When Is It Okay to Date a Patient? Medscape Ethics Report 2012

Shelly Reese

Disclosures

November 15, 2012

Is 6 Months Too Soon Before Dating a Patient?

Because relationships morph with time, it's often difficult to define starting and stopping points. Does a coincidental meeting at a cocktail party where you engage in a personal conversation constitute the beginning of a relationship? What if you attend the same church? Play in the same tennis league? Have children in the same school? The boundaries between friendship and "something more" aren't always clear.

Strangely, determining when the professional physician/patient relationship is over can be similarly murky. Many such relationships simply atrophy with inattention. If a patient is healthy, he or she doesn't visit the doctor. Sometimes for years, sometimes forever. But is the relationship over?

For many physicians, "once a patient/doctor relationship, always a patient/doctor relationship," says Dr. Martinez. "I think that's what sits behind the 68% of 'No/Never' responses."

As one podiatrist notes, "I have had patients return to my practice after 5 or 10 years, so they never stopped being patients really."

Others insist there has to be some logical point of demarcation between current and former patients. "If someone was once a patient, left the practice and left town, was out of touch for years, and then returned not as a patient and kindled a relationship, I think that would be acceptable," writes one internist.

But many respondents were uncomfortable with the 6-month waiting period spelled out by the question, insisting it was either too arbitrary or too short. Even though they answered "yes" to the question under those circumstances, they insisted that the wait should be a matter of years, not months.

Others insisted the difference between a current patient and a former one -- at least when it comes to romance -- depends on a formal letter terminating the professional relationship. Still others noted that a shift in role is more important than the time frame in which that shift occurs.

"The critical issue is the change from being a patient," writes a general surgeon. "Six months seems arbitrary. It is the termination of the doctor/patient relationship that is essential." A family practice physician expresses a similar sentiment: "I don't know what the magic number of months is that should pass after the doctor/patient relationship has ended. But it must be ended beyond all doubt, for a substantial period of time, before a romantic or sexual relationship can begin."

Cautious Behavior Doesn't Always Protect You

Although the ethics of a relationship may be situational, a wrong decision could work against you if any court-related issues subsequently arise.

"The point of ethics is not to be safe," Dr. Goodman says. "It's to promote thoughtful, reasoned decision-making. It's not personal risk management."

Consequently, whereas one physician might harmoniously pursue a relationship with a former patient, another physician may not be so lucky. If the relationship doesn't work out the way the patient wished, he or she could bring charges against the physician -- even if it was the patient who initiated the relationship -- and that can present big problems for the physician.

Bruce Vande Vusse, a Michigan-based healthcare litigator, notes that "These things only come out in situations where somebody is unhappy -- whether it's a former patient or a jilted spouse, or some concerned character who blows the whistle and says the relationship is improper. However the fuse gets lit, the provider is going to be starting on the defensive."

Vande Vusse cautions physicians against any involvement with current patients -- "that's a Mount Everest to overcome" -- and calls 6 months "way too short a waiting period to say 'proceed without risk.'" As for the risks, they include possible money judgments, loss of society membership, license revocation, and more serious consequences.

Even a well-considered relationship -- one that includes a formal letter terminating the doctor/physician relationship, knowledge that another physician had assumed care, and a lengthy waiting period before a romance -- can present obstacles due to the foibles of memory and the motivations of others, Vande Vusse says.

For many would-be Romeos and Juliets, those risks and the potential consequences are enough to squelch the flame.

"If you don't like ambiguity, the right answer is, 'No, never," says Dr. Goodman. "It keeps the situation a lot simpler. 'No' is the safest answer."

For those who remain undaunted? "Proceed only with great caution," says Dr. Goodman. "If there's any area where people's judgment is impaired, it involves sex and romance. Erring on the side of caution may cost you a really hot date, but you're probably better off for it."

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....