There is really very little that bears saying in the appalling case of Dr. Earl Bradley, a Delaware pediatrician who stands accused of molesting over 100 of his patients. I like to think that I have a facility for words, but I cannot find the right words to describe how I, as a pediatrician, feel about what this man has done with the trust given to him as a member of our shared profession. I am disgusted and horrified and infuriated in a manner unlike most of my more commonly-expressed ire. (While the obvious caveat about being innocent until proven guilty obviously applies, the existence of video evidence for many of these crimes makes that chance seem fleetingly small.)

Over at Not A Potted Plant (a blog I happened upon a little bit ago when it and our wee humble blog were both given simultaneous shout-outs at Ordinary Gents, and which I recommend heartily [except to the religious and easily offended]), Burt Likko (not his real name) offered some humorously-phrased but genuinely helpful legal advice. (In short, never ever talk to police without legal advice.) It's probably the kind of advice that, to him, seems like such common sense that it doesn't need to be said. In that vein, I offer some (more earnestly-phrased) medical advice, which seems obvious to me but clearly was not to the parents of over 100 children in Delaware.

The number of times I have examined non-adolescent patients without a parent present is zero. It is something I never do. A reputable pediatrician is highly unlikely to examine your child without you there. We want you there for your child's comfort and security, we want you there if we need help holding or calming your child to get the exam done, and we want you there for our own protection so everything we do is known to you. For adolescent patients, I defer to the preference of the patient, and generally ask if they want their parent present while the parent is still in the room. And I never, ever, ever perform any kind of gynecological exam without explaining why I'm doing it and without either a parent or other female chaperone in the room.

Any request to examine a child in the absence of a parent should be met with deep suspicion. (An exception worth noting is in cases of suspected child abuse, in which case another chaperone is typically present.) Parents who trusted Dr. Bradley to care for their children are absolutely not at fault, though I cannot imagine the guilt they must feel. But no doctor deserves to be left alone with your small child unless measures to ensure his or her safety have been made plain to you. Good ones would never ask in the first place.


  1. I want to say something that reflects how completely horrible this person is, and how infuriating it is that justice cannot be served and that he will never grasp the harm he's done. But words fail.

  2. It's hard to keep in mind that the presumption of innocence exists for exactly such situations as these, where the accusation is so overwhelmingly repulsive that merely being accused is the equivalent of being convicted. with that said, given this sort of support from his own attorney...

    "It seems to me that we need to do a very rigorous exploration of his mental health and see if there's any pathology there ... This case kind of cries out for that kind of analysis."

    ...suggests to me that counsel does not think that a defense on the merits of the case is going to go very far.

    Oh, and thanks for the shout-out!

  3. The presumption of innocence does not apply to public opinion. No one but the jury is required to assume innocence until the prosecution proves a crime has been committed. Usually it is a good idea to avoid the rush to judgment, but if the news report is accurate that video evidence exists, well...

  4. Don't want to talk about it, don't want to read about it (I did read your whole post, Dan, but only because it's you), don't want to think about it.
    And that's probably wrong, but that's what I have right now.

  5. "The number of times I have examined non-adolescent patients without a parent present is zero. It is something I never do."

    I dunno, when I was 11 I had an undescended testicle, and my doctor gave me a physical (which hurt like hell, because he forced it to descend, etc.) To an untrained eye it might have looked fishy, but believe you me, I knew there was nothing sexual about it.
    There is no way in the world I would have wanted either of my parents in the room. 7 and under I agree but there is a point after that that kids deserve their privacy. Maybe the parents can sit behind a curtain, so that they can hear everything (and at any moment come from behind it)

  6. Donald, I start offering unchaperoned exams to patients at about 11. However, as I said above, typically I do this with the parent in the room so it is understood to be the patient's preference. The area where parents wait is right around the corner, and I make a point of coming out and speaking with them as promptly as possible.

  7. OK dr.danny, when I hear adolescent, I think teenager. What is the cut off date for a pediatrician before they go to an adult doctor?

  8. The guidelines are fluid. I believe that the AAP defines pediatrics as extending to age 21. If patients are still in school and functioning as dependants, then we tend to keep them. Once they're out in the "real world," we gently suggest they transition to a "grown-up provider." Sometimes this transition happens very, very slowly.