When Is It Okay to Date a Patient? Medscape Ethics Report by Shelly Reese - Articles
Oct 28, It forms the basis for the physician-patient relationship. In order for the (For further discussion of this issue, see Student Issues.) Many patients. dealing with sexual boundary issues and take measures to educate their 5. using the physician-patient relationship to solicit a date or romantic relationship;. Docs themselves have mixed responses to the issue. A recent ethics survey found that the number of physicians who view such relationships.
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.
The Seductive Patient
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. 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.
- Unhealthy relationships with patients
- The 21st Century Patient-Physician Relationship
- Doctors allowed to date former patients
Because patients may need to return for 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 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.
Physician-Patient Relationship: Ethical Topic in Medicine
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. 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.
What do you think we could do to meet everybody's needs? And yet, physicians may not abandon patients. When the physician-patient relationship must be severed, the physician is obliged to provide the patient with resources to locate ongoing medical care. When is it appropriate for a physician to recommend a specific course of action or override patient preferences?
When Is It Okay to Date a Patient? Medscape Ethics Report by Shelly Reese - Articles
Under certain conditions, a physician should strongly encourage specific actions. When there is a high likelihood of harm without therapy, and treatment carries little risk, the physician should attempt, without coercion or manipulation, to persuade the patient of the harmful nature of choosing to avoid treatment.
Court orders may be invoked to override a patient's preferences. However, such disregard for the patient's right to noninterference is rarely indicated. Court orders may have a role in the case of a minor; during pregnancy; if harm is threatened towards oneself or others; in the context of cognitive or psychological impairment; or when the patient is a sole surviving parent of dependent children.
However, the use of such compulsory powers is inherently time-limited, and often alienates the patient, making him less likely to comply once he is no longer subject to the sanctions. What is the role of confidentiality? Confidentiality provides the foundation for the physician-patient relationship. In order to make accurate diagnoses and provide optimal treatment recommendations, the physician must have relevant information about the patient's illness or injury.
This may require the discussion of sensitive information, which would be embarrassing or harmful if it were known to other persons. The promise of confidentiality permits the patient to trust that information revealed to the physician will not be further disseminated. The expectation of confidentiality derives from the public oath which the physician has taken, and from the accepted code of professional ethics. The physician's duty to maintain confidentiality extends from respect for the patient's autonomy.
Would a physician ever be justified in breaking a law requiring mandatory reporting? They know what they want and they are less shy all the time about asking questions, challenging assumptions, and demanding an increased voice in their care. The common denominator in all of this is the Internet. Never before have patients had such fast and ready access to information of such complexity, varying reliability, and diversity. But the way in which this danger manifests has changed from a few years ago.
Before the Internet became so corporatized and settled, before the advent of the current landscape of well-known, user-friendly, and reliable healthcare information websites, patients were more or less on their own, adrift in a rather wild frontier of information and disinformation. Patients, new to the whole online experience, had no benchmarks for quality and reliability when it came to what they read online.
They necessarily had to rely on their physicians and other healthcare providers to vet the info they found and brought to the office visit, meaning the traditional patient—physician relationship remained more or less intact, with the physician as still the final dispenser of wisdom. But, as the Internet has matured as a conduit for information exchange, people have become more accustomed to the process of actively seeking out detailed and at times arcane medical information online.
Although it is true that there still are a great many unscrupulous websites out there that knowingly peddle false or slanted information, patients by and large are becoming more sophisticated in the selection of their sources of medical news and information. The power of the prescription pad means physicians are still the final arbiters of treatment decisions, but patients nowadays have the information available to allow them to have an ever greater say in what is written on that prescription pad.
E-mail us at tkunkler mdng. Physicians have nearly instantaneous access at the point of care to drug and formulary information www. When you factor in the rapidly expanding roster of comprehensive electronic health record products more than 50 have been certified by the CCHIT; see the complete list at www. Writing in the Sacramento BeeDr. He acknowledges the theoretical benefi ts of EHRs reduce medical errors, enhanced quality of care, etc. Patients and physicians both are already keenly aware of the lack of time providers have to devote to each patient visit; how will patients react to a physician who spends an inordinate amount of time in the exam room with his or her eyes glued to a computer monitor while he or she furiously clicks through screen after screen entering information?
The physical presentation of the EHR itself had an effect: All rely on interactive networking, information sharing, and open communication between patients and professionals.