When Is It Okay to Date a Patient?

Mark Crane

Disclosures

January 04, 2017

In This Article

What About a Patient's Relative?

Is dating a patient's family member acceptable?

Seventy percent of doctors in our survey believe that having a romantic relationship with a patient's family members is unethical. That's the same percentage of doctors who say it's never appropriate to have a relationship with a patient. Still, 19% say a liaison may be fine, depending on the circumstances. Only 10% say that such relationships aren't an ethical problem.

Most of the doctors who say that "it depends" cite the type of physician relationship, plus location and community size, as factors that must be considered. That's in line with what the AMA says in urging physicians to tread carefully with such relationships[1]: "Patients are often accompanied by third parties who play an integral role in the patient-physician relationship," such as spouses or partners, parents, guardians, or surrogates. "Sexual or romantic interactions between physicians and third parties...may detract from the goals of the patient-physician relationship, exploit the vulnerability of the third party, compromise the physician's ability to make objective judgments about the patient's care, and ultimately be detrimental to the patient's well-being."

Dr Hickson of Vanderbilt agrees. "I'm a pediatrician," he said. "Starting a relationship with a patient's relative is dangerous. Children have parents, often single parents. The need to maintain boundaries is important."

Most would probably doctors agree, but some cite exceptions.

"It's easy to make statements about the ethics of such things," said a psychiatrist. "But if you're taking care of Grandpa and his granddaughter brings him to office visits, chemistry may happen. It's impossible to legislate such things, the same as it is impossible to legislate workplace relationships."

A family physician said, "It's entirely dependent upon the nature of the patient's treatment. Yearly well-visits? One episode of poison ivy? That's not a problem. But ongoing treatment for major illness or psychiatric illness? That's a problem."

Relaxed Rules for Rural Doctors?

Where a physician practices also makes a big difference. As one family physician succinctly put it, "I live in a community of 2000 people, and 1500 are patients. What else is left—the priesthood?"

A general surgeon said, "Have you ever worked in a small town? I meet every patient I care for at Wal-Mart, whether I want to or not."

Another family doctor added, "I work in a rural community with only two doctors. I have treated essentially every person in my region at one point or another. While I am happily married, we do occasionally have unmarried providers in our area. I think it is not unreasonable for them to become involved with individuals who may have been seen for a minor injury or cold at some point in the past. It is difficult to set defined parameters, and that applies to family members of patients as well."

A critical care physician agreed. Dating a patient's relative "is probably not a good idea," he said, "but there are circumstances where that wouldn't be horrible. Think of a divorced dad who brings his child to an urgent care office with a cold. Then you meet up again at a Little League game several months later."

Still, most physicians say that dating a patient's relative is always wrong.

"It's a big world," said an orthopedist. "A treating provider should look elsewhere for emotional and physical involvement."

Dr Goodman, the bioethicist, sympathizes with physicians in small towns but agrees that they should maintain boundaries.

"In a small town, everyone knows everyone," he observed. "If anything goes wrong in the relationship, it could be damaging to the patient—and the doctor. It's best to find another town nearby to meet people. It's not about judging people, but maintaining professionalism and erring on the side of caution."

Tommy Bohannon, the physician recruiter, noted that single small-town physicians face a difficult problem. "It's hard to date when the other person knows all about your social standing, income, etc, before you've even had dinner," he pointed out.

The issue of dating often comes up when Bohannon is trying to recruit a doctor to a small town. "It's an important consideration," he reflected. "Often, the doctor has put his or her social life on hold while completing training. They are now eager to find a mate and want to know about the singles scene.

"It's easy to say that there are other fish in the sea, and a doctor should have little trouble finding someone to go out with," Bohannon said. "But you can't account for who you fall in love with."

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