. The number of doctors who have sex with their patients varies in the various studies but seems less than 1 percent—though one anonymous survey found that 7 percent, or one in every 15 doctors (including specialists of every stripe), admit to having had sex with their patients. This high rate has brought down a very strong interdiction from the American Medical Association, which has written, “Sexual contact that occurs concurrent with the patient-physician relationship constitutes sexual misconduct.”

Sexual misconduct can lead to loss of professional license. Right now, there is no known formal investigation of the DesJarlais matter by the Tennessee Department of Health, although some left-wing organizations are calling for one.

Scott, I ask you—please for the sake of all 700,000 other doctors in the U.S., can’t you just keep your pecker in your pants?

It seems perhaps a trifle anachronistic in this permissive age that sex between mutually consenting adults is the one crime a doctor must not commit. Are physicians really this high-minded and moral? (Hint: maybe not). The explanation usually given is that the doctor is far too powerful a member of the patient-doctor duo —the one with the answers, the one with the pills, the one with the way to health. The patient is seen as vulnerable, helpless, a victim. Similar to the public attitude when Bill met Monica, people don’t like an asymmetrical battle—the odds are too overwhelmingly on one side. There is no sport at all, no game, nothing but the unsettling sight of animal instinct.

This lopsidedness surely accounts for some of the problem, but there’s more to it, something outside the morals and ethics and invocations of ancient Hippocrates. Doctors understand this: When we diddle, our power is not consolidated, but completely lost. Ours is a profession built on the premise of the stiff-upper-lipped discipline of the British officer who bears it all with quiet strength. We are taught to meet every challenge with Arctic reserve. It’s the core of our professionalism (and drives many patients crazy).

Be it carnal infatuation or rabid political involvement or enthusiasms for any but the fixed set of Jane Austen-ian virtues—piano, reading, recitation—we are asked to stand down, shut up, and allow others to occupy center stage. Drama is not what we do. Our societal role is sobriety without the banker’s humorlessness, erudition without the lawyer’s prissy pride and haughtiness, rectitude without the minister’s chill of piety. And so, when one of us leaks and lets erotic distraction subdue him, we all sink. Therefore Scott, I ask you—please for the sake of all 700,000 other doctors in the U.S., can’t you just keep your pecker in your pants?