Doc: Nassar-inspired rules ‘onerous’ for physicians

Beth LeBlanc
The Detroit News

Lansing — A Grand Rapids area physician said Tuesday that “onerous” documentation procedures required under Larry Nassar-inspired House legislation would increase paperwork for the already “overregulated” health care profession.

The concerns were raised during a House Law and Justice Committee hearing Tuesday where lawmakers discussed seven bills that would make sexual contact or penetration under the guise of medical treatment a felony that would result in a revocation of a physician’s license. The bills also would require written consent, documentation and longer record retention for treatments involving vaginal or anal penetration.

Nassar, a former sports doctor for Michigan State University and USA Gymnastics, is accused of sexually abusing more than 250 women under the guise of performing medical treatment. He will spend the rest of his life in prison after pleading guilty to sexual assault and child pornography charges last year.

A months-long inquiry by the House into how MSU handled accusations against Nassar revealed that medical records were never kept or destroyed for some of Nassar’s treatments. The inquiry also found there was no informed consent policy in place for those treatments and no requirement for a chaperone to be in the room “during sensitive examinations of minors.”

Committee Chairman Rep. Klint Kesto, R-Commerce Township, said legislators intend to be deliberative, not reactionary, in what he expects to be a weeks-long review of the bills.

“We’re going to be responsible,” Kesto said. “Our vision and our foresight is going to be: How do we create a better environment?”

During testimony, Dr. Rose Ramirez of Jupiter Family Medicine in Belmont said she supports efforts that would prevent someone like Nassar from abusing patients, but is concerned about the unforeseen consequences the bills could create.

Ramirez expects other doctors will come forward with similar reservations.

“Our health care profession is overregulated,” Ramirez told reporters after the hearing. “And I want to just make sure that we don’t react emotionally and overregulate unnecessarily.”

The bills discussed Tuesday would:

■Expand existing rules that outlaw sex with a female patient under the guise of medical treatment to include male patients and sexual contact. The penalty for such actions would increase from a 10-year maximum to 20 years for sexual contact and 25 years for sexual penetration.

■Require the state Department of Licensing and Regulatory Affairs to sanction and permanently revoke a physician’s licence if the doctor is convicted of sexual contact or sexual penetration with a patient under the guise of medical treatment.

■Mandate state medical boards to provide guidance on generally accepted standards for services requiring vaginal or anal penetration provided by physicians other than obsetrician-gynocologists.

■Require vaginal or anal penetration procedures to be included in a patient’s medical record and maintained for 15 years.

■Mandate written consent from the parents of a patient under the age of 18 before conducting a procedure involving anal or vaginal penetration.

Ramirez’s chief concerns focused on extra documentation and longer record retention required for services that involve anal or vaginal penetration. Ramirez said she was uncertain which procedures would prompt the extra documentation and thought extending record retention from seven to 15 years could be burdensome.

The bills appear to exempt gynecological or sexual health services from the record retention changes and written consent requirements. But Ramirez said the legislation doesn’t account for other physicians who may be regularly performing anal or vaginal penetrations in the course of other treatments — physicians such as urologists, gastroenterologists or even family physicians.

She also worried about the criminal consequences for human error.

“If someone inadvertently doesn’t document, are they going to be a criminal after that?” Ramirez said. “There are so many situations I can imagine where the documentation may not be there even though an appropriate exam was done.”

The current seven-year record retention requirement already causes issues for some doctors nearing retirement, she said. More than doubling the time period to 15 years would exacerbate problems, she said.

“I think that that might be a little onerous,” Ramirez said.

Rep. Lana Theis, a bill sponsor, argued that many of the bills codified best practices and forgetting to document penetrative procedures is an oversight that Nassar could have exploited.

“We’re not blazing new ground,” said Theis, a Brighton Republican. “We’re raising the bar.”

Kesto said some of Ramirez’s concerns were valid and said the committee will continue to welcome input from nonprofits, businesses and physicians to ensure no loopholes exist that could be exploited.

“We want to make sure we get this right,” he said.

The Michigan Senate in March approved a sexual assault prevention package that would extend the statute of limitations for victims and strengthen mandatory reporter laws.

Kesto said the House will “take a look” at the Senate legislation after moving through the House package.

“We will look at them in a deliberative manner, not just for one hearing but for multiple hearings,” Kesto said.

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