Inappropriate Patient Sexual Behavior When Working in Sensitive Areas of the Body: Results From a National Physical Therapy Survey

Background: Career and 12-month prevalence for inappropriate patient sexual behavior (IPSB) among physical therapy practitioners is 84% and 47%, respectively. Risk factors include fewer years of patient care, treating patients with cognitive impairment, female-practitioner sex, and male-patient sex. The IPSB risk specific to PT pelvic health practitioners and those treating in sensitive body areas has not been investigated. Objectives: Determine prevalence and risk of IPSB in physical therapy practitioners performing internal examinations and working in sensitive body areas, and whether differences exist in IPSB response-strategies among these practitioners versus general PT respondents. Study Design: Mixed-methods survey research. Methods: A survey fielded through sections of the American Physical Therapy Association and selected PT and physical therapist assistant educational programs in 2016 collected responses to questions on internal examinations and on working in sensitive body areas. Comparisons were made to the general survey respondents. Results: Most IPSB events were unrelated to working in sensitive body areas for general respondents, but occurred significantly more often for pelvic health practitioners (13.8% vs 3.8%; P = .036). Performing internal examinations was not a significant risk factor for IPSB. The pelvic health physical therapists were mostly experienced female practitioners, treating mostly women. They terminated and transferred care to others more often in the face of IPSB. Conclusion: Pelvic health physical therapy practitioners incurred more IPSB when treating sensitive body areas and transferred and terminated care more often than general respondents. Future research may determine whether internal examination is a stand-alone risk factor.