Physician assistant dating a patient


Green light for doctors to date former patients so long as they use their 'professional judgement' to decide if it is appropriate



Can doctors have relations (sexual/non sexual) with their patients?

A year-old woman who was new to my clinic presented for a routine annual checkup with breast and pelvic examinations. As usual, I performed the examination with my female medical assistant present. The patient requested a prescription for assidtant oral contraceptive and was offered testing, including blood work and mammography. She pointed to my wedding ring and said that she had not physician assistant dating a patient it before.

She then asked me if I was interested in having a relationship with her. I told her that I had no interest in her or in any of phyysician patients outside of the professional doctor-patient relationship. I then told her that I was uncomfortable with her personal interest in me and that I thought it would dafing best if she saw one of my female partners in the future.

The following day, the patient sent a bouquet of flowers and a card to me at my office. I discussed the situation with the organization's risk manager and documented it. In addition, I noted the events in my dictation of the office visit of the previous day. I then sent the patient a letter pahient the transfer of her care to one of my female partners. The following week I received dried flowers, a package of homemade cookies and a card.

The card contained poems about love and romance. 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 physician assistant dating a patient 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.

Assistang 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. It assstant 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.

He documented that interchange in the medical record, discussed the problem with a colleague and formally terminated his professional relationship with the patinet 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 physician assistant dating a patient identify seductive behavior in their asistant. 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 assistantt focuses on boundary issues. It seems apparent that many of these datin doctors feel that they have not previously been provided with information on how to jls dating the saturdays 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. The onus, therefore, remains with fating physician to act always in the patient's best interest. The second assumption is that when a dual relationship exists physiian a patient such as being both physician and loverexemple de question pour un speed dating 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 assostant, 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 patint further therapy, personal involvement remains inadvisable. 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 patisnt do not appreciate that the transference phenomenon is physician assistant dating a patient 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 patifnt everyone in town for a patient. In nine years serving on the Maryland Board of Dafing Quality Assurance, that scenario never patieent to patieent. The typical physician who is disciplined for having sex with patients is married and has been involved with multiple patients. The patient most often makes complaints about physical impropriety after the sexual relationship has ended or when a subsequent treating therapist supports the patient in making a complaint.

Often, the complaints physician assistant dating a patient from the patient's spouse or even the physician's spouse. Licensing boards look at every complaint regarding physician impropriety and adjudicate it on the individual merits of the case. The physician in this case scenario acted swiftly and appropriately to avoid becoming entangled in an inappropriate relationship. However, physicians must realize that, especially when they are personally stressed, they are vulnerable to becoming involved with their patients.


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