The Exam Room Should Be Safe! "I am Jane Doe"

[00:00:00] We're seeing women stand together and say I am Jane Doe. Although this episode is about abuse in health care, that call for solidarity matters here too. Women deserve to be heard and their privacy respected and their concerns taken seriously.

[00:00:16] Well, us as women and mothers and daughters, we want the protection wherever someone is vulnerable in a school, hospital or an exam room. Supporting survivors means listening with compassion, investigating responsibly and demanding accountability.

[00:00:32] So before we begin, this episode discusses sexual assault by health care professionals, including abusive children, unfortunately. We will not describe the assaults graphically. No, no. Please listen in whatever way feels right for you. You can pause, you can skip this episode or come back with someone you trust.

[00:00:54] If you need support in the United States, call 1-800-656-4673 or visit rainn.org. If you are in immediate danger, please call 911.

[00:01:23] Welcome back to Credentialing Chronicles. I'm Nyleen here with... Today's episode is called The Exam Room Should Be Safe. We are discussing three cases with recent developments with what they tell us about trust, what patients and health care teams can do.

[00:01:44] This is education and discussion, not individual medical or legal advice. We will distinguish the court outcomes from our own questions, recommendations, opinions and allegations. I know. Usually we say we're spilling the tea, right? Today, we need to be very clear. These are people's lives. Women went to health care professionals for help, help, health, help, all of it, right?

[00:02:07] You know, children were placed in the care of adults with authority. And the question that will not leave me alone right now is how does a place where we are supposed to be protective become the place where somebody hurts us? I don't understand it, Nyleen. Wow. Well, again, as I mentioned, as women, mothers, daughters, that question hits close to home. We teach our children to ask for help. We teach them to tell us when something feels wrong.

[00:02:36] Then we take them into a medical care setting where we tell them the doctor's going to be okay. Like the doctor has to examine you. They're supposed to build trust with this adult and know that, and especially that, that adult that usually knows more than we do. That adult has a responsibility to explain, respect boundaries and make the experience safe. Mm-hmm. Mm-hmm. 100%. And I want the good doctors listening to stay with us, you all, because we need you in this conversation.

[00:03:05] Comment, please. There are clinicians who take consent seriously, who welcome chaperones, who protect the patient's dignity every single day. Yes. And we will talk about how clear procedures protect those patients, your patients, and help document appropriate care. Patient safety and fair treatment of clinicians belong in that same conversation, right?

[00:03:31] Right. But nobody gets to use fairness as a reason to dismiss a patient, right? Mm-hmm. An allegation deserves a serious, impartial response. An allegation is not a conviction. And an investigation is not an excuse to ignore immediate safety concerns. We can insist on evidence and insist on protection at the same time. And you can, and we can, right? I think so.

[00:03:58] I mean, yeah. If someone has harmed you in a medical setting, I want you to hear this before we say anything else. That was not your fault, okay? You did not cause it by trusting them. I mean, that's what we're told to do. You did not cause it by being alone. You did not cause it by freezing and not saying anything, by not knowing what an exam should involve, or by literally just needing to go there to get care. And we're not asking survivors to educate our audience by sharing painful details. No.

[00:04:27] Today, our engagement question is about the system itself. Does your organization make it easy to ask for a chaperone, stop an examination, and report a concern? Keep that question with you as we go through these stories. All right. All right, Shannon. When we talked about dedicating an episode to this, the first reaction was, why does it feel like there are more and more of these stories? I understand that reaction. Yeah.

[00:04:56] But before we call it a national rise in sexual assault by providers, we have to ask what we can actually measure. True. Are we counting assaults, reports, convictions, or disciplinary actions, or allegations for that matter? Yeah, right. I mean, exactly, Nyleen. You know, three horrible cases can show us serious harm. They cannot by themselves prove a national trend, right? I mean, that would just take so much of our time to collect and do.

[00:05:25] You know, a sentence denounced this year may concern abuse that happened years ago. It takes years to litigate these things. If we count the headline as a new assault, we have already distorted the story. And if reporting improves, the reported number can rise even when we do not know what happened to the underlying rate.

[00:05:47] Well, a historical study published in PLOS 1 examined the NPDB, the National Practitioner Data Bank, reports from January 2003 through September 2013. So that's 10 years worth of data. It identified over 1,000 physicians with at least one sexual misconduct-related report. Ooh. That is a count of physicians in that data set.

[00:06:16] And during that period. It is not the number of assaults. It is not all healthcare professionals. And it is not a current annual prevalence figure. Mm-hmm. That distinction matters. Sexual misconduct is a broader category than criminal sexual assault. A report can concern different kinds of conduct. There can be more than one report about one clinician, you all. That's true. Mm-hmm. And there can be harm that never produced a report, too.

[00:06:46] So we should not flatten all of that into one dramatic number. Just because a dramatic number would make a good clip. We don't want to do that. Right. So the NPDB's public data is useful for studying certain adverse actions and malpractice payments. It does not give us a complete national census, obviously, of the sexual assaults and exam rooms. It also does not turn every complaint into a report. So the honest question is, what are we missing? So much. And what would it take to measure this better?

[00:07:16] Mm-hmm. Mm-hmm.

[00:07:47] Well, here's my challenge to leaders. If your response is, prove it's increasing before we spend time on it, then what are we really saying? That the current harm is acceptable? I mean, no harm is acceptable, I think. Right? Right? So I don't accept that. I wouldn't accept that. As a woman, especially. As a patient, as anybody, right? We can be careful with the data and urgent about the response, is what I think. Clip that, y'all. That was good.

[00:08:17] We're going to keep our categories honest throughout this episode. We will identify guilty pleas and convictions correctly, accurately. We're going to do our best. When we discuss institutional findings, we will say whose findings those actually were, because it comes from all over. And when Eileen and I propose a better process, that's just our recommendation. We will not present our opinions as something a court ruled on you guys. Right. So before we get into it, let's talk a little bit about our sponsor. Tell me.

[00:08:45] A brief sponsor message before we do. This episode is supported by Credential Network, also known as CredNet and Eileen. Credentialing friends, imagine your workflow walking into a room carrying 14 folders, six reminders, and sticky notes that says, I know this is somewhere. We have met that workflow before, haven't we? We have been that workflow before, have not. And we would like to help it put, we would like to help you put the folders down and have a better workflow.

[00:09:15] So CredNet is a platform for healthcare credentialing and payer enrollment. If your team is ready to explore a different way to manage that work, take a look at Credential Network. Think of this, you all, as an invitation to your credentialing process. A little love. Right? Just a little bit. Give it a little love. Just give it a little love. Visit CredentialNetwork.com, request a demo, ask for Dylan, tell him the pink girl sent you, and yeah. All right.

[00:09:43] So let's get back to the discussion really quick. Okay. Tell us about our first case, Janet. Well, our first case involves James Heaps, a former UCLA OBGYN. And not another OBGYN. Yes. The Los Angeles County announcement dated on April 14th this year, 2026, y'all. Y'all, he says he pleaded guilty to sexually assaulting five female patients during the period of 2011 to 2018.

[00:10:10] He was sentenced to 11 years of prison and required to literally register as a sex offender for the rest of his life. While there's an important update here, the same announcement says his earlier conviction had been overturned in February of 2026 because of a judicial error. The April guilty plea and sentence are the development we are discussing. We should not tell an outdated version of this case or imply that the earlier reversal ended the matter.

[00:10:39] So just sit with the basic settings, right? A patient's scheduled care with an OBGYN. An intimate exam can be part of an appropriate treatment. We all know that. We've all been to an OBGYN. That means that the patient may already be what? Anxious. Absolutely. I'm exposed. I got to throw my legs in the stirrups. You know, I'm uncertain. I don't know what you're going to put up me and probe me with, right? So the clinician knows the procedures. The patient does not. Everybody goes in there not knowing.

[00:11:06] That difference in knowledge area creates an obligation to what? Explain. Not a license to take advantage. And a procedure's name doesn't matter. Definitely not when I'm in stirrups. No. No. A hospital's reputation can absolutely make a patient try and trust more. That does not guarantee anything. No. It should never make a concern less worthy of attention.

[00:11:35] Our question is not, why did a patient trust a respected institution? But of course, people seek care from respected institutions. So our question is, how does the institution make that trust deserved? And you know, as a mother of six daughters, I want to teach a sentence that is useful at any age, right? Okay. So please explain what you are doing and why. Very good. Say it again.

[00:12:04] Please explain what you are doing and why. And you can ask that to anybody. Absolutely. The person bagging your groceries, please explain what you're doing and why. Why are you putting the bread with the canned goods? Right. Right. I mean, but if you can ask that person, you definitely can ask somebody that's willing, you know, to put the stirrups in you. Right. I mean, so we apologize for, you know, asking. Some of us have spent our lives trying not to inconvenience anyone.

[00:12:32] We apologize for even asking a question, you all. And we cannot do that. We apologize for needing more time. We should stop doing that. Right. I mean, I do not want to be difficult, but a question about your body is not bad matters. Absolutely not. And if you didn't ask, that does not make abuse your fault. No. Either. No. We can offer useful language without rewriting a survivor's experience as a missed opportunity.

[00:12:59] The person with professional power had the responsibility. The organization had responsibilities to giving patients options is valuable and making patients responsible for stopping a crime is unacceptable. I hear your passion. And for our credentialing listeners, here is where I want to push past the paperwork, baby. Absolutely. For office managers. I'm sorry. Office managers too. Office managers. Y'all know exactly what is happening.

[00:13:30] MAs. Verifying qualifications answers important questions about training and professional standing, but it cannot tell us everything about what is happening during care. You are seeing it. An organization also needs a way to hear a patient's experience. Investigate a concern and connect that concern to clinical leadership. Yeah, that is our system's question. Not an accusation that every organization fails in the same way. If a patient tells a reception that something happened, where does the concern go?

[00:13:59] Does that receptionist feel safe? Does the MA feel safe? Does the office manager feel safe? If the concern reaches the department, who ensures it does not stop there? Is the person receiving it trained to recognize the patient's safety allegation? And who owns that next step? Those are questions that really need to be answered. Absolutely. We spend so much time asking whether the file is complete. Let us ask whether the reporting pathway is complete, you guys.

[00:14:26] A patient should not need the correct internal vocabulary to get a serious response. I mean, she may feel uncomfortable. She may say, I am not sure that this was normal. You know, she might be shy. Those words deserve listening and appropriate assessment and response. Yeah, so this case is a court outcome involving five women.

[00:14:50] And the plea describing, you know, described by the county or whatever, we are not turning it into a guess about every appointment that was had with this position or about every employee. We are taking a verified outcome and asking the wider question it raises. What does respectful, accountable, intimate care look like before harm occurs? If you're a provider, tap in. Let us know. We'd love to know.

[00:15:19] What do you do to set boundaries, right? In an exam. Yeah. So let us turn that question into something listeners can use. Before a non-emergency sensitive exam, try asking, what is the purpose? What will happen? And can a trained chaperone be present? Can my friend be present? Can my partner be present? You can ask before the visit if that helps you feel more prepared.

[00:15:48] You can also ask about a support person and the clinic's policies. Yeah. I mean, that's very true. And if they say no, then that should be like a red flag. You know? When a patient declines a chaperone, follow your policy and applicable rules. Explain the options respectfully. Document the decision accurately. The answer is not to invent a universal rule on a podcast. Okay? We're not saying that. No. Absolutely not.

[00:16:16] Practices need a process that their staff can actually follow, including what to do when the patient and clinician have different comfort levels, which happens. Right. And clear documentation may help establish what appropriate care is involved. It is not a guarantee against a complaint, obviously. And a chaperone is not necessarily always a shield for misconduct. The goal is care that is understandable and accountable and safe and fair and all the things, right?

[00:16:46] We should be protecting our patients, supporting ethical practices and making it possible to resolve concerns fairly. Well, here's a listener question. Does your clinic tell you what you can request a chaperone before you even ask? I mean, that's great. For professionals, does your policy describe what the chaperone's job is? Or does it just say another person may be in the room? How does it break it down? Discuss the policy in our comments. We'd love to hear from you all.

[00:17:12] Please keep personal medical details and allegations out of any public spaces, though. So let's talk about our second case, which is a Dr. Chang, which is a former GI or gastroenterologist doctor out of New York. On August of 2025, the Queens District Attorney announced a 24, get this, 24. 24 hours? No, 24-year prison sentence. Ooh.

[00:17:39] After guilty pleas involved rape and sexual abuse. Oh my goodness. The case included female hospital patients and women he knew outside the hospital. The official release describes abuse of girl unconscious victims. The release says he pled guilty to four first-degree rape counts and three first-degree sexual abuse counts. And additionally entered an Alfred plea, you all, to one sexual abuse count.

[00:18:08] We are keeping that distinction in the record rather than suggesting he admitted every account in exactly the same way because that was something important. We do not need graphic details to understand the betrayal. Well, this is the point where a prevention conversation has to grow beyond. It has to grow. It has. Speak up if you are uncomfortable. An unconscious patient cannot stop an exam from happening.

[00:18:36] She cannot request a chaperone in that moment. She cannot tell someone to leave. The protection has to be carried by the people, the procedures, and the oversight around her. Exactly. A person who needs sedation is not choosing to surrender her safety, Naila. No. She's accepting treatment. I mean, that's what she's there for. And treatment creates duties for the team. I am not willing to make this a story about whether, you know, the patient brought the right person or even asked the right question, honey.

[00:19:05] There are settings where the patient cannot be her own last line of defense if she's laying there unconscious. No. For somebody preparing for a planned procedure, and I do speak about this when I go to my thing. I say, you know, the OR or a procedure room is the most sacred because we are at our most vulnerable. We are naked and basically unconscious. So, a useful question is who will be involved in my care? True.

[00:19:35] And what examinations are planned while I am sedated? Another is how do you handle sensitive examinations? Are they done for teaching? Are my, you know, parts exposed for this exam? Ask the team to explain the consent process in words you understand. What is being recorded? Is there ambient listening? Is there ambience AI? Is there video happening? Who is allowed to record? Are there phones allowed in this room?

[00:20:04] I mean, we are allowed to consent or not consent as patients. And this is relevant because federal guidance here, you know, has said this. And we need to be very clear about it. In April of 2024, CMS reinforced hospitals inform consent obligations. Yeah. You know? Everybody needs to sign a consent. Yes. Concerning training, education, like you said, examinations outside the medical necessary procedures,

[00:20:31] including sensitive exams like Nailene is talking about, particularly on patients under anesthesia. So, that is hospital guidance with a specific literal scope. It is not a claim that every exam in every setting follows one identical federal rule, Lord. Well, and it's not permission for anyone to wait until the patient is unconscious and decide, oh, well, she would have agreed to this, right? Consent discussions belong where the patient can understand and make a decision.

[00:21:00] For individual care questions, ask the actual clinical team. Our point is that a vague signature should not be the whole conversation. And ask for a copy of your consent. Ask what's included in your consent. I'm just saying. Exactly. And here's our recommendation to healthcare leaders. Review who can access vulnerable patients, right? How staffing and supervision works and how concerns are escalated.

[00:21:26] Look at whether the workflow depends on one person behaving appropriately with no meaningful checks. Amen. Because if so, you know, I'm asking that as a preventive question, you all. Not stating that those specific failures were established in this prosecution. But you all need to ask that. If it's only one person that wants to do this certain thing every single time, those are the patterns that we're telling you to look for. Right.

[00:21:53] And if a concern emerges afterward, respond seriously, even if the patient's memory is incomplete. Do not ask a patient to investigate herself or himself. Or produce a perfect account before anyone listens. At the same time, preserve the evidence and use an impartial process. Compassion and careful fact-finding can work together. What this case makes me ask is not how can she have prevented it. Never, never.

[00:22:21] It is what did the care environment owe a person who could literally not speak? I mean, that is the question, Nyleen, that we should be asking administrators, medical staff leaders, and really any clinician listening to bring back to their team. That is a really good question. Well, we're taking a brief sponsor break. Thank you to Baton Health for supporting Credentialing Chronicles. Credentialing teams know that verifying information means going to the source.

[00:22:49] And Baton Health automates primary source verification by connecting to sources such as licensing board and federal exclusion list. If your team is spending its day navigating source after source, Baton invites you to explore how its verification tools can fit into your existing workflow. Hey, why don't you visit BatonHealth.com to learn more or even maybe request a demo. Please tell them that the pink girl sent you. Thank you, Baton.

[00:23:18] We'll see you to make sure our exam room stays safe. Our third story involves Darius Paduce, a former urologist. Former urologist. For federal prosecutors announced his life sentence on November 20, 2024. Following his May 2024 conviction girl. For offenses involving sexual abuse of patients involving minors. The 2026 development about this is about the institution's responsibility.

[00:23:48] And that is why this case belongs in our current conversation, Nyleen. Well, apparently, as you said, in July of 2026, the U.S. Attorney's Office announced a voluntary compliance agreement with this whale Cornell medicine. According, don't quote us on the way we're pronouncing this stuff. I'm just letting you know if y'all want to correct us. We're not namologists. I mean, yeah, we're not namologists. We're not namologists.

[00:24:16] Anyway, according to that announcement, this, that Weill Cornell Medicine, wheel Cornell. Not the Weill Cornell Medicine. Whale? Well, anyway, acknowledge its policies and programs during this doctor's tenure were inadequate. To detect, prevent, respond to patient sexual abuse. I mean, they analyzed their policies and said, hey, they're actually not good. The release says his victims included girl, boys as young as 13. That matters, Nyleen, for how we tell this story, baby.

[00:24:46] We are women and mothers of daughters, and that shapes our concern. But we cannot let that narrow our protections, right? Boys need to know that they need to speak up as well. And boys deserve just as much protection as our girls. Yes. Patients of every gender, and we have seen that on Credentialing Chronicles, need respectable care. Children who have trouble communicating need adults, who will pay attention rather than assume a silence means everything is fine.

[00:25:13] Well, the Justice Department described earlier patient complaints and failures to escalate or share important information. Its announcement also described safeguards in the agreement, including chaperone oversight and changes to complaint escalation and investigation. So this facility committed $30 million toward an institute focused on safe patient care and patient empowerment.

[00:25:43] That is one pretty penny to pay for one doctor acting a fool and hurting patients for absolutely no reason. Those are specific findings and commitments in this announcement, not a conclusion about every hospital. I'm assuming that other hospitals have already really good safeguards in place because that is our hope as moms. Well, what we need to talk about is when pieces of information live in different places. True.

[00:26:10] You know, a patient concern lives here, a staff concern lives over there, a reference request somewhere else, you know, that there was an issue. If no one is responsible for connecting these pieces, the process can make each piece look smaller than the whole. That is a system problem leaders should be willing to examine. Well, an institution can't simply ask whether the person receiving the concern likes the doctor or doesn't like the doctor, right?

[00:26:37] It needs people with the right training and the authority to investigate the concerns. That is why CMS, everybody says we have to keep track of our patient complaints. It needs escalation that works when the allegation involves someone influential, right? Or the chair of a department or the doctor that has the most influence in the community. It needs an honest review of whether important safety information reaches the people who are supposed to act on it.

[00:27:07] Yeah. Yeah. As mothers, let us also talk about what children hear from us, right? I want my children to understand that medical care can involve looking or touching a private part for a health reason. I also want her to know that an adult should explain... What they're doing and why. Yeah. And that she can ask questions. And that nobody gets to demand secrecy about something that hurts or confuses her. Well, and a medical exam should not be... Hurt or confused. Correct. Should not hurt or confuse her.

[00:27:34] The American Academy of Pediatrics encourages teaching children the correct names for our body parts. Yes. And discussing the body's autonomy. We can do that in a calm, everyday language. Be calm about it. We don't have to laugh. We don't have to giggle. We don't have to make it awkward. There are actual names, right? We have to prepare our children. We can say doctors help our bodies be healthy. And sometimes we have, you know, we call them in Spanish a ya-ya.

[00:28:04] Sometimes we have ya-ya's on our body and the doctors have to view our ya-ya's so we can feel better, right? And sometimes that requires me having to look a certain kind of way. But as long as we make it as something factual and then, of course, never leave our children alone. Be in there, you know? 100%. I would just say. So let us spend some time on the clinicians who are doing the right thing. Because we do thank our doctors that are doing the right thing. And want a fair way to protect everyone.

[00:28:32] Start by making appropriate care visible and understandable. Explain the clinical purpose of sensitive touch. Avoid sexualized comments or personal boundary crossings. Follow the chaperone policy and document accurately. These habits support trust before anyone has to raise a concern. Yeah, be equally clear about communications, you guys, outside the appointment, right? Use appropriate clinical channels and professional boundaries always.

[00:29:00] Do not treat friendliness as permission for personal intimacy, you guys. If a patient expresses discomfort, respond without being defensive. It's okay. You can clarify what happened. Seek an appropriate review. And preserve your record without literally attacking the patient. Yeah. And then if a complaint is made, don't contact the patient to persuade the patient to withdraw. Notify appropriate leadership. Follow the complaint process. Seek professional advice as needed or if needed. Preserve your records.

[00:29:29] Document appropriately. Be transparent. Definitely. And quietly rewriting the record just creates more problems. So state the facts. Say what happened. Say how you did what you did and go from there. You know? Our questions. Nylene. I want to end with why we dedicated an episode to this. Because women should not have to wonder whether they can trust a medical appointment. Because children should not have to carry an adult's betrayal.

[00:29:56] And because a patient who reports a concern should not feel like she has become a problem that an institution now has to manage. And because these are people doing excellent work who need a system that supports them. Ethical clinicians should welcome clarity. Okay? Staff should have a route to speak up. Patients should know what an examination involves. And families should understand how their child is protected.

[00:30:24] None of that, I think, is too much to ask in health care. And I don't either, Nylene. I want my daughters to know that their questions are welcomed when they're asked. I want them to know that they can tell me something confusing, even if they cannot explain it perfectly. And I want the health care professionals caring for them to reinforce that message through their actions. Yeah. It's only appropriate. Yeah. Protection should not depend on a child having some extraordinary confidence. Right.

[00:30:50] And as women, we know that asking a question can sometimes feel like women as children, boys, girls, it doesn't matter. When we are put into situations with people with authority, sometimes we feel intimidated to ask a question. So let's just make the practice routine. What is this exam for? Who will be present? How do I pause? What is okay? Am I in pain? Am I, do I feel safe to say that this hurts or doesn't feel right? Right? We should not feel ashamed to talk about our bodies or what's concerning us. Exactly. We want your thoughts on the system.

[00:31:19] In our comments, tell us what policy should be explained more clearly. Do you know what a chaperone is? Do you understand consent? Adolescent privacy, right? Or even reporting. Please do not identify patients or children or alleged offenders, please. But we, you know, we can't investigate allegations through our podcast comments. And no one should have to expose private trauma to join, you know, the conversation.

[00:31:43] So again, if you need support in the United States, call RAINS National Sexual Assault Hotline 1-800-656-4673 or visit RAINN.org slash hotline. If a child may be in danger, contact the appropriate local child protection authority or law enforcement. Always call 911 if you're in immediate danger. Ask support services about confidentiality and reporting rules if you have any questions. We cannot honestly say that these are three cases proven national increase.

[00:32:11] We can't honestly say that they give us urgent reason to ask better questions and demand accountability as always. The exam room should be safe. That is our title of this episode and we're sticking to it. A professional title should come with responsibility every time. And a patient's dignity should not be negotiated. So thank you for staying with us through this difficult conversation. Share this episode with someone who helps. That's the policy. Hashtag Jane Doe. Or I am Jane Doe. I am Jane Doe.

[00:32:40] Train the staff. Care for your patients. Let the conversation turn into a clearer process and a much safer environment for us, our children, our patients. I'm Shannon. And I'm Nyleen. Stay credentialed. Not canceled. Woo, Shannon. That was a lot of tea. Honey. But have they subscribed yet to hear it next week? On all of these platforms. Please subscribe, like, and follow us.