What If You Get Stalked by a Patient?

Mark Crane

Disclosures

August 02, 2017

In This Article

How to Set Boundaries With Patients

Physicians need to do a better job of setting boundaries and reacting quickly if boundaries are crossed.

"The line between 'overly friendly contact' and stalking/harassment is probably best defined by the term 'unwanted,'" said Dr Schouten. "Because of the nature of our work, psychiatrists approach the issue of boundaries more strictly than some other specialists. Physicians need to determine what their professional and personal boundaries with patients are going to be and make those boundaries clear during the course of the relationship and when the patient crosses those boundaries.

"For example, physicians should not pursue or be receptive to socializing, emailing, text messaging, social phone calls, after-hours meeting or communications, etc," he said. "Such boundary crossings send a signal to patients that further nonprofessional contact is acceptable. When a boundary crossing by the patient occurs, the physician should make the boundary clear. If the patient's efforts to contact or follow the physician continue, then it is unwanted and falls into the category of stalking."

Unwelcome approaches should initially be met with polite but firm indications that you cannot engage with the person (who could be a patient or a family member), said Dr Appelbaum. "If attempts at contact continue (eg, phone calls, emails, etc), it's best not to respond. The stalker is usually gratified by contact with the target. Denying that gratification may eventually lead the stalker to seek gratification elsewhere."

He added, "When boundary crossings occur, physicians may need to let the patient know—nicely but firmly—that the relationship must be professional and cannot lead to a social friendship. The doctor might say, 'I hope you won't mind that I don't joke around with you at the office. It would distract us from paying attention to your health issues.' The same goes for Facebook friend requests," Dr Appelbaum continued. "You can say, 'I have to keep my professional and private lives separate, and that's why I don't accept such requests from patients. I hope you'll understand.'"

When to Seek Outside Help

"When it becomes clear that the contact isn't ending and the person won't be dissuaded by your requests, then it makes sense to go to the hospital or clinic security," said Dr Appelbaum. "Bring them into the picture. Large hospitals and clinics are familiar with this and have protocols for dealing with it. This won't be the first time that this has happened in your facility, and the security department can help ensure your safety on hospital grounds."

Should you contact police? Experts say that it's essential if the threats escalate or if you become aware that the stalker is loitering at your office or home.

Still, the results have been mixed.

"For practitioners in the community, the police may be helpful, but contact is often frustrating because criminal charges are difficult to bring in these cases. And they may still not end the stalking. There may just not be a lot that the police can or are willing to do," said Dr Appelbaum. "Police aren't terribly interested in these cases unless there is an overt threat of violence."

The Midwestern psychiatrist did contact police and worked with them over the years. "They were eager to help and were very supportive," he said. "But ultimately there wasn't much they could do."

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