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

[TheShaker]

InB4MelissaThompsonTriesToDatePatient

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I feel like people are just trying to throw this face out as often as possible these days.

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[Yorick]

Now can doctors have an intimate relationship with another doctor, colleague?

 

[ComradeDoktor]

Now can doctors have an intimate relationship with another doctor, colleague?

I'm sure this must happen VERY frequently, since I personally know some examples. I don't see why this would an issue.

 

[r1d1]

Ethically it's never ok. Legally it's ok to date an ex patient, but not a current one.
In reality such things will not be discovered by board/authority until someone files a law suit--usually due to a bitter breakup. No medical staff would blow the whistle on a colleague if the patient is a consensual adult.
But seriously, you need to ask yourself: Why are you attracted to a vulnerable person under your care? Do you crave authority and masculinity? Napoleon complex much? Are you ready to marry her to keep her quiet, or face the nasty breakup that'll ruin you?

 

[tkim]

http://www.post-gazette.com/stories...itioners-not-held-to-sex-prohibitions-657592/

 

[Translation]

anyone watch/remember that grey's story line with Lizzy and her patient Danny.... yeah she went nuts and crossed serious ethical lines, but she also became a millionaire and opened a free clinic at the hospital....

 

[wholeheartedly]

It IS actually illegal in some states. The state of MN for one. Took a graduate forensic psych class awhile back, but this applies to all physicians not just psych. I can't find the link for the law at the moment, but it goes something along the lines of: it is illegal for a physician to have a sexual relationship with someone they currently have a doctor/patient relationship with. It is still illegal for two years AFTER the termination of that doctor/patient relationship.

That said, even after two years there are issues relating to the speciality type. Psych was already mentioned and the speciality board considers former patients always off limits due to the nature of the field.

There can be a lot of gray areas with things like whether or not one visit with a patient in the ED for a sprained ankle (I think this was sort of the case on Doctor's Diaries) constitutes an established relationship since it isn't ongoing.

It isn't worth it to risk your career on a gray area.

 

[Textbookversion]

anyone watch/remember that grey's story line with Lizzy and her patient Danny.... yeah she went nuts and crossed serious ethical lines, but she also became a millionaire and opened a free clinic at the hospital....

No I was too busy watching the dwarves get driven out of their home by a Smaug, at which point I decided I'd endeavor to secure a dragon for myself.

 

[DocVapor]

It IS actually illegal in some states. The state of MN for one. Took a graduate forensic psych class awhile back, but this applies to all physicians not just psych. I can't find the link for the law at the moment, but it goes something along the lines of: it is illegal for a physician to have a sexual relationship with someone they currently have a doctor/patient relationship with. It is still illegal for two years AFTER the termination of that doctor/patient relationship.

That said, even after two years there are issues relating to the speciality type. Psych was already mentioned and the speciality board considers former patients always off limits due to the nature of the field.

There can be a lot of gray areas with things like whether or not one visit with a patient in the ED for a sprained ankle (I think this was sort of the case on Doctor's Diaries) constitutes an established relationship since it isn't ongoing.

It isn't worth it to risk your career on a gray area.

*Bolding added by me.

It is unethical in all states, and explicity illegal in some, to date current patients. The former patient scenario is still grey area, (except for psych, and peds , which are never ok) but I want to clear up what some of you are considering "former" patients.

In all states, you are required to keep all medical records of your patients for X number of years. As long as you have these medical records, you have an official doctor/patient relationship, even if you haven't seen them in X-1 years. So it's not a situation where you can just refer them to another physician and then that same evening take them back to your place for a night of kinky sex.

Even if it is a platonic relationship, it is still dangerous territory. My ethics course laid out this scenario:

A female physician was seeing an elderly woman for routine visits, and they hit it off. They would meet for coffee or tea outside of the office, where the elderly woman would tell the physician about her financial problems, as well as her lazy good-for-nothing son. The physician's husband happened to be a financial planner, so she referred the lady to him (this is a whole separate ethical issue). As far as the son, she felt comfortable enough to counsel the woman to begin using "tough love" to try and get her son to straighten out. Over time the woman's relationship with her son deteriorated to the point that they were no longer speaking.

The woman eventually passed away, and in her will left all of her money to charity. The son knew about his mother's relationship with the physician, and thus sued the physician for manipulating the woman into changing her will to keep her money away from him.

He would win this case.

 

[wholeheartedly]

In all states, you are required to keep all medical records of your patients for X number of years. As long as you have these medical records, you have an official doctor/patient relationship, even if you haven't seen them in X-1 years. So it's not a situation where you can just refer them to another physician and then that same evening take them back to your place for a night of kinky sex.

Disagree with the records part. If you look at cases where this has played out, how the doctor patient relationship is defined can be based on different things depending on specific circumstances not necessarily how long you keep your former patients records: location, speciality type, date of last visit, formal documentation of termination of care, prescription history, duration of care, etc can all be used to define and characterize the actual end of the doctor patient relationship. None of the cases I've reviewed used how long you kept the records.

 

[487806]

I feel like people are just trying to throw this face out as often as possible these days.

Indeed

 

[DocVapor]

Wholeheartedly; sure I can see that. I'm not saying that I agreed with the policy, but it's the way it was presented to me. Seems that it is probably the best way to be 100% safe. Also probably comes down to your state's medical board views on the matter.

Of course, life is one entire risk vs. benefit calculation, and all physicians are adults, so they can make the decision. They just need to know when they are treading into some possible gray area.

 

[Textbookversion]

*Bolding added by me.

It is unethical in all states, and explicity illegal in some, to date current patients. The former patient scenario is still grey area, (except for psych, and peds , which are never ok) but I want to clear up what some of you are considering "former" patients.

In all states, you are required to keep all medical records of your patients for X number of years. As long as you have these medical records, you have an official doctor/patient relationship, even if you haven't seen them in X-1 years. So it's not a situation where you can just refer them to another physician and then that same evening take them back to your place for a night of kinky sex.

Even if it is a platonic relationship, it is still dangerous territory. My ethics course laid out this scenario:

A female physician was seeing an elderly woman for routine visits, and they hit it off. They would meet for coffee or tea outside of the office, where the elderly woman would tell the physician about her financial problems, as well as her lazy good-for-nothing son. The physician's husband happened to be a financial planner, so she referred the lady to him (this is a whole separate ethical issue). As far as the son, she felt comfortable enough to counsel the woman to begin using "tough love" to try and get her son to straighten out. Over time the woman's relationship with her son deteriorated to the point that they were no longer speaking.

The woman eventually passed away, and in her will left all of her money to charity. The son knew about his mother's relationship with the physician, and thus sued the physician for manipulating the woman into changing her will to keep her money away from him.

He would win this case.

Just FYI everything you said past the fourth sentence is untrue. Especially the last sentence. That sounds like something cooked up by someone who never stepped inside of a law school classroom. Doctor/patient relationship is not based on how long you keep the records, and the son can try and sue all he wants but his case would get thrown out in summary judgement.

 

[FSU2013]

Now can doctors have an intimate relationship with another doctor, colleague?

That's a joke, right?

It seems like half of all docs are married to other docs or nurses.

 

[DocVapor]

Just FYI everything you said past the fourth sentence is untrue. Especially the last sentence. That sounds like something cooked up by someone who never stepped inside of a law school classroom. Doctor/patient relationship is not based on how long you keep the records, and the son can try and sue all he wants but his case would get thrown out in summary judgement.

Thanks for the info. Here's concrete info that I've found after a short search, I'm not a lawyer so I'm not entirely sure how to search for this stuff quickly. I've bolded the most pertinent paragraph, but there is other good information in there that others might wonder about.

Source: register.dls.virginia.gov/vol22/iss01/f18v8520.doc

18 VAC 85-20-100. Sexual contact with patients.
A. For purposes of § 54.1-2915 A [ 7 12 ] and A 19 of the Code of Virginia and this section, sexual contact between a practitioner and a patient includes, but is not limited to, sexual behavior or involvement with a patient including verbal or physical behavior which that:
1. May reasonably be interpreted as intended for the sexual arousal or gratification of the practitioner, the patient, or both; or
2. May reasonably be interpreted as romantic involvement with a patient regardless of whether such involvement occurs in the professional setting or outside of it.
B. Sexual contact with a patient.
1. The determination of when a person is a patient for purposes of § 54.1-2915 A 19 of the Code of Virginia is made on a case by case basis with consideration given to the nature, extent, and context of the professional relationship between the practitioner and the person. The fact that a person is not actively receiving treatment or professional services from a practitioner is not determinative of this issue. A person is presumed to remain a patient until the patient-practitioner relationship is terminated.
2. The consent to, initiation of, or participation in sexual behavior or involvement with a practitioner by a patient does not change the nature of the conduct nor negate the statutory prohibition.
C. A patient's consent to, initiation of, or participation in sexual behavior or involvement with a practitioner does not change the nature of the conduct nor lift the statutory prohibition. Sexual contact between a practitioner and a former patient after termination of the practitioner-patient relationship may still constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge, or influence of emotions derived from the professional relationship.
D. Sexual contact between a practitioner and a key third party shall constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge or influence derived from the professional relationship or if the contact has had or is likely to have an adverse effect on patient care. For purposes of this section, key third party of a patient means spouse or partner, parent or child, guardian, or legal representative of the patient.
E. Sexual contact between a medical supervisor and a medical trainee shall constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge or influence derived from the professional relationship or if the contact has had or is likely to have an adverse effect on patient care.

 

[45408]

In situations like this, you frequently won't find a law because the government depends of physicians to police themselves. So while you may not get sent to prison, a sexual relationship with a current patient will get your license at least put under scrutiny by the medical board.

There are laws. My state requires something like 2 years after you terminate the physician-patient relationship before you can pursue a non-patient relationship with them. Psychiatrists are never allowed to pursue such a relationship, because of the nature of their patient relationships.

You're technically not even supposed to have a social relationship with your patients, which is simply not feasible in some situations. I've known more than a handful of my patients.

In all states, you are required to keep all medical records of your patients for X number of years. As long as you have these medical records, you have an official doctor/patient relationship, even if you haven't seen them in X-1 years.

Not true. This may be a law in a specific state (I don't know all 50 states), but on principle, just because you keep the records does not mean you still have an official relationship. You could easily have officially terminated a patient relationship (narcotic abuser, etc), but you would be a fool to get rid of those records.

In my state, you have to keep records longer than the duration of time required before dating the patient.



Just use common sense, people. If you saw a patient for a sniffle, and then run into them in a social situation (legally permitted number of) years later, that's not an ethical dilemma. If you were their PCP for years and counseled them through a difficult social/ethical situation, and you terminate the doctor/patient relationship because you have strong feelings for him/her, and then call that person up after the exact statute of limitations has expired, that would be ethically dubious at best.

C. A patient's consent to, initiation of, or participation in sexual behavior or involvement with a practitioner does not change the nature of the conduct nor lift the statutory prohibition. Sexual contact between a practitioner and a former patient after termination of the practitioner-patient relationship may still constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge, or influence of emotions derived from the professional relationship.

This is key.

 

[r1d1]

I just found something interesting: the ethics codes of American Psychological Association (governing board for psychologists) have a 2 years rule on sex with a former client.

"10.08 Sexual Intimacies with Former Therapy Clients/Patients
(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.
(b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient".

The American Psychiatric Association (governing psychiatrists), however, prohibits any involvement with a former patient.

I would think the psychologist-client relationship is much more intense than the one between the patient and the psychiatrist, because most psychiatrists only talk to patients for 10 min and prescribe meds. Maybe the American Psychiatric Association feels the need for the strictest ethics codes, because they're at the top of mental health professions?

 

[wholeheartedly]

Just reading part b of that shows it would still be pretty hard to justify a relationship.

 

[Edwise]

Family members are fair game.

Well, what if that family member goes to medical school and later works on the same level as this doc...(stretching my imagination) to the point of becoming colleagues together. Is it ethical now to start a relationship?? Many wasted years then...

 

[The Knife & Gun Club]

 

[21Rush12]

Or is it Necro hump?


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[AnatomyGrey12]

Why is this thread a thing?

 

[Planes2Doc]

I came to reply in this thread and saw I posted back in 2013!

 

[TheBiologist]

question - does this mean a doctor cannot treat his own girlfriend/wife? @Goro @LizzyM

 

[Planes2Doc]

question - does this mean a doctor cannot treat his own girlfriend/wife? @Goro @LizzyM

People are usually fine with prescribing non-scheduled meds, especially things like antibiotics.

 

[LizzyM]

People are usually fine with prescribing non-scheduled meds, especially things like antibiotics.

But be careful about being too close -- unable/unwilling to see the big picture. Many years ago in my hometown a doc treated his adult daughter for bronchitis for an entire winter. She was in her early 40s and had smoked from the age of 16.... eventually she saw another doctor and learned that she had lung cancer. She died less than 2 years later. Maybe the outcome would have been the same if Dad had referred her rather than writing one prescription after another hoping to knock out an infection.

 

[Planes2Doc]

But be careful about being too close -- unable/unwilling to see the big picture. Many years ago in my hometown a doc treated his adult daughter for bronchitis for an entire winter. She was in her early 40s and had smoked from the age of 16.... eventually she saw another doctor and learned that she had lung cancer. She died less than 2 years later. Maybe the outcome would have been the same if Dad had referred her rather than writing one prescription after another hoping to knock out an infection.

Wow! That's awful!

 

[Peach Newport]

Wait, but can I be in a relationship with a standardized patient? There’s literally no other way I’m gonna pass my OSCEs.