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Discussion in 'Step I' started by GynGuy1983, Jun 20, 2008.

  1. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow 7+ Year Member

    Jun 13, 2008
    Rathke's pouch
    1. A physician unexpectedly meets one of his female patients while waiting for a table at a restaurant. They are both alone and decide to have dinner together. At the end of dinner, the physician asks the woman if she would like to spend the night with him, and they proceed to have a consenting sexual relationship. What, ethically speaking, is the best advice for this physician?

    Click on the circle next to your answer choice
    A. He is free to engage in a sexual relationship with a patient if that person has consented.
    B. He can rely on the woman, who is an adult, to make her own choices.
    C. He is prohibited from having a sexual relationship with a current patient.
    D. He can continue to have a romantic relationship with her and give her medical care, provided that this care is on an intermittent basis.
    E. He can have a sexual relationship with her and treat her as a patient, provided that the state licensing board is informed of this relationship.

    The answer is pretty obvious (C), but I'm curious to hear what everyone would do in reality.
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  3. synapse lapse

    synapse lapse tokyo robotic 15+ Year Member

    Mar 14, 2003
    Obviously C is correct. In reality, I think it depends on what time of physician he is and what their relationship is. Is he her psychiatrist, treating her for feelings of inadequacy and sexual issues, who is now taking advantage of his position of dominance? Or is he her dermatologist who prescribes acne medication? There is a big difference between the 2, and in the patient's ability to truly consent.
  4. crazy_cavalier

    crazy_cavalier T3-Weighted 7+ Year Member

    F. Put it in her pooper
  5. tfom08

    tfom08 2+ Year Member

    May 2, 2008
    Post of the year.
  6. indo

    indo Feed me a stray cat 7+ Year Member

    Sep 28, 2002
    "I'm a doctor and semen is good for your skin." case closed.
  7. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow 7+ Year Member

    Jun 13, 2008
    Rathke's pouch

    "Butt seks does a body good."

    -Edward Goljan

    True story. :laugh:
  8. VPDcurt

    VPDcurt 2K Member 10+ Year Member

    Jul 20, 2004
    If you hook up with a patient, the obvious next move is to make sure they aren't your patient anymore. No big deal - they can continue to hook up and she can go see another doctor. Those questions are so lame and annoying - it's like they think we are all going to abide by everything we learn all the time - I basically trained myself like a monkey on UWorld for those questions.
  9. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow 7+ Year Member

    Jun 13, 2008
    Rathke's pouch
    I would really like to see some of these dorky, unrealistic test writers turn down some super hot patient that they had (obviously unless she was a Psych patient, or someone treated for an STD). We're human first, then doctors. I really wish the NBME would acknowledge that instead of dismissing any sign of feeling as being wrong.
  10. docmd2010

    docmd2010 Senior Member 7+ Year Member

    Apr 17, 2005
    tell me about it. the nbme acts like we are going to be seeing 4 patients a day because if the patient brings up anything, the correct answer is to always have an hour long conversation and ask open-ended questions.

    and oh, of course the correct answer is (if she's hot) to see her another doc so u can still hook up with her and then of course, put it in her pooper.
  11. hippocampus

    hippocampus Senior Member 5+ Year Member

    Jun 4, 2005
    does this really happen in real life? who really asks "would you like to spend the night?" i thought it just leads up to that... seems hooker-ish to me..
  12. djnels01

    djnels01 "You're the man now dog!" Physician 7+ Year Member

    Aug 8, 2005
    Epic post.

    I would have loved to ask that question during an ethics presentation (on this very topic) we had this semester: "But what about anal?" Hilarious...
  13. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow 7+ Year Member

    Jun 13, 2008
    Rathke's pouch
    I usually ask them if they're a consenting adult, not under the influence of alcohol and/or illicit substances, and if they would like to have sexual relations with me phrased in an open ended question. I then make them sign a consent form, do a quick whiff test, examine the area for vesicular lesions, chancres, gummas, check for friable cervix (fortunately, there is no chandelier in my bedroom) and if the coast is clear, I then whip out my trusty dental dam. The rest, I will leave to your imagination(s) for future self-induced hand relief.


    Please ladies, stop filling up my inbox with sexual advances. Your attempts have and will remain futile until I am done preparing for my exam.

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