An East County free clinic doctor who admitted he sexually assaulted female patients in his exam room and took photos of their naked bodies will serve one year on house arrest and five years’ probation, a stark contrast to a pre-sentencing report that recommended a 20 year, 8 month state prison sentence.

Jeffrey Joel Abrams, 68, was sentenced to one year in jail to be served as house arrest and five years formal probation. He pleaded guilty to eight counts of sexual penetration of an unconscious person, three counts of sexual battery and one count of possession of child pornography, involving pictures of an 8-year-old girl, according to Deputy District Attorney Kerry Conway. Abrams faced 25 years in prison.

"I can tell in the 30 years I’ve been doing criminal defense, it’s by far one of the most unique sentencings I’ve seen because these types of charges usually merit serious, serious prison time," said Marc Carlos, a criminal defense attorney in San Diego. "The recommendation here is 20 years, which you would expect under these circumstances.”

During his house arrest, he will be monitored through a GPS device and will not be allowed to leave his residence. As a part of his sentence, he will also be required to register as a sex offender for the rest of his life and will be barred from practicing medicine.

Eight victims were seen by Abrams at the Volunteers in Medicine (VIM) free clinic in El Cajon between June 1, 2010, and June 2014.

"It is extremely unique, and I think if you talked to 10 criminal defense attorneys who’ve been around a long time, they’d tell you the same thing," Carlos said. "You just do not see this on a normal basis, so there was something, something which we are not a party to, which happened in chambers, which happened between the lawyers involved which I don’t think was unethical on anyone’s part. It’s just the way business is done in the criminal court system."

At his sentencing Friday, prosecution, defense attorneys and lawyers representing Abrams’ victims argued for a much lighter sentence that recommended by the County Probation Department.

Abrams’ lawyer, Alex Landon, cited his client’s advanced age, his willingness to plead guilty at early stage of proceedings, and his medical problems as reasons why Abrams should not be sent to state prison or county jail.

Landon stressed that by pleading guilty, Abrams spared his victims from testifying about the details of the crimes and having their testimony vigorously challenged by the defense.

“It’s very stressful of victims of sexual abuse to have to come to court and testify and be cross examined by defense attorneys like myself,” Carlos said.

He also said his client suffers from complications of cancer surgery, including two “life-threatening,” unhealed surgical wounds that require twice-daily cleaning.” The defense also noted that psychological tests reveal that Abrams is a low-risk for re-offending.

Prosecutor Kerry Conway did not challenge Landon’s arguments, and told Judge Laura Halgren that a no-custody sentence is “the most just resolution to this case.”

The 23-page probation officer’s report, obtained exclusively by NBC7, forcefully rejects that conclusion. The report also provides explicit and disturbing new details about Abrams’ crimes against his female patients, some of whom spoke only limited English.

“He used his position as a doctor to lead the victims to believe the inappropriate acts served a professional purpose,” the report concludes. “It appears his actions were well calculated as some of his victims were Spanish speaking or economically disadvantaged, therefore making them less likely to report the crime.”

Probation officer Deanna Silva, who interviewed Abrams and his victims and wrote the report, acknowledged that Abrams was eligible for probation and in need of medical care for his surgery-related problems.

“However, given the facts of this offense, the impact it has had on the victims, the distrust he has instilled in the community and the medical profession as a whole, and for the protection of the community, it does not appear probation is appropriate in this matter,” Silva said. “Given the victims and numerous occasions the offenses occurred… it is recommended the defendant be sentenced to state prison for 20 years, 8 months.”

Judges are not required to follow the probation officer’s recommendations, and need only consider those findings as one part of the sentencing equation.

At Friday’s hearing, Judge Halgren also heard from two attorneys who represent Abrams’ victims in civil lawsuits filed against him and the clinic where the sex crimes happened. Both those lawyers said their clients are satisfied with the no-custody recommendation made by the defense and prosecution.

“They want to show mercy on him,” said attorney Jessica Pride. She said her clients are happy that Abrams will have to register for life as a sex offender, is permanently barred from practicing medicine in California, and “sympathize that is very ill.”

None of the victims testified at Friday’s sentencing.

Pride also confirmed that Abrams will pay her clients for the harm he caused them, though Pride declined to discuss how much money those victims will receive. It is possible that any payment amounts will remain a secret, because financial settlements in civil lawsuits are often confidential.

Money for those payments to victims could come from insurance policies held by Abrams and the El Cajon clinic, but a court document also reveals that Abrams has a significant amount of money. Though currently unemployed, Abrams reported his home is worth approximately $1.2 million. He also has more $1 million in savings and owns vacant land in Florida worth about $30,000.

Court documents also reveal that Abrams has the benefit of high-powered legal advice. In addition to attorney Alex Landon, who is a respected veteran criminal defense attorney and faculty member at the University San Diego School of Law, Abrams hired Robert Shapiro, who helped O.J. Simpson win an acquittal on murder charges. Shapiro, who works for the Los Angeles law firm Glaser Weil, also defended actor Marlon Brando’s son, Christian, and counts Steve Wynn, Wynn Resorts and Rockstar Energy Drink among his current civil law clients. According to court documents, Shapiro was in San Diego last week for a pre-sentencing conference in Judge Halgren’s chambers.

When Abrams was arrested in November, investigators claimed to have found more than a thousand photos of women’s vaginas, breasts and buttocks on his work phone.

There was also a video of a patient touching herself in the exam room with Abrams, a search warrant alleged.

A lawsuit was filed by five women who were patients to the clinic VIM in El Cajon.

One of the plaintiffs in the case said that she initially went to the clinic to get a referral to a psychologist and a therapy group. Another woman requested a fertility specialist to help her conceive. A third woman said she went to VIM for a rash on her hand.

All say they were instructed by Abrams to remove their clothes so they could receive a vaginal exam. In some cases, the women were given rectal exams.