Working hard to keep patients safe

No patient should have to face the trauma of being abused by a doctor, nurse or other health-care provider. My heart aches for the victims of this very personal violation. When health-care providers cross sexual boundaries, the Department of Health wants to know about it right away so we can investigate and take action.

The Seattle Times series on this topic ("License to Harm" page one, April 23-25) has been sad and disturbing. There are nearly 300,000 health-care providers in our state. Most are very professional and provide quality care for their patients. Unfortunately, there are some who use their license as a cover for heinous acts. I am appalled by it — personally and professionally.

Sexual contact between a health-care provider and a patient is absolutely not acceptable. It's a misuse of trust and power; our state law clearly says it is wrong. The Times brought us information on this issue that we did not have, and I thank them for it.

We've been striving to improve our system so when we learn about these cases we can act more swiftly and decisively. Working closely with several boards and commissions that oversee health-care providers, we're making changes that are making patients safer.

We've established a system to quickly respond to complaints about situations that put patients in imminent danger. These "high priority" cases now move right to the top of the list. A team that includes an investigator, case manager and staff attorney is quickly convened to assess the situation and determine what action is needed to protect the public. All complaints that involve sexual allegations are considered the highest priority and are being investigated.

The changes are helping. As with the criminal court system, an accused health-care provider is considered innocent until proven otherwise. However, we can immediately remove someone from practice if we believe the public is at imminent risk. We've been using that tool more and more. Patients are better protected because of it. Two recent massage therapist sexual-misconduct cases are good examples. Both were resolved in a matter of weeks rather than several months. Both therapists are out of practice.

Sexual misconduct by health-care providers is more than a violation of the law. It's a personal violation that can impact patients and their families for years. Providers must have a clear understanding of boundaries and clear guidelines designed to ensure that patients feel safe when seeking treatment. We're establishing sexual-misconduct guidelines so that health-care providers will know the boundaries. If they cross them, it could cost them their ability to practice ever again.

Ideally, we would know if someone applying for a license has had problems in other states. All applicants are required to inform us if they have criminal convictions; unfortunately, not everyone tells the truth.

Gov. Chris Gregoire recently signed legislation that will allow us to check national databanks for information about people who apply for health-care credentials in our state. It will help us know whether a provider has had problems before coming here. We also expect to find out about some criminal convictions that way. These background checks will be starting soon.

The Times series has pointed out some serious problems with registered counselors. The paper was correct to point out that there are virtually no qualifications necessary to become a registered counselor in our state. The system was created by the Legislature many years ago and is managed by the Department of Health.

While registered counselors provide important services, critics say that registration by the state deceives patients into believing the counselors are more qualified than they actually are. On the other hand, registration provides clients of registered counselors a way to complain if something goes wrong. Both sides have valid arguments.

We need answers and we're asking for some help. We are bringing together health-care professionals, the public and others to take a look at this situation and make some recommendations on how to fix it.

Should the Legislature mandate education or experience requirements for these counselors? If so, should those already doing this work have to get additional training? These are important questions that could affect the careers of thousands of people in our state as well as impact access to counseling for thousands more.

When I was appointed by Gov. Gregoire, she asked me to make patient safety a top priority.

Everyone should be able to visit a health-care provider confident the provider is qualified and there's a strong system in place to take action if a provider harms them in some way.

These are painful and difficult issues that will take all of us — health-care providers, the public and government — to work through. We're making progress, and I'm committed to seeing it through.

Mary C. Selecky is secretary of the Washington state Department of Health.