Doctors Behaving Badly: Minnesota doc bends pregnant patients to weird whims

If you were going to make a bet on which doctor lost his license in Minnesota, who would you choose?

The doctor who didn't pay his taxes?

The doctor who repeatedly had female patients undress in front of him, asked them to assume unusual positions while undressed and then touched their genitals without explaining why?

If you chose the tax laggard, you win. If you are a female patient in Minnesota, you may be losing.

The Minnesota Board of Medical Practice has twice reprimanded Dr. Erik Linck of Shoreview, Minnesota, for what can generously be described as bizarre behavior but never stopped him from seeing patients.

Linck, a board-certified family medicine specialist, has practiced in Minnesota for the past two decades. According to medical board documents, he asked a 16-year-old pregnant patient to touch her own cervix in front of him "to assist her in understanding how the pregnancy was changing her body." During this patient's next pregnancy, when she was 19, he performed a pelvic exam on her and then asked her to get up on her hands and knees on the examination table, naked from the waist down, while he performed the same exam using one hand and put his other hand "on [her] hip to steady her during the examination," the board wrote. He "did not provide [her] anything else to cover herself" nor did he explain to her the reason for the exam.

Isolated incident?

Another patient complaining of pelvic pain was also asked to get up in, as the medical board puts it, the "all-fours position," while naked from the waist down for an unexplained pelvic examination. This patient, whose history of prior sexual abuse was documented in her medical records, said that the "behavior traumatized her and set her back in dealing with past issues of abuse."

A 16-year-old patient complaining of back pain was asked to stand up while undressed from the waist down and place one foot on the platform of the examination table. Linck rolled his chair directly in front of her and gave her a pelvic exam while he "placed his other hand on the cheek of [her] buttocks". This was ostensibly to check for a hernia. On this patient, he also performed a breast exam even though the patient "did not tell [Linck] she had any concern about her breasts."

When doctor's examine patients, they usually make notes of how and why. When Linck asked patients to contort their bodies in odd ways so he could perform pelvic exams, he made no notes.When he examined their breasts without explaining why, he made no notes.

During a hearing before an administrative law judge, Linck disputed the patients' allegations that he had done anything untoward. Instead, he argued that, if anything, he should be faulted for not leaving the room while they were undressing or, perhaps, for failing to cover them up adequately during their exams. At no point in the board's lengthy description of the allegations is it made clear why Linck needed to examine these women this way. If you read through guidelines offered by organizations such as the American College of Obstetrics and Gynecology or the Royal College of Nursing, you will find that there are many different ways to perform a pelvic exam. Putting a woman on her hands and knees is not one of them.

The judge, apparently, did not think it was important to address this basic question. In fact, the judge said that the doctor could only be accused of one thing: bad recordkeeping. This is a standard get-out-of-jail free card for doctors. They can do many off-the-wall things and then claim there were medical reasons that they just failed to document.

In reviewing the judge's recommendation, the board did not quite buy that. The board found that Linck had "departed from or failed to conform to the minimal standards of acceptable and prevailing medical practice". As punishment, the board reprimanded Linck in May 2000 and ordered him to take classes in "communications/sensitivity," "professional boundaries" and, of course, "recordkeeping."  He also was ordered to pay $18,943.61 to partially reimburse the state for the costs of the investigation, but the board later dropped that fine to $7,500. Crucially, Linck also was told that he should always allow women to undress in private and should offer them the option of having a female nurse present during any examination.

In June 2008, Linck was caught falling into the same pattern. He had "conducted a breast examination for a female patient but failed to adequately explain the rationale for the breast examination to the patient, failed to offer an appropriate gown or drape, and failed to offer a female chaperone." When questioned by the board, Linck said that the patient had complained of back pain and, as a result, he had found an enlarged lymph node that made him want to check her breasts, too.

Once again, the board reprimanded Linck and, this time, fined him $1,000 in July 2010.

Contrast that punishment with what happened to Dr. Thomas Hennessey, Dr. Victor Lazaron and Dr. Jenise Teske in around the same time that Linck was reprimanded. All of them fell behind on their taxes. All of them had their licenses suspended. No hearings. No recordkeeping classes. No excuses.

The message is clear. If you don't pay your taxes in Minnesota, you can't practice medicine. But if you want to take some liberties with the way you examine female patients, just be sure to take good notes.

Final question: Why can't all medical boards make their websites as easy to use as Minnesota's? Linck's profile was easy to find. Linck's case history was easy to find, and there was thorough documentation for both the old charges and the new one. Astute readers may have noticed that Antidote skipped Michigan this week in this alphabetical tour of state medical boards. That's because Michigan has taken the exact opposite tack. They not only provide no documents online, they force consumers to make a formal request in writing for any documents about a doctor. Antidote was told that we should be receiving some records in about a week.