Perhaps the headline should read “Iowa Board of Medicine Makes Making Love an Actionable Offense.” Boards of Medicine generally take action if a physician inappropriately propositions a patient for sex. Some boundary issues are obvious. If a psychiatrist is in the middle of an active treatment plan with a patient, it is unlikely a sexual relationship between the two will pass muster. On the other hand, if a primary care doctor in the only physician serving a remote rural community and he sutures a small laceration on a patient, is that patient foreclosed from ever being a romantic interest. These two examples should not have the same outcome.  

I understand the rationale behind prohibiting doctors from actively engaging in a sexual relationship with current patients. The argument goes that the patient cannot make an informed decision about proceeding because of the complexities inherent to a doctor-patient relationship. And only when the doctor-patient relationship is formally terminated does the patient in most, but not all, circumstances regain their faculties about such matters. 

I think such a dogmatic approach sells many patients short. It also reeks of excessive paternalism.  

Hence my disappointment at the following Board action. 

The Iowa Board of Medicine disciplined Dr. Joseph Darrow, a physician who practiced orthopaedic surgery in Iowa and now practices medicine in Missouri.  

In the Board’s own words.

Sexual Misconduct: The Board alleges that Respondent engaged in sexual misconduct in violation of the laws and rules governing the practice of medicine in Iowa when he engaged in a sexual relationship with a female patient concurrent with, or immediately following, the physician-patient relationship, in Fort Madison, Iowa, in 2014. Respondent subsequently married the female patient. 

So, we have a patient who presumably had orthopaedic surgery. The doctor and patient fell in love. They married. There is no evidence to suggest the patient had buyer’s remorse or they were anything other than happily married. Not wanting to fight the matter, Dr. Darrow, aged 68, signed off on a consent agreement with the Board. 

CITATION AND WARNING: Respondent 1s hereby CITED for engaging in sexual misconduct in violation of the laws and rules governing the practice of medicine in Iowa. Respondent is hereby WARNED that engaging in such conduct in the future may result in further disciplinary action against his Iowa medical license. 

CIVIL PENALTY: Respondent shall pay a $5,000 civil penalty within twenty (20) days of the date of this order. The civil penalty shall be made payable to the Treasurer of Iowa, and mailed to the executive director of the Board. The civil penalty shall be deposited in the State General Fund. 

NEUROSYCHOLOGICAL TESTING: Respondent shall complete neuropsychological testing under the direction of a Board-approved neuropsychologist as recommended by the Professional Renewal Center within 30 days of this order. Respondent shall ensure that a report is forwarded to the Board directly from the neuropsychologist. Respondent is responsible for all costs associated with the neuropsychological testing. 

PROFESSIONAL BOUNDARIES PROGRAM: Respondent shall successfully complete a Board-approved treatment program for professional boundaries. 

WORKSITE MONITOR: Respondent shall establish a worksite monitor with the Board under the following terms and conditions:… The worksite monitor shall agree to inform the Board immediately if there is evidence of sexual misconduct, unprofessional conduct or a violation of the terms of this Order…. Respondent shall ensure that the worksite monitor submits quarterly reports to the Board not later than 1/20, 4/20, 7 /20 and 10/20 of each year of this Order.

I’m guessing the doctor, aged 68, did not want to expend a lot of energy fighting this. He’s a newlywed and had other priorities. But, this penalty seems heavy handed. 

What do you think? Use the comment box below to share your thoughts.

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