Miami Herald
Psychiatrist suspended for ‘inappropriate relationship.’ He got a $196K state job.
By Steve Contorno and Lawrence Mower
February 28, 2019

Psychiatrist Domingo Cerra-Fernandez

Psychiatrist Domingo Cerra-Fernandez

TALLAHASSEE – Less than a year ago, Domingo Cerra Fernandez was suspended from practicing medicine in Florida. He still can’t in New York.

The Ocala psychiatrist allegedly committed one of the cardinal sins of his discipline: He propositioned a patient to have a sexual and romantic relationship with him. He then continued to treat her.

But just months after his Florida suspension ended, Cerra Fernandez has a new job. He’s a senior physician at the North Florida Evaluation and Treatment Center, a maximum-security, state-run treatment facility for men who are committed by a court as being incompetent to stand trial because of a mental illness or found to be not guilty by reason of insanity and dangerous to themselves or others.

Cerra Fernandez is now one of the 30 highest-paid state employees.

How did a recently suspended psychiatrist find himself working with some of Florida’s most vulnerable and dangerous residents, with a $196,000 annual salary?

The Department of Children and Families, which runs the facility, knew about his case before hiring him to a job that had been vacant for more than a year. DaMonica Smith, a department spokeswoman, told the Herald/Times that Cerra Fernandez was up front about his discipline.

“Cerra Fernandez’s medical license was active with no pending issues at the time of hire and is currently in good standing,” the department said in a statement sent by Smith. “The department was aware of the action taken on Dr. Cerra Fernandez’s medical license and thoroughly reviewed the circumstances prior to hiring.”

A former Army captain, Cerra Fernandez came with glowing recommendations from other doctors, according to a review of his application file.

“Dr. Cerra always conducted himself in a professional manner,” wrote Dr. Mark Knapp, former chief medical officer for the Veteran Affairs Community Based Outpatient Clinic in Ocala, in a recommendation to the department. “He was a very compassionate physician and held in high regard by patients and staff.”

Cerra Fernandez did not respond to numerous attempts to reach him through an email address and phone number listed on his application to the state.

Amid the reviews in his file was the suspension — a rarity for doctors. Of the more than 70,000 active doctors with a Florida license last year, only 29 received suspensions from the state.

According to an administrative complaint from the Florida Department of Health, Cerra Fernandez was a psychiatrist in Ocala where he treated a longtime patient for depression, anxiety, anorexia, bulimia and other issues. In October 2011 he asked this patient to start a “romantic relationship.”

The patient agreed, and Cerra Fernandez suggested they switch her to another doctor. But he didn’t follow through.

Instead, Cerra Fernandez continued to treat the woman, identified as Patient M.W., providing prescriptions while they dated for six months. During that time, he sent her “inappropriate” emails and text messages, according to the complaint.

Cerra Fernandez “used his professional physician-patient relationship as a treating psychiatrist for Patient M.W. to engage or attempt to engage Patient M.W. in, or to induce or attempt to induce Patient M.W. to engage in, verbal or physical sexual activity outside the scope of the professional practice of medicine,” the Department of Health concluded.

At the time, Cerra Fernandez held a private practice, with privileges at Munroe Regional Medical Center, now Advent Health Ocala, and Ocala Health.

In a settlement reached in February 2018, the Florida Board of Medicine formally reprimanded Cerra Fernandez and suspended him for six months.

Cerra Fernandez also agreed to pay a $20,000 fine plus nearly $10,000 to cover the cost of the state investigation. He was ordered to complete a course on “boundaries” and to inform the state whenever he moves.

The state only submits an administrative complaint when “the investigation and/or the expert opinion supports the allegation(s),” according to Department of Health protocols. Nevertheless, in the settlement, Cerra Fernandez “neither admits nor denies the allegations” in the complaint, according to the agreement.

Meanwhile, New York revoked Cerra Fernandez’s medical license there for two years because of what happened in Florida.

The American Psychiatric Association warns in its ethics guide that even the possibility of a romantic relationship between a doctor and patient “may contaminate current clinical treatment” and “should be avoided.” Cerra Fernandez included the association under his affiliations in state records.

“Sexual behavior with patients is unethical,” the association’s Commentary on Ethics in Practice says.

The reason such behavior is unethical is because of the power a doctor has over a patient, said Katherine Drabiak, a lawyer and medical ethicist at the University of South Florida. That’s especially true in the field of mental health, where doctors have knowledge of a patient’s vulnerabilities and determine their treatment.

It’s not only unethical, it’s also illegal, she said.

“When you’re revealing your mental health issues to a professional there’s a potential for exploitation of those psychological weaknesses that everybody has,” Drabiak said. “This is something especially nefarious because the person is seeking support and counseling, not a relationship.”

At the time of his suspension, Cerra Fernandez worked for a Veteran Affairs Community Based Outpatient Clinic in Ocala. He said he left in June due to “family illness,” according to his application to the state.

The U.S. Department of Veterans Affairs did not respond to a request for comment.

Cerra Fernandez’s suspension in Florida ended in August.

On Jan. 11, he was hired by the Department of Children and Families into one of seven positions created by the Legislature in 2017 to “help increase psychiatric evaluations” in the state, said Smith, the spokeswoman. The spot filled by Cerra Fernandez had been vacant since its creation and had no other applicants, according to the department.