Is Doctor/Patient Romance Becoming More Acceptable? A Medscape Ethics Survey, in which more than 21,000 physicians took part, found that having intimate relations with a patient, although still taboo to most respondents, is no longer as unthinkable as it once was to a significant number of doctors. Most participants were dead-set against a doctor dating a current patient, and many objected to a physician having intimate relations with a former patient as well, regardless of how much time may have elapsed, a position that mirrors that of the American Medical Association (AMA) and most specialty societies. Be that as it may, the survey revealed that the number of doctors who believe otherwise is growing substantially. In the survey, 68% of participating doctors felt that having an intimate relationship with a patient, whether current or former, was unequivocally unethical and wrong. That's down from Medscape's 2010 Ethics Survey, in which 83% of the respondents took that position. While only 1% of doctors in both surveys felt that sex with a current patient was permissible, only 12% of participants in our 2010 survey believed that it was okay to date a former patient; in our most recent survey, over one fifth of the respondents (22%) felt that this was no longer taboo. " I think we are enormously misguided, if not narcissistic, to believe that there is no amount of time out of the physician/patient relationship that 'resets' the relationship," an emergency physician wrote in response. "If 'individual patients often unquestionably submit to a physician's authority,' as an expert was quoted as saying, then we should give up on the concept of medical informed consent, as our patients clearly cannot separate themselves from the omnipotent physician/patient relationship adequately to be able to give such consent. As a profession, let's at least be logically consistent in our positions." "What about caring for a person with whom you have had a relationship in the past?" a family physician wanted to know. "How about the conflict with having to care for someone (in the ER after hours, as an example) with whom you have/had a relationship or conflict? This goes to show that blanket statements/rules cannot be concrete and cannot fit all situations." "Consider this scenario," a general practitioner suggested. "You're the only physician in a small town. If you can't date a patient or potential patient, then you can't date anyone, since every person in the town is potentially your patient. I guess you'd just have to get a mail-order bride from Russia. Once you're married, you can't have sex with your wife because she will also be a patient of yours. This is why hard-and-fast, zero-tolerance rules are always a bad idea." "I think that it borders on delusional to believe that we as doctors are so all-powerful that it is an abuse of power and a crime to have a sexual relationship with a competent adult who happens to have been or even is a patient," a psychiatrist wrote. "If such an act is to be a crime, don't you think each case stands on its own to show the harm done? Otherwise, the authorities should respect a doctor's privacy and stay out of the bedroom." "It's like many blanket statements—not applicable in all circumstances," an emergency physician wrote. "A lot depends on the nature of the doctor/patient relationship. A male gynecologist and a patient who has seen that doctor many times—probably not. An ER doc who sees someone once for a broken ankle? I don't see the problem. How about a radiologist who interprets the ankle x-ray? Does the radiologist get a blanket pass?" "I believe that the 'rules' are in place for very good reasons," a cardiologist commented. "Intelligent physicians before us have seen the ramifications of doctor/patient relationships over many years and on a larger scale. Individual circumstances vary. There will always be exceptions to the rule on a small scale, and there are exceptions in remote locations or small towns. However, the dynamic of our relationships is unique and should be held up as such by our community." "Rules are rules, and for a good reason," a family physician pointed out. "They remain rules until exceptions are created. Respect for our profession is eroding constantly. The least we can do is hold ourselves to a higher standard and stay out of such entanglements. If a physician becomes involved with a patient, there's always the possibility of HIPAA violations, as the physician enters the patient's social or even family circle. We all ought to have the discipline and self-control to avoid such entanglements." "I hate to say it, but the AMA is absolutely right," a psychiatrist stated. "Certainly for psychiatrists and pediatricians it is an absolute. How adept are people at knowing when it is 'true love'? Because 'some are happy' is the worst kind of anecdotal information." "Medical ethics is what it is for very good reasons, and what was true about the doctor/patient relationship in Hippocrates' time hasn't fundamentally changed," another psychiatrist noted. "Exploitation of this relationship in any way, by either party, is all too possible if the boundaries are not recognized and strictly adhered to. Boundary violations almost inevitably bring trouble. It's the doctor's, not the patient's, responsibility to behave ethically at all times." "While I believe a doctor must not have a relationship with a current patient, it is also true that the traditional doctor/patient relationship does not exist as before," commented a family physician. "We have become 'healthcare providers'—service providers not much different from plumbers, hairdressers, and auto mechanics. Whose fault is this? I don't know. Maybe plumbers should also be prohibited from having relationships with their clients, or maybe, in the modern world, doctors should be allowed to have relationships with their 'clients.'" Source
