The Seductive Patient - Curbside Consultation - American Family Physician
We took a deeper look into these long-term doctor-patient relationships to better a long-term relationship with one doctor than with one romantic partner. Similarly, the American Medical Association (AMA) highlights that any prior doctor-patient relationship may unduly influence the patient. There are several important reasons why doctor-patient dating or a romantic relationship is discouraged in most societies. For one, the doctor is in a position of.
The patient asked if a referral to my partner meant that we could interact socially. The card also contained professional-grade photographs of her and her son. I did not respond to her gifts and cards. I placed a note in the clinic computer that the patient was not to have an appointment scheduled with me or any other male physician. I also asked to be notified when she was in the clinic. The patient made no further attempts to contact me. Four months later she returned to the clinic with a sore throat and was seen by one of my partners.
Commentary It is likely that all physicians, regardless of training, would recognize that this case scenario deals with a seductive patient.
The physician's response was appropriate in that he immediately rejected the patient's proposal in a clear and unequivocal manner.
Doctors allowed to date former patients - Telegraph
He documented that interchange in the medical record, discussed the problem with a colleague and formally terminated his professional relationship with the patient in writing. He did not respond to the patient's subsequent cards and gifts. Practice challenges rarely present in the clear and blatant manner described in this case scenario. In fact, most physicians-in-training are unable to identify seductive behavior in their patients.
Furthermore, many physicians recall little specific training about the appropriate boundaries to maintain with patients. In Maryland, all new physician licensees attend an orientation session that focuses on boundary issues. It seems apparent that many of these new doctors feel that they have not previously been provided with information on how to successfully navigate these uncharted waters.
The preclusion against becoming socially intimate with patients stems from two basic assumptions. The first is that the physician holds the greater power in the doctor-patient relationship by virtue of his or her training and position. Because of this disparity, patients might be exploited by their physicians.
Doctors allowed to date former patients
The onus, therefore, remains with the physician to act always in the patient's best interest. The second assumption is that when a dual relationship exists with a patient such as being both physician and loverobjectivity is lost. As a result, subsequent treatment may be compromised. In addition, a large body of literature suggests that when physicians become intimate with their patients, the patients often suffer significant and lasting emotional harm.
The code of ethics of the American Psychiatric Association instructs psychiatrists that the doctor-patient relationship is an enduring one, which precludes them from pursuing a personal, social or sexual relationship even if the patient is no longer under their care. Because patients may need to return for further therapy, personal involvement remains inadvisable.
The Seductive Patient
The codes of the American Medical Association and the American Osteopathic Association warn physicians of their duty to act in their patients' best interests and not to exploit the doctor-patient relationship. Beginning a personal relationship with a key third party might jeopardize the care of the patient. When instructing new licensees in the orientation sessions, I encourage them to terminate their doctor-patient relationship before pursuing a social relationship with a patient.
I also warn them that if their doctor-patient relationship included counseling or intimate examination of the patient, or if it was a long-term association, the risk remains that a subsequent personal relationship may be considered patient exploitation.
Physicians often do not realize the enduring nature of the doctor-patient relationship and do not appreciate that the transference phenomenon is not limited to psychiatric care. Even a brief association with the physician can significantly affect the patient. In these orientation sessions, someone always asks about the rural physician who has everyone in town for a patient.
In nine years serving on the Maryland Board of Physician Quality Assurance, that scenario never presented to me. Note that it is not the geographic reality, but rather the contractual restriction that forms the ethical bind.
I have yet to hear of any incidences, neither have we read anything in the press. What if a relationship turns sour? The patient might turn on the HCP. Professor Ishak stands with Dr Ng on her ethical concerns, suggesting either the termination of the either the professional or personal relationship if such a situation arises. Developing trust for HCPs: A societal issue Perhaps the cultural mindset of society plays a part in the issue.
He argues that society could be more open-minded and not frown upon personal relationships that arise after the professional relationship between HCP and patient has ceased to exist.
The practical problem that is attached to the state of vulnerability of the patient is, how long must the HCP-patient professional relationship be ceased before a personal relationship can be pursued? This way, it allows room for genuine relationships between a HCP and a former patient when the professional relationship has ceased and the danger of undue influence is no longer present — for example, what is done in the UK or some states in the US.
Again, the GMC does not specify appropriate length of time after which the professional relationship ceases, but interestingly California does. But what is the basis for that?