Is it ethical to date former patient you discharged from the hospital?

[Medisaint]

I'm not advocating for dating a patient, but I don't think you guys understand how commonly this happens. I know of physicians not only dating patients but having extra-marital affairs with them! Granted, it's in smaller towns where you are less likely to get in trouble.

Honestly, if someone was your patient at one point and you no longer have any kind of doctor patient relationship, I really don't see a problem. Yeah, you have to be extra careful and I definitely wouldn't do it while in residency - your program will hate the liability and then possibly fire you if HR/legal finds out about it. After training...much less risky...

This is a highly disturbing post.

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[Food]

This is a highly disturbing post.

Just telling you the reality that I have come across. Yes it is shocking and reprehensible.

 

[Food]

You know multiple physicians in multiple small towns having extra-marital affairs with patients and you are ok with this because:
1. Small town less likely to get into trouble
2. No longer Dr. -Pt relationship
3. Done with training so less risky
4. they are extra careful

Sorry I think I may have read this wrong?

Scenario just for fun:
Dr. YS: So Ms. Johnson labs look good and I will see you back.........never because I just ended our Pt.-Dr. relationship.
MS. J: What?
Dr. YS: Yes, we won't just be dating... because you know... I'm married!
Ms. J: What???
Dr. YS: Look I know, I know and its ok. I'm finished with training, extra careful, and we do live in one of the smallest towns ever!

just having fun

Yeah I am not advocating this behavior, just telling you that it is much more common than you think and frankly actively overlooked by our so called respected colleagues.

This is distinct from, IMO, having treated someone in an inpatient setting years ago, with whom you no longer have any sort of doctor-patient relationship, and now you happen to meet each other in an un-relatee context. Again, not something I would advocate , but I think that is in a different ethical realm than the above scenario

 

[emergentmd]

Everyone has their own drama tolerance. I am actually married to a nurse but met in college before either of us knew what we wanted to do.

I would consider dating a nurse that works at another hospital, preferably a different hospital system. But likely would not with someone in the same hospital. Definitely not with someone working in the ER. No way can you separate work and the drama.

Never take such a risk in residency. All it takes is one sexual harassment complaint and you will be looking at working in the boonies if lucky.

 

[Food]

Everyone has their own drama tolerance. I am actually married to a nurse but met in college before either of us knew what we wanted to do.

I would consider dating a nurse that works at another hospital, preferably a different hospital system. But likely would not with someone in the same hospital. Definitely not with someone working in the ER. No way can you separate work and the drama.

True. I'm dating a nurse I met while working in the ED at my second job out of residency. I went back for fellowship so we don't work together anymore but it was never an issue for us.

 

[B1GM0N3Y86]

I can understand the view of many saying dating nursing during residency is risky. For sure, you need to be up front about stuff with the person your considerring to date, would not advise flings due to risk in causing drama.

It was different in my residency then I would have ever imagined prior to starting. You hear as a med student to never date nurses, never date the bee hive. When i got to residency I saw quite a few residents dated nurses. Most of us are engaged to the one we were dating but it isn't always the case.

At end of day, its risk tolerance. Helped me feel more comfortable with knowing I'd never bump into her again at work which made it easier.... unless I had a uterus I didnt know about and was inseminated without my consent...

 

[Medisaint]

unless I had a uterus I didnt know about and was inseminated without my consent...

If this is carries a non-zero chance for you then you need to enter it into the equation.

 

[ganner2012]

DUDE, COM ON NOW! date Nurses, date doctors, STAY AWAY FROM PATIENTS/ FORMER PATIENTS/ PROSPECTIVE PATIENTS. Dont fall for that trap!!!!!!!!!!!!

 

[B1GM0N3Y86]

So I have a problem and wanted peoples input.
throw away , im a resident.

I took care of a pt for a couple hours, not in clinic, not mental health/counseling, no chance of continuing care.
I learned that this patient worked at my hospital during encounter.
couple months go by, and I match with said pt on dating app. I didn't recognize said patient, but they recognized me.
after I found this out I googled if it was even legal-

saw AMA info which states:

A physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a patient.
Likewise, sexual or romantic relationships between a physician and a former patient may be unduly influenced by the previous physician-patient relationship. Sexual or romantic relationships with former patients are unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship, or if a romantic relationship would otherwise foreseeably harm the individual.

We ended up going on couple dates.
I have been reading more online, and now im worried. I looked up hospital handbook, and its against their professional guidelines, so was cursing, hipaa violations etc...
I also looked at my states board, doesn't seem to mention former patients, unlike other states that state wait months until this is allowed.

I know I F'D up. At the time I didn't think much of it because it was a natural process.

what do I do from here?
- Im worried about getting kicked out of residency

First off, whatever you do is completely up to you... everyone is different and below response is just a possible way I would do this if I had this happen to me....

I likely would attempt to exit the relationship as if I was on egg shells. I would not mention this reason to this individual due to my own fear of them retaliating at HR. Each partner is different, but I would likely mention being even more busy with responsibilities of residency which has worsened due to covid surges and people calling in sick. Also would mention that my schedule had recently been deemed more time consuming in the near future due to covid on top of having to prepare for board exams.

Due to these above reasons, I am unable to fully dedicate myself to both my training to become a competent physician and to this relationship. With that said, I would like to be able to re-evaluate this after finishing residency if he/she were still interested but understand completely that he/she may venture out and start dating.

Using this approach, downside is you pretty much now have to make sure they don't find out you ever start dating again for a while. Would be best you keep stuff on DL until they start dating again to prevent them getting pissy.

Not the only way to handle this, maybe not even the best, but my paranoia as a resident would likely try to keep it hush hush and keep them from knowing why your ending it so they don't retaliate back to HR.

If the PD finds out about it after you already ended it by him/her making a fuss, I would tell the PD that when you found out that the employee handbook advised against this kind of relationship you ended it immediately following the rules.

Hope it ends well. And I'm sure someone else will have a different recommendation on this. Keep us updated.

 

[operaman]

Thank you for your response. I actually not too concerned about ending the relationship we are both on the same wave length about it being more casual for now.

My concern was the hospital/state board or anything crazy like that

The response above seems safest. Exit now and you maximize your chances of getting through unscathed. The longer it goes on, the worse it looks if someone decides to make an issue out of it.

 

[B1GM0N3Y86]

Thank you for your response. I actually not too concerned about ending the relationship we are both on the same wave length about it being more casual for now.

My concern was the hospital/state board or anything crazy like that

Good, congrats then. Get out while able to before any feelings get hurt. Just a lesson learned is all. I wouldn't bring it up at all to the PD and just leave it be to avoid any hassle.

And from this point, definitely remember this situation if you ever consider doing this once more. We are all human, and not everything is black and white, but sometimes that Grey area may be best left alone....

 

[Iamnew2]

I am an internal med resident and treated a patient in the ICU for 3 days. She recovered well and got discharged. Then I went on to cardiology for my next rotation and one of my colleagues said unfortunately she was readmitted a few days later for another condition but I was not involved for this second admission. She then got discharged again from the hospital. I never seen this patient before outside the ICU and she don't follow up with us for outpatient. A few weeks later, I was looking for housing and the person who helped us in person happens to be this former patient. We got along well and she is interested to develop a relationship, but I am not sure whether it is ethical. She has no psychiatric conditions.

this is simple: No. If nothing goes wrong and you two married and lived happily ever after until you both died, then great. But should anything go wrong in any capacity - which tends to in romantic relationships - your career could be done for good. Not worth it.

 

[Iamnew2]

Yeah I am not advocating this behavior, just telling you that it is much more common than you think and frankly actively overlooked by our so called respected colleagues.

This is distinct from, IMO, having treated someone in an inpatient setting years ago, with whom you no longer have any sort of doctor-patient relationship, and now you happen to meet each other in an un-relatee context. Again, not something I would advocate , but I think that is in a different ethical realm than the above scenario

there mere fact that anyone would have an extramarital affair - doctor or not, with patient or not - is reprehensible and disgusting.

 

[Iamnew2]

Thank you for your response. I actually not too concerned about ending the relationship we are both on the same wave length about it being more casual for now.

My concern was the hospital/state board or anything crazy like that

You must be a dude. If I am wrong, then I apologize. Men and women view relationships differently. I am going to go out on a limb and make this statement as if you are a dude. If you and this person dated (bad idea!), and you think it's "casual" but she doesn't, and she gets pissed - your career can be potentially done. No one - I repeat - no one - employers, boards, residency programs, partners - want to deal with messes particularly he said/she said nonsense. In fact many malpractice policies don't even cover any type of sexual related complaint - it's your life and you can do what you want, but beware- you are going down a path of badness here that will likely bite you in the butt. Don't say no one warned you!

 

[Iamnew2]

I ended it pretty mature response from person. They reiterated that they were thinking the same.
I understand that I shouldn’t have done this but I did.

How do I move forward with my career knowing this could mess me up?
I have “read” cases of blatant Breaking of rules and seen only suspension by the board.


I honestly didn’t know this could have this big of an impact. I regret it so much and I’m afraid.

Did things end nicely and with no drama? Best thing would be if she left you, and she wants to move onto someone else. In that case she likely won't ever think about you again. The drama comes in when someone (typically the man) thinks it's "casual" and the woman thinks it's not and she doesn't want things to end. If she ended it then you are likely done. Don't contact her. Don't write her, call her, email her. It's definitely a gray area. Hopefully she's happy with the next person and forgets you ever existed. Learn for the future and don't do it again.

 

[Iamnew2]

I ended it. Our relationship only lasted 3-4 dates although did become intimate. Our intentions were pretty clear from the start. It ended smoothly.

It won’t happen again, but I foresee myself worrying about this for sometime.

Well no one can tell you what will happen in the future. Just be smart and don't do it again. Not the most ethical move.

 

[NotAProgDirector]

I tend to be pretty conservative, and I don't see this as that much of a big deal. It is certainly true that you cannot date people with whom you have an active care relationship with -- no questions there. And if the care delivered is psychiatric, then also a huge problem even if the care was in the past. But if you saw them for a sprained ankle, didn't go delving into their chart, etc, then this really isn't something to worry about. If you looked in her chart after you started dating, or if you looked up her phone number in the chart to call her for a date -- that's all bad.

It is certainly true that if she were to "make a big stink" of this, you'd get investigated. And it wouldn't be fun. But ultimately if your clinical relationship with her was minimal, it would be unlikely to end in any sanctions. It depends on how sensitive the care you delivered was.

Still, overall worth avoiding. But I wouldn't lose any sleep over this from the story as written.

 

[Keona]

I'm not advocating for dating a patient, but I don't think you guys understand how commonly this happens. I know of physicians not only dating patients but having extra-marital affairs with them! Granted, it's in smaller towns where you are less likely to get in trouble.

Honestly, if someone was your patient at one point and you no longer have any kind of doctor patient relationship, I really don't see a problem. Yeah, you have to be extra careful and I definitely wouldn't do it while in residency - your program will hate the liability and then possibly fire you if HR/legal finds out about it. After training...much less risky...

Small towns are not friendly to cheaters. I know of multiple surgeons who the community shunned basically when they cheated on their wives and some had to leave the town to have enough patients again.

 

[Iamnew2]

Small towns are not friendly to cheaters. I know of multiple surgeons who the community shunned basically when they cheated on their wives and some had to leave the town to have enough patients again.

The way it should be. Cheating on one's spouse is disgusting. My ex-husband cheated on me and his mistress asked him to tell the Catholic Church say that our almost 14 year marriage wasn't "real" so they could "marry" in the Catholic Church - I'm a little sensitive to this topic, so I'm glad that doctors get shunned and driven out of town when they cheat. Serves them well. Cheating causes devastation in families, marriages, lives. Only fair that it would cause devastation in careers.

 

[rokshana]

Small towns are not friendly to cheaters. I know of multiple surgeons who the community shunned basically when they cheated on their wives and some had to leave the town to have enough patients again.

agree...in small towns (grew up in one), everyone knows you and your business...and smaller towns are more conservative and ...judgy...cheaters get outed and it can have significant fallout.

 

[Splenda88]

What qualifies as a small town?

I am in a town of ~60k and I feel like it's small. Can't imagine being in a town of <10k where people know each other.

 

[VA Hopeful Dr]

What qualifies as a small town?

I am in a town of ~60k and I feel like it's small. Can't imagine being in a town of <10k where people know each other.

I grew up in a town a bit smaller than that (35k), wasn't an issue.

 

[Saddleshoes]

What qualifies as a small town?

I would say just about every hospital would qualify as a "small town", when it comes to people watching you and your actions.
(Especially your personal actions!)

 

[gutonc]

I tend to be pretty conservative, and I don't see this as that much of a big deal. It is certainly true that you cannot date people with whom you have an active care relationship with -- no questions there. And if the care delivered is psychiatric, then also a huge problem even if the care was in the past. But if you saw them for a sprained ankle, didn't go delving into their chart, etc, then this really isn't something to worry about. If you looked in her chart after you started dating, or if you looked up her phone number in the chart to call her for a date -- that's all bad.

It is certainly true that if she were to "make a big stink" of this, you'd get investigated. And it wouldn't be fun. But ultimately if your clinical relationship with her was minimal, it would be unlikely to end in any sanctions. It depends on how sensitive the care you delivered was.

Still, overall worth avoiding. But I wouldn't lose any sleep over this from the story as written.

I was waiting for a dose of sanity in this thread. Thanks as always.

 

[B1GM0N3Y86]

I was waiting for a dose of sanity in this thread. Thanks as always.

Just asking, but did my initial advice given in regards to this question seem not sane? Btw, mean no hostility with this question.

 

[gutonc]

Just asking, but did my initial advice given in regards to this question seem not sane? Btw, mean no hostility with this question.

I must have skipped over your reasonable advice amid the hailstorm of judgement of the OP.

 

[dpmd]

Thanks for the response means a lot coming from you.
So no there was no chart digging or getting said pts number from the emr. I didn’t even know I “matched” with one of my patients until it was told to me.
Pt also works in the same hospital so it made it less weird than if was a complete stranger.
No psych or continuity of care…
But there was a sensitive exam done during said patients care. With chaperone and proper documentation as well as within reason to preform said exam.

I’m an honest person. I didn’t have any bad intent, I didn’t know states and even hospitals had stricter AMA guidelines…

And it’s probably bothering me more than other people. The chances it will be made into a problem is very slim, said person was super understating and a great person overall.

I find it a little creepy that you dated (and were intimate with) someone you once did a vaginal or breast exam on, but I guess if you really didn't remember them when you hooked up then it isn't as bad. Then again, I would remember and avoid dating you after so if this person didn't care why should I.

 

[B1GM0N3Y86]

I must have skipped over your reasonable advice amid the hailstorm of judgement of the OP.

All good, appreciate the reply. Btw, "Hailstorm of judgement," I like that phrase...

 

[TraumaLlamaMD]

Small towns are not friendly to cheaters. I know of multiple surgeons who the community shunned basically when they cheated on their wives and some had to leave the town to have enough patients again.

Just look at that show Sweet Magnolias 😂

 

[Mad Jack]

My 2 cents:

I agree with a above that probably 95% of people that get admitted to a hospital twice in 30 days at age <30 are outliers in a bad way (I admit this probably isn’t true and due to recall bias).

Any LAW stating some minimum time before two otherwise consenting adults can date is pretty preposterous imo. Is there a similar law against dating firefighters or EMTs?

Asking if this girl is pretty enough is the wrong question. There is no girl (or boy) pretty enough to risk your career on, period. Not to mention it you lose your career you might find said person mysteriously less interested in the first place.

Be friends with this girl at your own peril and talk to your PD if you absolutely must. If you opened her chart during admit #2 I would delete her phone number and find a different apartment. If you truly live in an area with a population of 4,000 then I sympathize with you and wish you the best whichever you choose. If it does end up blowing up please do us the courtesy of coming back and making a thread about it!

Laws exist for a reason. Physicians are in a unique position with regard to power dynamics and can easily abuse that if they so choose. These laws exist to protect patients from manipulation and abuse and rightly so, similar to the reason high school teachers can't date their otherwise adult 18 year-old students.

 

[Matthew9Thirtyfive]

I grew up in a town a bit smaller than that (35k), wasn't an issue.

I didn’t grow up there, but I lived in a town of 1,600 for a couple years. Still wasn’t a problem.

 

[instantkarma]

In the USA especially in the current atmosphere of pc, wokeness, me three, etc etc it is very unwise to enter such a relationship. your only goal should be to get that paper after the third year. although i completed a US residency a long time ago part of my training was in latin america where the culture is much different and such a relationship less frowned upon especially if you are both from similar socioeconomic level.

 

[dienekes88]

Too risky.

 

[j4pac]

Just telling you the reality that I have come across. Yes it is shocking and reprehensible.

Well...you did say this: " if someone was your patient at one point and you no longer have any kind of doctor patient relationship. I really don't see a problem."

The problem is that you can and will likely lose your job. "Being careful" is horrible advice. There is so much risk that it makes the upside incredibly low. There are millions of people out there...and with internet you have access to just about all of them. Dating a prior patient is just STUPID.

 

[Splenda88]

Well...you did say this: " if someone was your patient at one point and you no longer have any kind of doctor patient relationship. I really don't see a problem."

The problem is that you can and will likely lose your job. "Being careful" is horrible advice. There is so much risk that it makes the upside incredibly low. There are millions of people out there...and with internet you have access to just about all of them. Dating a prior patient is just STUPID.

Except if that patient looks like Jessica Alba.

 

[j4pac]

Except if that patient looks like Jessica Alba.

Looks like Jessica Alba isn’t good enough. To risk your career it better be Jessica Alba