The AMA Says No, With One Exception Medscape's 2016 Physician Ethics Report shows that 7 in 10 doctors oppose the idea of physicians dating patients, at least while they're still patients. The article When Is It Okay to Date a Patient? generated heated discussion on a topic that has always been considered taboo. The American Medical Association (AMA) code of conduct explicitly forbids physicians from entering into romantic relationships with patients, because doctors might be tempted to exploit any weaknesses or difficulties that patients are going through or become less objective in treating them. The AMA does, however, say that if a doctor persists in initiating a relationship with a patient, he or she shouldn't do so before terminating the professional relationship, "at a minimum." The Federation of State Medical Boards likewise considers dating patients to be a type of professional misconduct. Practicing physicians appear to agree. But are the medical profession's—and society's—views on physician/patient dating changing? Perhaps. Whereas in 2016, 70% of respondents felt that dating a patient is unethical and should be forbidden, in 2010, 83% of respondents opposed these relationships. One recruiter quoted in the article sees a connection between today's less formal patient/physician interactions (no lab coats, call me by my first name) and the reason why fewer people might be opposed to patient/doctor dating. A More Liberal Attitude Emerges Readers who commented on the article expressed strong feelings about the subject. A retired psychiatrist, now in his 80s, offered cautionary tales involving young patients who were extremely seductive during office visits. One of them appeared to be in her own fantasy during office visits. She complained that her husband couldn't please her. A turning point came when she sent herself flowers and charged them to the psychiatrist. As it turned out, she was in the middle of a divorce, and had told her husband that she had been having an affair with the doctor for years, providing fictional information about his lifestyle, his children, and where he lived—all of which stemmed entirely from her own fantasies. He dealt with the problem by scrupulously maintaining his distance from this woman and all of his other patients, suggesting that any of them who were aggressively flirtatious and unhappy in their marriages talk with their spouses and receive relationship counseling. As he wrote: Rigid rules of professional behavior, going back to antiquity, may have saved many a doctor from falling into the trap of a dysfunctional, rage-based attachment, and compounding the damage to his patient begun by a dysfunctional family of origin. Many readers commenting on the article maintained that patient/physician relationships are never acceptable. One psychiatrist commented, "With 3.5 to 4 billion women and 3.5 billion men in the world, if you have to troll your practice for a date, you are mentally ill or flat-out pathetic." Others were quick to mention the possible professional fallout. "Never, never, never. Not worth losing [your] license, reputation, paying fines, and doing jail time," wrote one family practitioner. Or in the words of two surgeons: "Never a good idea. We're better than this," and "No, not at all. It's definitely going to compromise professionalism." Held to a Higher Standard One general practitioner had a sense of humor about the subject. "I have never dated, nor do I have plans to date, a patient or their family member. However, I would recommend that any doctor considering this make sure that the now-former patient has first paid his or her bill in full." Some readers noted the inherent unfairness of expecting so much more from doctors than other professionals, especially when physicians are considered highly attractive as potential mates. After all, notes one doctor, the public doesn't ask as much from professional athletes or top executives. "Seems like, from reimbursement to our personal lives, doctors are held to higher standards," muses one general practitioner. A retired plastic surgeon believes this stance is hypocritical: I don't remember taking any oath of celibacy when I entered medical school... Why should someone not be able to pursue a normal relationship, simply because they treated the patient for some medical condition? The idea that physicians hold some mysterious force over their patients that compels patients to behave like robots, like slaves, is nonsense. If that were the case, we wouldn't be paying outrageous malpractice premiums. An Imbalance of Power A few readers referred to recent regulations proposed in California that would revise the rule of conduct for lawyers so that they can't date clients—a standard to which doctors are already held. And that's a good thing, notes an oncologist, because of the potential imbalance of power implicit in patient/physician relationships: "I guess anyone in favor of doctor/patient sex would also support professor/student sex, employer/employee sex, arresting officer and suspect sex... I can go on, but I would hope I don't need to." The ever-present threat of litigation is also a strong deterrent. An emergency department physician wrote: It may be 2017, but [dating] should never be mixed with patient care. Why? Because this is a sue-oriented society. We may be okay with [the idea of dating a patient], but until rules change we can lose our licenses and get sued. It's not worth the risk. Lose the patient, not your career!" Singing the Small-Town Blues Other scenarios addressed in the article were whether it was ever ethical to date patients' family members, and what to do in small towns, where patients may make up the most accessible (if not the only) dating pool. In fact, a rural plastic surgeon shared the fact that his patient later became his wife, describing a long and happy marriage. One family practitioner, a widow living in a small town, noted the fact that she can only date people within her community. She believes that ending the physician/patient relationship should be sufficient to allow such couples to date. However, she added, concerns about objectivity and the taboo on dating often extend to having any kind of social relationship with a patient. "I have some wonderful female patients that I would love to go out and have coffee with, but I'm afraid that my judgment would be tarnished," she wrote. "Unfortunately, I have no close female friends now." Readers were divided on the subject of whether physicians should be able to date one of a patient's family members. One physician health administrator concluded that the most sensible course of action is for doctors to date other physicians instead. "We all train as single people in our 20s, and owing to our unsocial hours and workloads, a fellow physician seems the eminently sensible option." A few readers turned the question on its head by asking whether it's okay for physicians to treat their own spouses and family members. Several physicians noted that they already do so, but only for minor ailments. Never Say Never, but With Eyes Wide Open As the article and comments on it suggest, physician/patient dating is far from fully accepted, either by those in the profession or by society at large. However, under the right circumstances—and provided that the physician is no longer treating the patient—some see no reason why these types of relationships shouldn't be ethical, or possible. One neurologist summed up succinctly the feelings of a majority of his colleagues: Any physician who engages in a romantic relationship with a patient is playing with fire. The reality is that licensing boards consider this a violation of professional ethics. One verifiable complaint is all that is required to flush your career down the toilet. If it turns out that you have a patient who is a 1 in 7 billion match, then go for it. But [first] transfer their care to another physician. Source
