Physicians Are Talking About... Would You Ever Date a Patient?

Medscape Family Medicine > Physicians Are Talking About...
Would You Ever Date a Patient?
Brandon Cohen
Sep 25, 2013

The sensitive topic of doctor-patient romance heated up a recent all-physician discussion on Medscape Connect. The conversation ranged from general ethical warnings to specific forms of temptation, as doctors bravely explored some delicate areas.

A dermatologist began the discussion with personal history and a question: "Since I stopped wearing my wedding band about a year ago, more of my patients have increased interest in me. Just out of curiosity, how many of you have dated active patients or former patients?"

Several colleagues were clear and firm in their opposition to these kinds of associations. An internist framed the dilemma in contrasting lists: "Reasons to date a patient: fleeting excitement. Reasons to never date anybody you have a physician relationship with: your license, your reputation, your license, unhealthy psychodynamics, your license, STDs, your license."

Another internist found the answer self-evident: "I think everyone should know that we lose objectivity and the ability to provide care when we enter into an intimate or romantic situation with patients... it is IMPROPER."

Others had strong opinions but made a distinction between current and former patients.

"NO, NO, NO," intoned a genomic medicine specialist. "Discharge them from your practice. Then see what happens. If they are still interested, ask away. If they are not still interested, then they may have been looking for a lottery ticket."

A surgeon added, "A physician dating a patient is a lot like smoking while pumping gas. I've seen people do it with no problem, but it carries a high risk of unpleasant (and permanent) consequences."

Other physicians went back to Ancient Greece to bolster their arguments.

"Since the time of Hippocrates this has been a no-no," wrote a pediatrician.

A primary care physician agreed and offered the relevant quote: "'Whatever houses I may visit, I come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations.' And there's the rub in this oath we take."

But some did not feel bound by a pledge to Apollo and saw glimmers of hope for doctor-patient unions: "My previous boss married his psoriasis patient," brightly offered a dermatologist.

"So much temptation, so little time! Sometimes one wonders what is gained or lost when one is cautious, serious, dignified, upstanding," wondered an internist, dismissing the caution of many colleagues.

A primary care physician went even further.

"Up until the 1990s, dating patients or even marrying them wasn't at all that uncommon," he wrote, and he went on to reject the caution of colleagues as a "[projection of] the anger of or your envy onto those of us who did [date patients] back in those Golden Days of American Medicine."

But an orthopedic surgeon quickly responded: "I am not jealous. I could have so many girlfriends, it is scary. I choose to avoid them."

Many other physicians picked up on the idea that it is a difficult road for the attractive physician because of so many potential suitors.

An internist claimed to have been "hit on like Normandy beach."

And a dermatologist mentioned that female patients have provocatively left red panties in the examination room or asked him to go on motorcycle rides.

Ultimately, most of these heartthrobs came to the decision that it was not worth the risk of damaging one's professionalism.

One internist, while understanding the temptation, argued against pursuing patients because there are so many other available options: "I don't think it is difficult to find interested companions for just about any activity. Bars are still full of desperate people seeking inappropriate connections. The Internet is funded largely on unchecked libido. If one is looking for [sexual partners], why risk the problems of patient relationship issues?"

And another internist questioned the basic pleasures of such risky relationships: "Imagine the consequence of marrying or dating a patient; likely you will be practicing your trade every minute...after a long day in the office."

A survey on Medscape found that 68% of physicians believed that it was never ethical to date a patient, even if the patient had been discharged.

The original poster, seeking a more official standard, provided the guidelines of the American Medical Association (AMA) on the topic:

Sexual contact that occurs concurrent with the patient-physician relationship constitutes sexual misconduct.... Sexual or romantic relationships with former patients are unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship.[1]
An internist was even more austere than the AMA: "As soon as a patient is examined by a physician in your office, you establish a physician-patient relationship. That relationship ideally is sacred, and if one is turned on by an attractive patient during such an encounter in the office, your options are to either discharge the patient or ALWAYS have a chaperone."

The final word goes to a primary care physician, presumably with some experience in gerontology, who quipped, "I use carbon-14 to date some of my patients."

The full discussion of this topic is available at http://boards.medscape.com/forums/.2a590fef. Please note that this is open to physicians only.

http://www.medscape.com/viewarticle/811327