Rheumatologist says patients will stand behind him

GUILDERLAND — A doctor accused of sexual harassment says he is not concerned about his reputation or the fate of his practice.

Dr. Richard Wilmot has treated patients with chronic pain for nearly 20 years, working in an office at 2 Executive Park Drive, Guilderland, for the past eight years. The 60-year-old rheumatologist graduated from Albany Medical School in 1988.

In 2008, a female patient complained to the New York State Department of Health that Wilmot had acted inappropriately during some of her visits to his office for treatment of groin pain.

Additionally, the department, citing seven patients, found that Wilmot prescribed thyroid medication without documentation of abnormal blood tests.

Subsequent to a three-year investigation, the health department charged Wilmot with professional misconduct by willful harassment; moral unfitness; ordering of excessive tests, treatment, or use of treatment facilities not warranted by the condition of the patient; negligence; incompetence; and failure to maintain records.

Wilmot did not refute the charges of poor record keeping, but denied the allegations of sexual harassment. He signed a consent agreement with the state’s Board for Professional Misconduct stating that he did not contest the charge of negligence, and admitted to failing to maintain accurate records. He accepted the board’s penalties.

When he pleaded guilty to the charges of negligence and failing to maintain accurate records, he accepted the penalties of a license limitation requiring the presence of a chaperone when he is examining or treating female patients; 36 months of probation; enrollment in a continuing education program on the appropriate boundaries with patients and the use of thyroid hormone replacement therapy; and the knowledge that, if he fails to comply with the terms of probation, he will have his license suspended.

Wilmot told The Enterprise that, while he is trained as a rheumatologist, he doesn’t do typical rheumatology work.

“Our practice is a little bit different; we treat people with diffuse body pain and fatigue, which is not treated well by most doctors,” said Wilmot on Wednesday. The conditions he treats include fibromyalgia and soft tissue injuries, which he said go hand in hand and aren’t well understood by many doctors.

Fibromyalgia is a syndrome characterized by long-term, body-wide pain and tenderness in the joints, muscles, and tendons, and is linked to fatigue, anxiety and depression.

“I have become very good at figuring out these problems and how to treat them,” Wilmot said. He is ranked as a top doctor by U.S. News and World Report.

Allegations of harassment

Wilmot said the 35-year-old patient who made the allegations came to visit his office for treatment on 21 separate occasions. She suffered from severe fibromyalgia and soft tissue injury to her groin, possibly as a result of a bad car accident.

“We tried very hard to make her better using our procedures, but, in her case, nothing worked. She kept coming back, complaining of severe pubic pain and asking if there was anything we could do,” said the doctor.

Wilmot described a treatment called the electric stimulation technique, in which he uses a graphite glove to deliver a current to the damaged soft tissue; the stimulation can encourage healing.

He suggested the treatment to his patient because he had used it successfully with another female patient who had a groin injury from kayaking, and the patient agreed to try it.

“The treatment involved running the graphite glove over the outside edges of her pubic bone, and her hip bones,” said Wilmot. The patient received the treatment several times.

Two months after the patient in question finished treatment, Wilmot received notification from the health department that there had been a complaint of inappropriate behavior.

“We were shocked, because she had never made any indication that she had a problem or was uncomfortable during her visits,” Wilmot said.

The patient’s allegations, according to a consent and agreement order from the state’s Board for Professional Misconduct, were that Wilmot hugged her and kissed her cheek at the end of several examinations and treatments; that he leaned against a table she was lying on so that his genital area was touching her arm; that he pushed on the outside of her labia and vulva without wearing gloves while he was examining her pubic bone; and that he made inappropriate comments about her buttocks and how much he enjoyed working on her.

Wilmot told The Enterprise that he had, in fact, hugged the patient and kissed her on the head after some of her appointments, something he said he did with many of his patients.

“When you’re treating someone with chronic pain, for an extended period of time, and you’re able to help that person when no one else could, you develop a close relationship,” Wilmot said. “It means so much to people to have a doctor who will advocate for them; it’s an important relationship.”

He said he no longer hugs patients.

“I think that’s sad,” he said.

However, said Wilmot, he never made inappropriate comments about his patient’s body, nor did he touch her inappropriately.

“Those are just things that would never happen,” he said. “Eighty-percent of our patients are female, and I’ve treated dozens of groin injuries, and never had a problem.”

Wilmot said his practice is well versed in dealing with patients who have a history of abuse, whether it be physical, emotional, or sexual. He believes there may be a connection between abuse and chronic pain disorders.

“We’re usually even more sensitive to those types of issues than other doctors would be,” he said. “Clearly, the patient truly believes something inappropriate happened, but I never got the chance to even talk to her and try to understand it, which is a shame because I thought we had a close relationship.”

Prescribing thyroid medication without abnormal blood tests

When the health department looked at the patient’s records, it found that Wilmot had also treated her with thyroid medication, despite the fact that blood work showed her thyroid was functioning properly. When the health department made that discovery, said Wilmot, it asked to see the records of 10 other patients he was treating with thyroid medications.

The records showed that he had treated eight of those patients with the medication even though they had normal blood work.

Wilmot told The Enterprise that his practice employs a technique implemented by John Lowe, fibromyalgia expert and author of the textbook The Metabolic Treatment of Fibromyalgia.

Lowe, a licensed psychologist and a chiropractor, did extensive research on the connection between the thyroid and the symptoms of fibromyalgia, and, according to Wilmot, found that the problem in fibromyalgia is within the processing center of the brain.

“What is wrong is in a portion of the brain that doctors can’t measure; it is like the volume control on the pain center is turned way up in these patients,” said Wilmot.

In addition, he said, Lowe found that the changes in the brain were affecting the hypothalamus, which instructs the pituitary gland on how to produce the thyroid hormone. In fibromyalgia patients, there is too little thyroid hormone regulation of cell function.

Standard endocrinology tests for the thyroid hormone do not properly measure that regulation, said Wilmot. However, Lowe found that, by treating fibromyalgia patients with low doses of thyroid medication, nearly 85 percent saw a dramatic improvement or full recovery.

Wilmot began treating some of his fibromyalgia patients with thyroid medication, and said at least 70 percent had what they described as a “miraculous” recovery or reduction in pain. In the instances where the medication did not appear to provide any relief from symptoms, Wilmot ceased to prescribe it for them.

“The health department did not take into consideration the fact that I stopped treatment with thyroid medication if it did not help the patient,” he said.

Wilmot said he did not blame the health department, since it was only doing its job to make sure patients were kept safe. The department, he said, had to work within the guidelines of traditional endocrinology, which stipulates that thyroid medication should not be prescribed in the absence of abnormal blood tests.

“Even if the patient is clearly exhibiting hypothyroid symptoms, if the blood tests are normal, you aren’t supposed to prescribe the medication,” he said.

Striking a deal

For financial reasons, Wilmot decided not to pursue any of the charges in a trial.

“We were working with the health department over a period of three years, and, honestly, I thought the charges were going to be dismissed,” Wilmot said. “It came down to a ‘he said, she said’ battle; we have no history of abusing patients, and they had no way of making the charges stick.”

In the end, he said, the health department told him it would give him the opportunity to plead guilty to the record-keeping charges and it would drop the charges of sexual harassment.

“I did not understand at the time that the charges would still go up on the website for Professional Misconduct and Physician Discipline,” Wilmot said.

During his probation, Wilmot will be subject to random unannounced monitoring of his practice; will be required to provide records on request; and will be required to maintain at least $6 million of medical malpractice insurance per year.

Wilmot said he is fine with the terms of his probation.

“When I was in medical school, we discussed the benefits of having a chaperone in the room for certain exams, like pelvic exams,” he said. “I thought to myself, ‘That makes sense,’ but I don’t do pelvic exams, so I never had a chaperone.”

It will be an added expense to his practice, but he said it will be beneficial and will protect him from another situation like the one he has been in for the past three years.

The chaperone must be a licensed or registered health care professional, and not a family member, personal friend, or professional relation of Wilmot’s.

Wilmot also managed to negotiate with the health department to get permission to set up a research program of the benefits of thyroid treatment in fibromyalgia patients.

“Under those auspices we will be able to continue to administer thyroid medication to our patients, just in a different way,” he said. He hopes to publish the results of his research.

“You can understand that people were very concerned about the charges,” Wilmot said. “But the number of people who have contacted us and been completely supportive is amazing.”

“We have a very dedicated following of patients,” he concluded. “And I am not concerned about the practice suffering.”