HEC Forum

, Volume 24, Issue 2, pp 115–126 | Cite as

The Role of Family of Origin in Physicians Referred to a CME Course

  • Charles P. Samenow
  • Scott T. Yabiku
  • Marine Ghulyan
  • Betsy Williams
  • William Swiggart


Few studies exist which look at psychological factors associated with physician sexual misconduct. In this study, we explore family dysfunction as a possible risk factor associated with physician sexual misconduct. Six hundred thirteen physicians referred to a continuing medical education (CME) course for sexual misconduct were administered the FACES-II survey, a validated and reliable measure of family dynamics. The survey was part of a self-learning activity. We collected data from February 2000 to February 2009. Participants were predominantly white, middle-aged males who represented the full range of medical specialties. Their results were compared against a sample of 177 physicians. The FACES-II is a self-report test that measures family of origin (the family in which one was raised) dynamics on two dimensions (1) flexibility, ranging from too flexible (chaotic) to not flexible enough (rigid) and (2) cohesion ranging from too close (enmeshed) to not close enough (disengaged). The most common family pattern observed among physicians accused of sexual misconduct was rigid flexibility paired with disengaged cohesion, indicative of unhealthy family functioning. This pattern was significantly different than the pattern observed in the comparison group. Physicians who engage in sexual misconduct are more likely to have family of origin dysfunction. Ethics is developmental and learned in one’s family of origin. Family of origin dynamics may be one risk factor predisposing one to ethical violations. These findings have important implications for screening, education, and treatment across the medical education continuum.


Sexual misconduct Boundary violations Professionalism Continuing medical education 


Conflict of interest



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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Charles P. Samenow
    • 1
  • Scott T. Yabiku
    • 2
  • Marine Ghulyan
    • 3
  • Betsy Williams
    • 4
  • William Swiggart
    • 3
  1. 1.Department of Psychiatry and Behavioral SciencesGeorge Washington University School of MedicineWashingtonUSA
  2. 2.School of Social and Family DynamicsArizona State UniversityTempeUSA
  3. 3.Center for Professional HealthVanderbilt University Medical CenterNashvilleUSA
  4. 4.Departments of Behavioral Sciences and PsychiatryRush University School of Medicine, Professional Renewal CenterChicagoUSA

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