Poor Oversight: DoH drops the ball on optometrist accused of sexual assault “He had an obvious erection, and just started grinding on me. There was nothing ambiguous about it.” This is not how you would expect someone to describe their last visit to their optometrist. Yet this woman, who has asked to have her identity withheld, has. She describes the most vulnerable part of an eye exam – equipment that makes you feel confined, stuck with peripheral vision cut off and sight- impairing eye drops making everything fuzzy. And then being taken advantage of by a person you trusted. She’s one of a number of women who found one another online, through their similar reviews of their experiences with West Side MD Dr. Paul DeCesare, of DeCesare Eyecare. Many of these reviews were removed recently without explanation from sites like CareDash and Healthgrades. A couple are still visible on Yelp, and have reappeared on other sites. What is more alarming in the realm of disappearing complaints is that at least three were filed with the Department of Health (DoH) over the last few years. Motif was able to track down three official complainants (We’ll call them A, B and C for this article). All three said they had found other women with similar experiences through online review sites, but we were unable to contact them all. Two of the three we spoke with provided us with copies of their official complaint paperwork, filed with the DoH. Both described attending hearings, and they each said they felt the hearings were conducted with little sensitivity, and both subsequently received basic notices saying that “an internal investigation has been conducted, and no disciplinary action was taken.” There was no further information or indication of why there was no censure — nor recommendations for further action. One appeal was denied on the grounds that there was no new evidence. Dr. DeCesare has been practicing for more than 47 years in Providence. He is a past president of the RI Optometric Association, and served on the board of examiners — the same board that was asked to assess complaints against him — for a decade. He operates from offices on Broadway, and focuses on family practice with his colleague Dr. Cassandra Oliveira, who joined the practice in 2016. While the police handle any criminal complaints against doctors, the Department of Health has its own internal adjudication system to handle ethics, malpractice and competency complaints. There are hundreds of reprimands and a few other disciplinary actions that can be found on the DoH site from the last several years, spanning most medical specialities as well as nurses, pharmacists, barbers and nail salons. According to Joseph Wendelken, spokesperson for RIDoH, “If we get a complaint regarding a boundary violation or issue of sexual harassment here is the usual process: 1. Complaint is reviewed at Team Review Tuesdays at 11am 2. Every complaint is screened daily so if a complaint was particularly serious it would be opened that day 3. Notice is sent to the physician that a complaint has been opened for investigation 4. It is common for the complainant in a matter like this to be interviewed 5. After we get a response, the case is presented to the Investigative Committee for their review and decision. It is common for the Investigative Committee to interview the physician and if appropriate, the complainant 6. If the above situation were considered to present an immediate danger to the public, the Director of Health is notified for consideration of applicable usage of her emergency powers.” We asked the DoH for any complaints filed against Dr. DeCesare. They declined to provide that information. We filed a public records request and were informed that complaints are not considered public record unless disciplinary action is taken. The DoH has not taken disciplinary action against this doctor, so an unknown number of complaints against him are locked away (when disciplinary action is taken, the action can be viewed publicly at health.ri.gov/lists/disciplinaryactions). We also requested police records on complaints filed against Dr. DeCesare. The Providence Police declined to disclose anything on the basis that it might jeopardize an ongoing investigation (before you jump to any conclusions from that response, you should know that this is the response the Providence Police have given to every open records request we have filed with them — over a dozen on various different cases over the years. It’s really just their way of telling the press to go get a lawyer if we want anything). We asked an independent practicing optometrist about sensitivity to this sort of issue. He also wished to remain anonymous, but told us, “That’s why I always leave the exam room door open. It’s not an issue that’s really come up, but you want people to feel comfortable.” He told us that doctors don’t receive any special training regarding sexual misconduct or sensitivity. They do receive special training on how to interact with children, with elderly patients, patients on the autism spectrum and patients who are prone to fainting when something comes too close to their eyes (a rare but real disorder). Each of these presents unique challenges, but training on generally or sexually appropriate behavior is not something that’s available. Or, in his opinion, should need to be. “There’s an element of common sense you should have. That’s just not okay.” The women who had bad experiences tell similar tales, with different levels of escalation. One review still on HealthGrades says, “I visited Dr. Paul DeCesare several years ago and he made me feel very uncomfortable. He repeatedly called me condescending pet names like ‘sweetie,’ ‘honey,’ ‘young lady’ (I was nearly 30 at the time, not 5 years old), while at the same time touching me constantly for no reason. I’ve been going to eye doctors for about 20 years and this definitely went beyond the normal intimacy of a typical visit. Stay away from this guy.” On Yelp, there are three reviews with a similar theme. One of the reviewers is not a frequent Yelper, but the other two are verified and have put up reviews on many different topics. From HM: “The staff at the front was nice but the doctor was super creepy and I wanted to leave but was afraid to. “He kept calling me ‘sweetie,’ ‘babe,’ ‘baby,’ ‘honey’ etc … But worst of all he kept touching me constantly. He rubbed my thigh with his hand, pressed his crotch against my legs repeatedly, held my hands and pressed his face against mine. I’m not new to seeing optometrists, I get that there is a level of closeness that needs to happen during an eye exam, but this was way over the top.” And from Barbara S: “I was a patient here for a couple of years with no incident and liked going to this office. Until my last exam when Dr. Paul suddenly, deliberately, with no provocation and staring at me, assaulted me while I was in the exam chair. I was shocked, and pinned behind all the equipment and didn’t know what to do and said nothing at the time. “Upon searching Yelp for … a new doctor, I discovered two other women who have had this experience with him!” In some cases (A and C), the women who posted negative comments were asked by the practice to remove them, and some comments were removed from other review sites. It was through these comments that the women were able to reach out, connect, share their stories and gather the resolve to file formal complaints, first with the Department of Health, then with the police. “There’s a reason people keep getting away with this behavior,” said complainant A. “I didn’t know how to report it, and couldn’t really find that information online or by Googling. I called a lot of different places and got a lot of wrong info along the way. I called Day One, and some other advocacy groups, and was told they couldn’t advise me because it was a legal matter.” Calls to the Providence police were misdirected or unanswered. “You hear no, no and no and you do give up. Honestly, at first, I didn’t even realize second degree sexual assault was a crime. I was going to just find another doctor. But I saw the other statements online. That moment was a game changer for me. I wasn’t alone, and I had to wonder how long this sort of thing had been going on, and for how much longer.” But even the process of how to report it and to whom isn’t a clear one. “I didn’t know the attorney general would take on something like this. I thought I had to hire a lawyer,” says A. “I finally walked into the police station and asked the officer at the door for help — the one who runs people through the metal detector. Because the established channels didn’t seem to work. He brought me to the right detective.” The DoH expressed no intention to change how complaints of this sort are handled. Disciplinary action could include, “license suspension or revocation, public reprimand, consent order or probation, provided adequate evidence is obtained to support the complaint,” but in these cases they found no grounds for any disciplinary action (both women received the same form letter). One complainant appealed the decision and was told, “Through board management and legal counsel, we conducted a thorough review of the above complaint, previously filed by you with RIDoH, as well as the additional message you recently submitted.