Bitty

Is this inappropriate professional conduct to flatter patients?

12 posts in this topic

If a male psychiatrist tells a young, vulnurable, attractive female patient who clearly has feelings for him that she makes him happy, would that be inappropriate and a boundary violation?

would this also indicate that he has also powerful feelings for her or just playing and exploiting her emotions? Or is such comment actually a valuable tool to strengthen the patient - clinician bond / relationship?

this happened on a nhs mental health in-patient ward where there is usually a strict conduct about keeping patient and staff boundaries intact and distant.

thank you

 

 

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That sounds horrendously inappropriate. At best, he's not picking up that she has developed an attachment to him which could place her at risk of harm. At worst, he's knowingly exploiting the emotional vulnerabilities of a patient who is trusting him to help her recover from illness.

Even if he does have feelings for her, he is her doctor - the doctor-patient relationship has to be the priority. Boundaries exist for a reason - to protect patients and staff from risk of harm. We don't have to be detached robots, but there is a line... and in this case I think he'd be crossing that in a pretty big way.

Rather than helping her in any way, by saying such a thing to her when she's in a vulnerable mental state, he'd actually be far more likely to be harming her. Exploiting the emotions and psychological vulnerabilities of a patient is unethical and wrong. 

If you know the doctor in question, it may be worth tactfully reminding him that people get pulled up in front of GMC investigations and can even get suspended or erased from the medical register for having inappropriate romantic or sexual relationships with patients - while he's (hopefully) not doing this, it's a warning about the importance of maintaining clear boundaries.

Maintaining appropriate boundaries can be hard work at times, especially in specialties where our clinical work involves a lot of interpersonal discussions and talking about quite intimate and private things (like in psychiatry, general practice, etc). So it's even more important for us to have access to supervision, mentoring, peer group discussions, Balint groups, etc..., so that we have a space to discuss any issues that arise and seek help in dealing with them. If the doctor in this situation has access to it, he might want to talk with his supervisor or mentor about challenges in maintaining appropriate boundaries. If he can't keep his personal feelings about this patient from affecting his work, then it may be best for him to move to a different ward or take on different duties for a time, so that the patient can recover and he can develop the skills he needs to avoid a repetition of this.

 

 

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Any chance of us collating more information before anyone else thinks this sounds "herrendously inappropiate"?

Probably not.

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Yeah that's a very limited account of events

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At first read that sounds inappropriate...makes him happy how? I can understand the idea of sing a bond with a patient as a motivtor to get better...like pleasing your teacher at school...but if there is a sexual connotation,clearly not ok

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I do apologise; I have not checked the replies of this post much. 

Here is some more information. In ward rounds with other professionals around he would be different and more detached.

In meetings with client and him alone; much more friendlier and open. 

She was manic and telling him about a spiritual book being a handbook to cure bipolar. She asked him 'do you think I am crazy?' To which he then replied in a friendly, warm 'no, you just make me happy' while smiling. No other inappropriate behaviour or comments took place. He is the consultant psychiatrist and clinical lead of a cmht.

One one occasion long after this incident; she expressed anger towards him and was being cold and harsh (usually being friendly, open and warm towards him)

Next day, a Saturday morning, he out of the blue send her an email which was very innoscent in nature about a free course she and her family might be interested in about caring for people with psychosis. 

Hope this helps. 

Good day everyone! 

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Very surprising that this doctor is the consultant on the ward!! I'd be interested to know if there were any other incidents of inappropriate behaviour or whether that may have been a one-off incident...

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I don't think its appropriate, but hey, im a newbie

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it sounds inappropriate from what's written.

scenario 1: GP says to teenager who has learnt to use insulin "it's made me very happy to see you doing well" = fine

scenario 2: psychiatrist (who should be aware of transference and countertransference) saying the words "you make me very happy" as a general statement to a young patient without reference to any action or qualification..  absolutely inappropriate then!  

unless it's a learning disability patient and he is simplifying his language but u haven't stated this.

if it seems wrong in your gut, it probably is.

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I had a patient come in today. 80 year old lady with dementia who was flirting outrageously with me. 

Her daughter was there, and I said that speaking to patients (like her and others) gave me great joy, and was the highlight of my job. 

I've often said told patients when they say it's a difficult job, that dealing with patients is the nicest part of the job. 

Listen, if you want to make trouble for the consultant you probably can. 

But I'd see it as harmless banter, and let it slide. 

Sure, personal emails and You make me happy is probably crossing boundaries. But there's bigger sins. 

We're all out there trying to do our best for patients, and looks like he's someone who cares and not someone who's looking to sleep with his patient or do something completely out of line. 

Pick your fights, pick your grouses, pick when you want to make a stand. Make sure it's worth it, and not hassling a doctor, possibly unnecessarily using up precious resources for something that on face value looks like an innocent rapport building statement. 

 

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It's odd that the OP would raise such questions and then not be around to discuss and help clarify they meant. Were they present and witnessed what was happening, or did they hear from the patient and/or consultant in question?

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