Dr Beverley Ward
There is clear guidance on appropriate relationships between current patients and doctors. Dr Beverley Ward considers the dating dilemmas you may not see coming.
You probably wouldn’t expect this question to arise, but there have been situations where doctors have approached the MDU for advice about whether it’s OK to date a patient or not. As future doctors, its important medical students understand and comply with the same requirements as their qualified colleagues. Most doctors realise dating a current patient would not be considered appropriate.
But what if you develop feelings for a friend only to discover they happen to be a patient at the practice or hospital where you are working, or realise you have treated them in the past? What if you work in a remote area, and there is only one organisation that provides care. Something like this might make it harder to clearly define social and professional relationships.
What the GMC says
The GMC makes it clear in its guidance it is never appropriate for a doctor to pursue a sexual or improper emotional relationship with a current patient or someone close to them. It is also inappropriate to end a professional relationship with a patient in order to then pursue a personal relationship.
In terms of former patients, the situation is more nuanced. You will need to consider how long ago and for how long you were involved in their care, and whether they were vulnerable at the time, or now. If your professional interaction was a long time ago, and short-lived, then it would be easier to justify a later relationship. It also depends on the nature of your work. If they were a paediatric or psychiatric patient, any relationship is more likely to be seen as an abuse of your position. It would also be seen as inappropriate if you still provide care for members of their family.
It makes no difference if the patient approaches you. The GMC says that you should politely decline their offer and try to re-establish a professional boundary.
If you are considering embarking on a personal relationship with a former patient, ensure you have considered the factors above, and are satisfied that there could be no perception that you are taking advantage of your position, or of a vulnerable person.
Do not contact them using information obtained from their records. This would be an unlawful use of their data, and doctors have been criticised by the GMC for doing this. You also should not use social media to contact them. Even if their profile is public, it would not be appropriate to use this to contact them, when the reason you had met was professional. Similarly, if a patient contacts you through social media, the GMC makes it clear that you should decline their offer and maintain a professional boundary.
It is also worth considering the possible impact on your career, should the relationship fail. There have been cases of doctors referred to the GMC by disgruntled ex-partners who later claim the doctor abused their position of trust to start the relationship. If any concern were raised to the medical school about you, this could result in a fitness to practice investigation, and this could cause problems when applying for registration with the GMC.
All things considered, relationships with former patients come with an added risk of criticism, and you would be wise to protect your position by documenting any approach by a patient within the record, and seeking advice about dating a current or former patient from a trusted senior colleague before making a decision.
Here is an example of a fictional case highlighting the issue and the factors worth considering:
A consultant neurologist called the MDU advice line because he was concerned that he was dating a former patient. He had met her at a friend’s wedding, exchanged telephone numbers, and gone out for dinner a week later. On that occasion she had told him that she had liked him when she had first met him, three years earlier. He did not recall meeting her before, but she told him she had attended his NHS clinic with recurrent headaches.
After some investigations, he had diagnosed migraine, and she was discharged. The member asked whether he could continue the relationship, or should he break it off? The adviser suggested he discuss his concerns with his clinical lead, and consider whether there was any reason to suspect the patient was vulnerable when she attended clinic or now. If not, then it seemed unlikely that he would be criticised under these circumstances, but the member should be aware that he may need to justify his position should anyone raise concerns about the relationship.
Dr Beverley Ward
Beverley is a former GP and has been a medico-legal adviser at the MDU since 2008. She provides advice and assistance to members of all specialties on ethical and legal matters arising from their care of patients.
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