The nation's largest medical society says it has zero tolerance for doctors who sexually abuse patients. But ... the association does not favor the automatic revocation of the medical license of every doctor who commits sexual abuse of a patient. It does not expel every offender from its membership rolls. It has never independently researched the prevalence of sexual abuse in clinical settings. Twenty-six years ago it declared sexual misconduct a breach of medical ethics, but since then it has remained all but mute on the issue. It has, however, fought to keep confidential a federal database of physicians disciplined for sexual misconduct and other transgressions. When a proposal to open the database emerged in Congress, a former House staff member said, the AMA crushed it like a bug." Patient advocates say the AMA and other medical organizations have shown reluctance to confront the scope and impact of sexual misconduct, further exacerbating the problem. "At some point the profession has to take responsibility to accept that there are things that need to be done in regard to protecting patients," said Lisa McGiffert, manager of the Safe Patient Project for the advocacy group Consumers Union. "It's always been puzzling to me that doctors don't collectively say, 'We don't want these bad apples in our profession. They give us a bad name.'"