Do You Know The Boundaries of a Patient/Doctor Relationship?

When consulting with a doctor you have a right to feel: -

Informed
Heard
Safe
Comfortable

As patients, we have the utmost trust and faith in our doctors and treatment providers. An integral part of the doctor patient relationship is open communication and honesty. We tell our doctors things we would never tell anyone else, and we place our trust in our doctors to provide advice and undertake appropriate investigation and management.

Given the nature of this relationship, it is clear the doctor patient relationship is one which is inherently unequal.

Doctors have an ethical and legal obligation to make sure their patients feel safe, informed, and comfortable when receiving care and treatment.

Unfortunately, some doctors and medical providers use their position of power to exploit their vulnerable patients for their own gain.

Given the vulnerability of patients in this relationship, it is important that patients be aware of what constitute a breach of the doctor’s guidelines and the doctor patient boundaries.

What is considered a breach of the boundaries?

Generally speaking, behaviours that would constitute a breach include, but are not limited to: -

Forming emotional or sexual relationships with patients (regardless of patient consent)
Conducting physical examinations that are not clinically indicated or warranted
Sexual humour
Inappropriate touching, hugging or communications with a patient (including written communication)
Requesting details of sexual history or preference when not reasonably necessary to treatment
Engaging in a sexual relationship with a former patient or relative of a patient

Consent

Both the AMA and AHPRA have identified the issues surrounding patient consent to enter into sexual/intimate relationships with their treatment providers.

The issue with consent stems from the influence a doctor has over a patient and whether that consent is in fact informed consent, whether the patient has capacity, and whether the treatment being provided by the doctor could be expected to influence the patient’s decision making.

Relationships with former patients are also considered to be a breach of the guidelines as it is considered that the influence and power imbalance of the doctor patient relationship could extent long after the doctor ceases treating the patient.

Issues for Patients

Most patients who have been exploited by their doctors do not know what has occurred until sometime later as patients rarely understand what constitutes a breach of the guidelines and legal obligations of doctors and treatment providers.

In other circumstances there is a delayed recognition of breach by patients due to patient: -

Vulnerability
Being medicated
Not having capacity
Feeling threatened
Fear of losing the relationship
Being told not to tell anyone
Not understanding the behaviour is wrong until being advised by a third party

The delay in recognition is very common due to the nature and circumstances of the relationship.

Unfortunately, a breach of the boundaries can have detrimental effects on patients including: -

Significant psychological injury
Inappropriate care and treatment provided by the doctor resulting in further injury
Injury, loss, and damage

If these circumstances sound familiar, and it appears there has been a breach of the doctor patient relationship the patient may be entitled to bring a medical negligence claim against that doctor.

By bringing a medical negligence claim against the doctor the patient may be entitled to compensation for the injury, loss, and damage sustained as a result of that breach.