By Megan Twohey, Tribune reporter
7:03 PM CST, December 27, 2010
A private program that has long kept secret watch over Illinois doctors receiving substance-abuse treatment is now monitoring health care professionals with sexual misconduct violations — including some convicted of crimes.
Begun several decades ago by the state's doctors' lobby, the Illinois Professionals Health Program has drawn criticism for the off-the-books nature of its work and its lack of accountability.
That it has expanded its reach to sex-offending health workers has heightened the controversy. Critics say such individuals don't belong in a program shrouded in secrecy. Sexual misconduct demands disciplinary action, they say, not just treatment. And the public deserves to know who violators are.
"Who is being protected?" said John Goldberg, a former Illinois medical prosecutor.
It's part of a pattern of questionable oversight of medical professionals across the state. A Tribune investigation revealed that regulators have waited years to act on well-founded allegations of sexual misconduct. Offenders are allowed to practice even when convicted of crimes. And some are placed in a government-run monitoring program that is overburdened and unable to prevent harm to patients.
At the privately run Illinois Professionals Health Program, offenders have been monitored in a similar way — only out of public view. Among them was Venkatesan Deenadayalu, a doctor from the western suburbs who entered the program after he was convicted of sexual abuse and battery of a patient.
"We are getting all kinds of referrals now for disruptive behavior in the workplace, and we also receive … regular referrals of boundary violations, improper prescribing practices, sexual misconduct and other professional boundary issues," Dr. Martin Doot, then director of the Illinois Professionals Health Program, said at a 2007 medical disciplinary hearing for Deenadayalu, according to a transcript.
At another hearing for Deenadayalu, the medical prosecutor assigned to the case asked Carole Hoffman, the program's manager, if it included physicians with criminal convictions.
"At times," she said, according to a transcript.
Most state programs of this kind stay away from sexual misconduct cases.
The Des Plaines-based Illinois Professionals Health Program is sponsored by the state medical malpractice insurance provider and the doctors' lobby, according to its promotional literature.
It has received $234,275 from the state Department of Financial and Professional Regulation since fiscal 2009 to monitor nurses and pharmacists, the regulatory agency said. Physicians in the program pay out of pocket.
The program monitors hundreds of health care professionals who typically "face allegations or actual instances of addictions of all kinds, disruptive behavior, boundary violations, sexual misconduct" and other issues, according to the promotional material.
The staff — which consists of five people, according to a national association — steers participants into treatment, then monitors their progress. Those who fail to comply are supposed to face consequences, including possible public disciplinary action. If participants adhere to the monitoring agreements, the program will advocate on their behalf.
Participants sign up on their own or are ordered to by employers or state regulators, who have relied on the program with increased frequency, according to data obtained by the Tribune.
The Department of Financial and Professional Regulation has more than 100 confidential "Agreements of Care, Counseling or Treatment" in place that allow physicians and other health workers to submit to private monitoring instead of public discipline. The agency also tracks cases in which individuals are placed in the Illinois Professionals Health Program by their employers.
It is unclear how many cases of sexual misconduct have been handled by the private program.
Hoffman and Cynthia Gordon, the program's current director, did not respond to interview requests or questions submitted by e-mail. The regulatory department declined to provide copies of Agreements of Care, Counseling or Treatment, even with names redacted.
Spokeswoman Sue Hofer said the regulatory agency does not refer cases to the program that involve harm to patients, such as sexual misconduct. Because it does not track by category, it cannot say how many of the other cases in the program involve sexual misconduct, she said.
Deenadayalu, who goes by the name Deen Venkatesan, turned to the program in January 2001 following his conviction for sexual abuse and battery of a patient, records show.
The conviction sprang from an incident at a Downers Grove clinic, but at the time of the court ruling, the doctor was in private practice. Because he was his own boss, Deenadayalu was free to continue seeing patients for nearly two years while the state regulatory agency and its medical disciplinary board decided how to respond.
Under the watch of the Illinois Professionals Health Program, Deenadayalu was evaluated by a fellow doctor who determined it was safe for him to continue his practice. The evaluator did not talk to the three former patients who alleged Deenadayalu sexually abused them nor to law enforcement officials, the records show.
The program instructed Deenadayalu to implement lessons from a boundaries course at Vanderbilt University, to take on a family physician as a role model and to have a chaperone when treating females, a requirement of his two-year criminal probation.
The program relied on assurances from Deenadayalu and his office manager that a chaperone was being used, records show. Testifying on behalf of Deenadayalu at a 2001 medical disciplinary hearing, Hoffman said she would speak with the doctor by phone once a month for as little as five minutes to ensure his compliance.
Goldberg, the medical prosecutor, asked her what the program's goal was in monitoring Deenadayalu.
"It's to help him continue to function in a healthy way," Hoffman replied. "The purpose in the monitoring is basically his adjustment to taking care of himself and also following — maintaining proper boundaries."
Goldberg asked how the program could guarantee Deenadayalu would implement the instructions.
"We can't guarantee," Hoffman said. "What we hope to do is with continued support and follow-up, to help him, I guess, to support him in facilitating following through with this, but as a guarantee, I can't guarantee anything."
State regulators suspended Deenadayalu's physician license in July 2002 even though Hoffman and Doot argued that he be allowed to continue practicing under the watch of their private program.
But when Deenadayalu reapplied for his license in 2006 and Doot again testified on his behalf, the regulators agreed it was safe for him to resume practicing. The state dismissed the medical prosecutor's claim that Deenadayalu "had failed to present sufficient evidence regarding his rehabilitation."
Deenadayalu, who now works for Physician Care Services, S.C., said he valued the monitoring he experienced through the private program.
"They talk to us in such a way that we understand the things, and how we can be, how we can change, what are the boundaries," he said in an interview. "They are more a teacher and a friend than anything else."
But critics say the program is set up to shield dangerous doctors.
"Why should we trust doctors to monitor each other?" said state Rep. Mary Flowers, D- Chicago.
The state's contract with the Illinois Professionals Health Program says the program shall maintain a committee with state officials to evaluate its operation and develop policies and positions on related issues. But no formal written policies and positions have come out of the committee, Hofer said. And there have been no public assessments of the program, she said.
The Federation of State Physician Health Programs has produced guidelines for the monitoring of substance-abuse cases but has no such guidelines for responding to sexual misconduct, said Dr. Peter Mansky, the group's president.
Many state programs have concluded that sexual misconduct cases are best handled in the public disciplinary process.
"Programs have tried to stay away from that," Mansky said. "We are supposed to be health- and wellness-oriented."
In a presentation to the federation, Philip Hemphill, an expert on treating physicians, said those with sexual misconduct violations require "360-degree" monitoring, involving anonymous reporting from patients, colleagues and administrators.
Some critics argue they shouldn't be allowed to continue practicing at all.