Communicating About Sexual Misconduct: Opportunities for Regulatory Boards
September 2023Regulatory boards have put increased attention on preventing sexual misconduct in the profession and handling complaints appropriately when they do occur. HRRI commissioned this research project to help identify strengths and opportunities among physical therapy licensing boards in terms of communicating information regarding sexual misconduct.
Authors
C. Dower
Executive Summary
Regulatory Boards have put increased attention on preventing sexual misconduct in the profession and handling complaints appropriately when they do occur. With a goal of advancing these efforts further, the Healthcare Regulatory Research Institute (HRRI) commissioned this research project to help identify strengths and opportunities among the physical therapy boards in terms of communicating information regarding sexual misconduct by physical therapist (PTs) and physical therapist assistants (PTAs). The results contained in this report – including the accompanying materials and resources– build on efforts of the Federation of State Boards of Physical Therapy (FSBPT) Sexual Misconduct and Boundaries Committee and are modeled on work published by the Informed Patient Institute and Patient Safety Action Network.
The prevalence of sexual misconduct in the physical therapy profession is difficult to quantify with precision; to date no comprehensive research studies have calculated rates. However, data from a number of sources corroborate the seriousness of the problem. CNA/HPSO reported that claims involving injury resulting from sexual abuse or assault by physical therapy professionals accounted for between 1.1% and 3.8% of closed claims with paid indemnities of $10,000 over the most recent 15-year period. Perhaps more relevant for purposes of FSBPT and its member boards are the data related to professional license protection. In CNA/HPSO’s 2020 dataset, allegations of physical, sexual, or emotional abuse were the most frequent charge, comprising 18.2 percent of all professional license protection and defense matters. The prevalence numbers that are available for physical therapy sexual misconduct undoubtedly underestimate actual totals because of underreporting.
The methodology for this report included summarizing and validating some of the findings of the FSBPT Sexual Misconduct and Boundary Violations Committee and then exploring 53 physical therapy licensing jurisdictions’ websites for the following:
Complaint process components and usability;
Ease of finding relevant statutes and administrative rules;
Availability of policy statements on sexual misconduct written for patients and the general public, and written for PTs and PTAs;
Search feature availability and functionality;
Availability of disciplinary actions by licensee name and type of misconduct;
Use of language, to determine presence of euphemistic versus clear terminology; and
Availability of consumer/public tabs and references to sexual misconduct on home page.
Results include finding that it takes an average of just over three “clicks” to get from a website’s home page to a complaint form that could be used for filing a sexual misconduct complaint. This was consistent if not slightly better than what the Committee Communicating about Physical Therapy Sexual Misconduct 2023 6 found two years earlier. However, it still took ten or more clicks to get to some sites’ complaint forms. Moreover, relatively few sites had instructions or guidelines for the forms or information about the process.
Most sites provided easy-to-find links from the home page to the jurisdictional codes or statutes and administrative rules, most of which prohibit sexual misconduct somehow. However, the states vary greatly in where laws are located, terminology, and presence of clear definitions. In contrast to state laws and rules, no licensing authority provided clear policy statements on sexual misconduct that were written for patients, the general public, or physical therapy professionals.
Most but not all sites had search features, but their functionality varied tremendously across jurisdictions. Specific searches for terms including “sexual misconduct”, “boundary violation”, “sexual abuse”, “sexual trauma”, “sexual relationship”, “sexual harassment”, and “complaint” sometimes returned meaningful results. Often, however, they returned no results, or results that were not on point, or not relevant to physical therapy. Some searches returned inappropriate results such as ads for external dating sites.
To explore the availability of disciplinary actions by licensee and type of misconduct on licensing authority websites, an experiment was designed using names of PT professionals publicly known to have been disciplined for sexual misconduct. All of the websites of the jurisdictions in which the disciplined individuals held licenses were visited to verify whether the person was licensed, confirm that the person had been disciplined, and determine whether the reason for the discipline – sexual misconduct – was obtainable. Most sites had some sort of license verification system. Fewer had easy-to-use tools for members of the public to confirm disciplinary action, much less the reason for the discipline if it was based on sexual misconduct. Searches were tedious and time-consuming, even armed with known disciplinary actions in advance.
The use of language when dealing with sexual misconduct on regulatory websites was explored and often determined to be euphemistic rather than clear and straightforward. Finally, a search for specific tabs or sections on websites that were dedicated to consumers or the public was conducted, as was a search for any information about sexual misconduct on home pages. Several sites had well-functioning consumer or public tabs and resources. No site provided information about sexual misconduct on its home page.
The report concludes that, while considerable and respectable work addressing sexual misconduct has been done by several leading states and by the FSBPT Committee, numerous opportunities are available for physical therapy licensing authorities in the U.S. to improve their communications about sexual misconduct. To this end, recommendations are offered for the FSBPT and PT regulatory agencies to update and add to their websites, and to specifically revise and expand their communications about sexual misconduct to audiences including consumers and patients, PTs and PTAs, licensing authorities, educators, and continuing education providers.
Additional Resources
Communications by Regulatory Boards about Sexual Misconduct: Self-Audit Template and Standards
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