Dating a patient-hypothetical

[forchinet121]

So if you are an intern and you treat a patient on inpatient psych, 9 years later you are obviously an attending and you meet this same person at a bar and don’t recognize them and have sex..is this unethical and would you lose your license?

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[clausewitz2]

If this in any way describes you or someone identifiable you know I would strongly advise you to stop posting about it immediately.

 

[PsyDr]

never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never never

 

[comp1]

Ha. So you have to terminate (completely and utterly) the relationship as soon as you recognize that there was a previous patient/doctor relationship. This is immensely simple. As far as to whether you would lose your license, probably not, but it might get put on some sort of probation if there was a complaint and the board felt that this reasonably should not have happened. If there's other extenuating circumstances not described and I'm pretty sure there would be, you might.

 

[littlefred]

The APA won't renew your membership because you've been naughty.

 

[erg923]

Not the 70's anymore....

In all seriousness, what is described is not "dating" anyway. Have some self respect.

But also, no, you wouldn't lose your license for this action alone if that's all completely factual and nothing more to the story.

 

[FlowRate]

I think the fields of psychiatry and psychology take a particularly stringent stance on this sort of thing because of the unique nature of the mental health patient-doctor relationship and the history of abuse in our field.

The question would be different if you're the only family doc in town and you sutured the farmer girl's hand one time or whatever.

 

[Fan_of_Meehl]

So if you are an intern and you treat a patient on inpatient psych, 9 years later you are obviously an attending and you meet this same person at a bar and don’t recognize them and have sex..is this unethical and would you lose your license?

Sounds like a plan. A VERY VERY VERY unwise plan that should NEVER be carried out. No way, Jose!

 

[Sushirolls]

I'll play and bite on this hypothetical....

What @comp1 said.

If truly no recall, no recognition until after the fact... then all further contact needs to be ended at point of recognition.

Next level question to this hypothetical, is does the doc in question, keep it brief and simply say its generically me and not you, its over. Assuming there was potential for more/continued contact. Or does the doc clearly say, OMG, I was your doctor in the past, and this is why we can't have further contact?

Does the doc self report to the medical board? Detail no further contact will take place, to stave off any negative report of the former patient saying they were preyed upon?

And for the next level of this hypothetical... since prompt is alcohol/bar hookup, what if one gets pregnant?

 

[comp1]

Okay, well now we clearly are doing actual hypotheticals. So no, you don't self report to a medical board. That's weird and I doubt there's even a mechanism for such a thing. If you really MUST get some sort of absolution, you could talk to your malpractice carrier for more clear guidance specific to your state. I don't recommend that, but it's a heck of a lot better than talking to the medical board. Since you have now discovered you have a professional relationship, you keep it professional and just state that you aren't interested in meeting again and wish them well. There's no need for more discussion, particularly given the description of the relationship such as it is. Pregnancy is really unrelated to the underlying dual role that prevents a romantic relationship. If the pregnancy is brought to term, a court or two sets of family lawyers will determine appropriate custody and financial support of the two parties, as with any other couple who are not in relationship at the time of a child's birth.

 

[Ceke2002]

This hypothetical also supposes that the former patient doesn't recognise their former Doctor, and unless they were being treated for SMI (and was so out of touch with reality they had no idea what her former Dr looked like) I would find that hard to believe. Maybe it's just me, but I'd definitely recognise a majority of my former Doctors if I saw them out, even the ones I haven't seen in years.

Agree with the hypotheticals Sushi Rolls has put forward as well, although I'd add a caveat that maybe this hypothetical Doctor shouldn't get drunk in bars and pick up one night stands if there's even the remotest chance they could end up having relations with a former patient.

 

[Stagg737]

Is it actually unethical? If the doc legit didn't recognized the person and did not know until later, then I'd say that initial night was not. What the doc decides to do after finding this out certainly could be.

Would this be seen as unethical? If the patient decided that the doc knew they were a former patient and can convey that to the board...maybe? The board's view would probably depend on how the doc handled the situation after the realization and what the patient reported. Could just disappear and never be an issue or could become a nightmare. 100% would depend on the patient and later interactions with the board if there were any.

I've thought about similar (non-sexual) situations in terms of what I'd do or how I'd handle interacting with former patients in the wild if they ended up as my kids' teacher or something of that nature.

 

[BiscoDisco]

So this actually happened to me, sort of.

I still don't fully recall her, but I went out (and had some physical contact) with a former patient I met on a dating app. Apparently during my intern year I briefly was assigned a patient who was on our inpatient unit. I think I saw her 2-3 days before she was discharged by another intern.

Fast forward 4 years and I match with a girl. We talk, go out a handful of times. Around date 5 she asks if I remember her. I do not - I probably spent a total of 30 minutes over a few days with her like 4 years ago.

I immediately freak out, cut things off. This was 4 months ago and I haven't heard anything further. I would THINK (hope) if the board caught wind of this, there would be nothing to punish here. It would be kind of insane for a doctor to remember every single patient they have particularly if they only saw them for a very brief period of time years ago.

 

[Stagg737]

"Guild ethics" are not ethics. Ethics do not really exist. I wish people would stop pretending.

The poster is a scumbag if he at all knew about any of this in advance. If he didn't, it is totally moot/irrelevant. But I don't believe that for a second or else he would not have posted it here. Is this a "Psychiatry" forum? Jesus.

I’m not talking about guild ethics. I’m actually talking about the opposite. You really think some patients/exes wouldn’t be vindictive enough to make something up and report it to the board to get back at someone they dated or that medical boards wouldn’t come down harshly on this? That’s what I’m referring to and I’ve seen patients do just that (though not the dating part) resulting in pretty severe punishment.

Also, I don’t think the OP is as ridiculous as you make it sound. I’m only a second year attending and from med school to now I’ve seen thousands of psych patients. If I were single and dating, running into former patients would be a legitimate concern. If this actually happened to OP I could see this being a reflexive “please tell me I’m not screwed” on an anonymous forum, because I sure as heck wouldn’t talk about this with anyone irl…

 

[forchinet121]

"Guild ethics" are not ethics. Ethics do not really exist. I wish people would stop pretending.

The poster is a scumbag if he at all knew about any of this in advance. If he didn't, it is totally moot/irrelevant. But I don't believe that for a second or else he would not have posted it here. Is this a "Psychiatry" forum? Jesus.

I’m a scumbag now? I’m surprised you haven’t been banned for all of your trolling recently

 

[esob]

Personal attacks are a violation of our TOS. Cloaking a personal attack in a conditional statement is walking a very thin line and il advised in an already heated thread.

 

[Bartelby]

If you don't remember the person was a former patient and you have sex with them is that unethical? Of course not! You did not know you were having sex with a former patient. If someone was zealous enough they could still potentially say your conduct was unprofessional, but I think the case would be very weak.

The problem is whether the medical board (or, far less likely, a jury/ plaintiff's attorney) would believe that you didn't know.

I think I would either:

1- Cut off contact with the person as mentioned above and just hope it goes away. I suspect this is highly likely to work, but has potential to blow up on you if a complaint somehow arose. They might make the case that you later realized you did something potentially harmful and tried to conceal it.

2- Call your malpractice carrier and ask them what to do. If you follow the advice of your malpractice attorney it is hard to make the case that you were attempting to conceal this or that you did it intentionally and maliciously.

 

[Bartelby]

I will add, though, that most (all?) malpractice policies don't pay out for lawsuits related to having sex with patients.

 

[docksan]

So if you are an intern and you treat a patient on inpatient psych, 9 years later you are obviously an attending and you meet this same person at a bar and don’t recognize them and have sex..is this unethical and would you lose your license?

You would have to prove beyond reasonable doubt you did not know this person or this person knew you, did not tell you, and you acted out of ignorance, otherwise forget it.

This is an oddly specific question.

 

[erg923]

I’m a scumbag now? I’m surprised you haven’t been banned for all of your trolling recently

Its not “trolling.” I just don’t believe your story.

 

[TexasPhysician]

Yes you could lose your license.

That same patient could say they were intoxicated and do a rape kit. They could argue you knew and preyed upon them.

The number of possibilities is high as to degree of punishment.

 

[calvnandhobbs68]

I will add, though, that most (all?) malpractice policies don't pay out for lawsuits related to having sex with patients.

They won't ultimately pay out if there's damages but they'll defend you in court. Mine for instance specifically has a clause stating this (just with an overarching "sexual harassment" or "sexual allegations" or something along those lines, I'd have to look at the wording).

 

[forchinet121]

Its not “trolling.” I just don’t believe your story.

It’s a hypothetical..have you been drinking again dad?