A doctor accused of sending sexually explicit videos and texts to a patient should be barred from treating females and should be suspended until he completes a psychiatric evaluation, the Florida Board of Medicine said Friday.
But the board cannot order Dr. Tuan Dean, a family practitioner in The Villages, to comply. He can continue to practice until he receives formal notice of the board’s decision and then can take seven days to reply. If he doesn’t want to accept suspension and a male-only practice, which is likely, he can force the Department of Health to prove its case before an administrative law judge.
DOH prosecutors warned the medical board that may be difficult; they said the patient is not willing to cooperate and testify. But the majority of board members insisted they try.
“The doctor-patient relationship is sacred, and I can’t imagine any higher betrayal,” said Dr. Jorge Lopez of Maitland, a board member. “I don’t feel very comfortable with this individual practicing medicine.”
Dean, who came to the Orlando meeting with an attorney, expressed remorse. “I know I’ve done something really bad,” he said. “I have taken steps to make sure this never ever happens again.”
The alleged incident occurred in August 2011, when Dean was working at a Lakeland walk-in clinic. By the time the patient came forward, however, Dean had moved to a different job. He has been practicing at TriCounty Physicians in The Villages, according to the practice’s website.
In August through early October of 2013, after Dean became aware the state was investigating, he went to an inpatient treatment center in Lawrence, Kansas, the Professional Renewal Center. He was due to return to the center for follow-up in March, but said he could not because of family issues. He said his 2-year-old son is very ill.
Dean told the Board he has been attending therapy sessions and support-group meetings each week, and is limiting his work hours to reduce stress. He said he has signed a five-year contract with Professionals Resource Network (usually called PRN), which contracts with the state to monitor physicians who have been in trouble.
His misbehavior in 2011 was brought on by overwork and stress, he told board members on Friday. “I was working seven days a week,” he said. “I was burned out.”
Three members of the board pushed to accept a settlement that would let Dean continue to practice with PRN monitoring, as long as he always had a female licensed health professional in the room when he saw female patients.
Dr. Zach Zachariah, a board member from Fort Lauderdale, said that would make more sense than offering a settlement with a stiffer penalty, one that Dean is likely to reject. Given how difficult it would be for DOH to mount a case against Dean without the main witness, the state may lose, which would leave the board with no control over the doctor. Even if the state prevails it takes a long time to prosecute.
“It could take a year or two years. If he has a damn good lawyer, it could take five years,” Zachariah said.
But two women members of the board, Dr. Onelia Lage of Miami and consumer member Brigitte Goersch of Satellite Beach, objected. Lage said the board usually goes for revocation of the license – suspension at a minimum — in sexual misconduct cases. Goersch said it just made her “uncomfortable” letting Dean continue to practice without any warning to his patients of what he had done.
The state’s investigative report says Dean focused on a 29-year-old Medicaid patient who had come to a Doctor Today clinic where he worked. The woman, identified as “E.S” said the doctor behaved strangely while performing a pelvic exam. That night she received the first of several texts that to her seemed overly personal. When she questioned whether it was ethical, since he was her doctor, she said his texts became vulgar; he sent a photo and five videos that the investigator said were of him “pleasuring himself.”
At one point E.S. went to a police agency to report Dean, she told the investigator, but she said they told her it was a matter for civil authorities. She turned over the materials, which she had backed up on her computer, to her attorney, Kimberly Hosley, who passed them on to the DOH investigator.
The complaint against Dean was actually filed by Dr. Rekha Issar at the Lakeland Clinic after E.S. and Hosley contacted her, records show. Health News Florida was unable to reach either Issar or Hosley.
DOH prosecutors and Dean’s attorney, Michael L. Smith of Altamonte Springs, worked out an agreement that would have settled the case with a reprimand; $10,000 fine; courses on rules, ethics and risk management; a requirement that a woman health professional be in the room whenever Dean sees a female patient; and compliance with the PRN program.
After rejecting that settlement, the board adopted one that included the previous discipline and added the temporary suspension and prohibition on seeing women patients.
