All physicians swear to honor the Hippocratic Oath upon entering the medical field, vowing to “do no harm” to patients. As such, patients enter into doctor-patient relationships with an assumption of trust, but unfortunately, some healthcare providers take advantage of that trust.

According to an article in Sexual Abuse, many abusive doctors are men older than 39 who see patients behind closed doors. The article notes that most patients who are sexually assaulted by healthcare providers do not report the incident, which makes accurately determining the number of transgressions extremely difficult. Less than 10% of victims report incidences of sexual abuse.

Over the past 24 years, upwards of 2,400 physicians nationwide have been disciplined for behavior relating to some form of sexual abuse, according to the Atlanta Journal-Constitution. Shockingly, around 66% of Georgia doctors who were disciplined for physician-initiated sexual abuse maintained their licenses and continued to practice, and this is solely based on publicly known cases. Doctors are often not brought to justice, the article notes, because victims often feel confused, intimidated, or embarrassed. Additionally, colleagues of the offending physicians may keep quiet, thereby siding with the abuser and undermining the victim’s confidence.

To make matters worse, hospitals sometimes sweep such sexual assault allegations under the rug or they may request that the offending physician leave their job before word spreads. In such cases, offending physicians go unflagged by medical boards and law enforcers, maintaining their licenses and continuing to practice medicine. Even when physicians have seemingly been brought to justice, things are not always what they seem. According to the Atlanta Journal-Constitution reporters, silencing of patient-victims is a systemic issue in the United States, as medical boards overrun by doctors lean toward providing offenders with second chances.

An article in the Journal of General Internal Medicine notes that both physicians and the general public must be better educated on the subject of patient-victim sexual assault. Certain measures must be also required, such as reporting mandates for physicians that would entail penalties for failing to report abuse. If a patient has disclosed an incidence of patient-victim sexual abuse, physicians should be prepared to respond. The American Academy of Family Physicians offers suggestions for sensitive and effective communication, which includes sitting and making eye contact with the patient to make them feel safe and comfortable. Physicians should listen without judgment, using language that supports and empowers the patient to act. Physicians can convey compassion through their eyes and language—never with physical touch. It is also helpful to provide the patient with a list of resources available.