quietmedic Posted October 8, 2011 Share Posted October 8, 2011 During my last job, one of my regular patients and I seemed to hit it off...very subtly, of course, and though we talked about common interests (and traded nervous smiles and glances in the very beginning when I was at first a little awestruck), on follow-ups I made sure that any flirtations (and subtly flirt she did!) were returned with friendly but diversionary responses from me (i.e. I was pleasant and friendly, but kept it professional). I definitely felt the tension and I think we both knew there was some chemistry there. At the time, I was working in a field that I would not consider terribly invasive, nor unusual relationship such as psychiatry, just a typical office. I am no longer at that practice and have no intention of returning, nor do I live in the area of my practice or know anyone in common with this former patient, no complicating factors. I would really like to reach out and contact her... I know as far as the A.M.A is concerned, this is probably permissible ethically...at least it is in the case of a doctor who sends an official discharge letter...not sure how that applies to us P.A.s... What do y'all think? Is there anything inherently unethical/improper/unprofessional if I were to ask her out to coffee (which actually she offered first while I was still working!)? Link to comment Share on other sites More sharing options...
jmj11 Posted October 8, 2011 Share Posted October 8, 2011 During my last job, one of my regular patients and I seemed to hit it off...very subtly, of course, and though we talked about common interests (and traded nervous smiles and glances in the very beginning when I was at first a little awestruck), on follow-ups I made sure that any flirtations (and subtly flirt she did!) were returned with friendly but diversionary responses from me (i.e. I was pleasant and friendly, but kept it professional). I definitely felt the tension and I think we both knew there was some chemistry there. At the time, I was working in a field that I would not consider terribly invasive, nor unusual relationship such as psychiatry, just a typical office. I am no longer at that practice and have no intention of returning, nor do I live in the area of my practice or know anyone in common with this former patient, no complicating factors. I would really like to reach out and contact her... I know as far as the A.M.A is concerned, this is probably permissible ethically...at least it is in the case of a doctor who sends an official discharge letter...not sure how that applies to us P.A.s... What do y'all think? Is there anything inherently unethical/improper/unprofessional if I were to ask her out to coffee (which actually she offered first while I was still working!)? I only see a conflict of interest if you are PRESENTLY providing care to her. Link to comment Share on other sites More sharing options...
Jason09 Posted October 8, 2011 Share Posted October 8, 2011 I thought there was a law that stated you are not allowed to date a former patient until 1 year from your last official contact as PA-pt. Link to comment Share on other sites More sharing options...
jmj11 Posted October 8, 2011 Share Posted October 8, 2011 I thought there was a law that stated you are not allowed to date a former patient until 1 year from your last official contact as PA-pt. I can't imagine such a law, but there may be a code of ethics by certain medical boards. I've seen physician (in poor judgement) date their present patients. Always ends up in a mess. Link to comment Share on other sites More sharing options...
LIPPER Posted October 8, 2011 Share Posted October 8, 2011 Quietmedic; Believe me I know this is a stretch...... lets just pretend for a minute that after a few months of dating things sour. She she turns out to be a real nut. You become aware that she has had issues you didn't know about.......She starts making wild accusations about how you abused her trust regarding things she divuldged to you... you never put these "issue in writing in the chart for selfish reasons...........Is this something you'd like to deal with? I wouldn't date a patient, current or former...... Also I'd disapprove of dating a coworkers..... Link to comment Share on other sites More sharing options...
ashley simms Posted October 8, 2011 Share Posted October 8, 2011 Quietmedic; Believe me I know this is a stretch...... lets just pretend for a minute that after a few months of dating things sour. She she turns out to be a real nut. You become aware that she has had issues you didn't know about.......She starts making wild accusations about how you abused her trust regarding things she divuldged to you... you never put these "issue in writing in the chart for selfish reasons...........Is this something you'd like to deal with? I wouldn't date a patient, current or former...... Also I'd disapprove of dating a coworkers..... Yeah, right "lipper". I'm sure you're a real catch yourself, huh? From the tone of all your other posts, you sound totally obnoxious, self-serving, egotistical, stuck-up, and generally annoying. And of course you wouldn't date a former or current patient! You'd most likely have trouble getting a date with your grandmother or anyone else belonging to the human species for that matter. You come across like a complete jerk; no way should you be giving DATING ADVICE!! Who do you think you are, Dr. Ruth???? p.s. Your spelling and your grammar are horrendous. "dating a coworkers"? "divuldged"? Really?? Ever hear of "spell-check"? Never mind that this forum auto-spell checks as you type, and misspelled words are underlined in RED. What a sorry, poor, little lonely man. So many posts on this forum. You must have an awful lot of time on your hands, huh? NOTE: THIS MEMBER (AKA: LUDACRIS, ASHLEY SIMMS, CROSBY1) HAS BEEN BANNED. Link to comment Share on other sites More sharing options...
Contrarian Posted October 8, 2011 Share Posted October 8, 2011 Maybe you should send her/him a "discharge letter"... then wait 30 days. The notion that dating co-workers is inappropriate is demonstrative of more "a$$hatery" by Mr. B. Lipper ... so disregard what he writes on this subject. Especially when you consider that our SPs regularly marry each other and the nurses in the hospitals they see patients in... or that its so common that there are literallly 2-3 TV shows with this as a central theme on tv every year without fail. Yeah... send a discharge letter... have her/him inform you of when they have a new provider. Wait 30 days from that date... proceed. Link to comment Share on other sites More sharing options...
ToppDog Posted October 8, 2011 Share Posted October 8, 2011 Hmm, nice first post. I think it would be fine. I would find a way to casually run into her that doesn't involve using any of the contact info she provided in her chart, otherwise she might think you're some weird stalker. If she still feels the same toward you upon meeting you in the street or grocery store, or whatever, then ask her out & make it clear that you will no longer see her in a professional patient/provider relationship, which should be easy since you do not work there anymore. Link to comment Share on other sites More sharing options...
ToppDog Posted October 8, 2011 Share Posted October 8, 2011 ...Especilly when you consider that our SPs regularly marry each other and the nurses in the hospitals they see patients in... or that its so common that there are literallly 2-3 TV shows with this as a central theme on every year without fail... Yep, that's how I met my wife... Link to comment Share on other sites More sharing options...
SocialMedicine Posted October 9, 2011 Share Posted October 9, 2011 the discharge letter seems strange. you are not even with the practice. I had a patient make a suggestive comment at a party we both happened to be at. When i arrived at work the next day I sent him a friendly phone call and said "look forward to seeing you around town but cannot see you as a patient anymore" the patient understood and switched to another provider in office. i documented it carefully. this is obviously a very different issue. ethically it is fine in my opinion. legally i believe it is fine. what an awful way to start things off but maybe you would want to be sure to document these things in same way. save a letter where she expresses interest or something :shrug: Link to comment Share on other sites More sharing options...
Contrarian Posted October 9, 2011 Share Posted October 9, 2011 We all know folks from three practices ago that still think we are their providers. Especially if we work in a specialty and the patient only seen us -3 times a yr when they were officially our patients. Thats the point of the "discharge letter"... Its as clear of a "pro-active," CYA 101 indication as you can give that "YOU ARE NOT MY PATIENT ANYMORE." Send it certified... then file it so if anyone raises an eyebrow, you have a record of the OFFICIAL termination/discharge at hand. Then... if she/he sees you around town... (s)he is not seeing their provider since the clinical relationship has been clearly and legally teminated with a record of such on file. YMMV Contrarian Link to comment Share on other sites More sharing options...
KCMA79 Posted October 9, 2011 Share Posted October 9, 2011 I dunno, I'm a firm believer in Murphy's Law, if something can go wrong it will. In my opinion a relationship with a former patient has too much potential for problems. Link to comment Share on other sites More sharing options...
LIPPER Posted October 9, 2011 Share Posted October 9, 2011 The notion that dating co-workers is inappropriate is demonstrative of more "a$$hatery" by Mr. B. Lipper ... so disregard what he writes on this subject. proceed. Speaking of "a$$hatery" how would you classify an aged PA that prefers vedetta-driven name-calling to mature dialogue? Certainly were there no risk, then a letter of discharge would be a moot point. So why even right one in the first place. Insofar as dating coworkers, I've seen a sexual harassment issue that had degenerated from a dating scenario, so guess I'm biased that wAy. my dating/marrying a Doctor worked out great for me nonetheless. Link to comment Share on other sites More sharing options...
Contrarian Posted October 9, 2011 Share Posted October 9, 2011 ... [more of the same]... ....................................... Link to comment Share on other sites More sharing options...
LIPPER Posted October 9, 2011 Share Posted October 9, 2011 or that its so common that there are literallly 2-3 TV shows with this as a central theme on tv every year without fail.... proceed. LOL because we all know TV shows are real ;) A quick google search on "the pitfalls of dating coworkers" will give you plenty to read. http://www.texmed.org/Template.aspx?id=4557 Former patients: Sexual or romantic relationships between a physician and a former patient may be unduly influenced by the previous patient-physician relationship.* Sexual or romantic relationships with former patients are unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship.* (AMA Code of Medical Ethics, Opinion 8.14)**The AMA stipulates that a former patient may still be influenced by the previous relationship and may not be able to function in an equal, consenting adult manner.* Also the physician should not use his or her position to gain special knowledge or influence even when the person in question is technically a “former” patient. Link to comment Share on other sites More sharing options...
Contrarian Posted October 9, 2011 Share Posted October 9, 2011 LOL because we all know TV shows are real ;) Silly rabbit... Those of us who has spent a considerable amount of time in and around healthcare know who our co-workers are dating and marrying. Take a stroll in any hospital... ask any random physician what their spouse or S.O. does... you may find that its usually something in healthcare. Why...??? Because we spend more time at work than we do sleeping each night... and in many cases more time than we do at home or out socializing. So any reasonable person would see that healthcare professionals are usually tied to other healthcare professionals. Hell... even YOU are married to a physician. Thing is... once romantically attached, the wise usually try to work separate from their "significant other" because working too close can cause problems. My wife is in healthcare. Prior to meeting and marrying her, I dated hundreds of nurses. Why...??? Because thats where I spent most of my time as a medic and nurse. The one hospital in this town is staffed with physicians who's wives and husbands are nurses, RTs, NPs, PAs, and other physicians. Every hospital I've ever worked had a significant population of inter-married providers. The reason there are shows on tv every yr since you were a kid, where the central theme revolves around the functional and dysfunctional interpersonal relationships between the staff of the hospitals and clinics is because it IS what happens and is expected and experienced. YMMV Link to comment Share on other sites More sharing options...
tlahut Posted October 9, 2011 Share Posted October 9, 2011 In the category of objective data, discovering the prevalence of sexual contact with patients is difficult. However, this article from an old journal is quite revealing. In the study, of 1,891 respondents, 9% acknowledged sexual contact with one or more patients. This is good reading from Gartrell, et al. (1992). Physician-Patient Sexual Contact: Prevalence and Problems. The Western Journal of Medicine 157 (2). Retrieved 10-9-2011 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011231/pdf/westjmed00084-0035.pdf Ethics, statistical realities and anecdotal consequences are a major part of that discussion (including a suicide). Guidelines for ethical conduct from AAPA disapprove. Legalities may be the best strategy to minimize longer term concerns. Relationships are complex. I agree with Contrarian, and recommend a formal letter. See what happens afterward. -Tom . Link to comment Share on other sites More sharing options...
sscheinfe Posted December 24, 2011 Share Posted December 24, 2011 Some sources seem to say it's OK to date a former patient if you send a letter of termination of care and all. But in this guys case...if he left the practice (or was let go), he is obvously no longer this patient's provider...but technically, he never really officially was (or was he?), his SP was...and the patient was not discharged from the practice, but the PA was! The OP can't send a letter of termination, as he has nothing to terminate her from...he no longer works there, nor did he ever run the practice. I don't really know what to make of that one! Complicated. Link to comment Share on other sites More sharing options...
physasst Posted December 24, 2011 Share Posted December 24, 2011 I have to agree with Lipper on this. I personally don't think it is worth it. It's not hard to meet people outside of work, and I wouldn't want the possible problems associated with dating a former patient. Co-workers, again, not the best idea, but probably a better idea than dating a former patient. Think of it this way. What if you date this former patient and things go well for awhile, but then sour. Let's say things really sour. Then he/she makes a statement to the Medical Board that you were courting them while you were their provider? Or worse, that you were involved with them while you were their provider? Or that they felt pressured to go out with you? That opens a BIG can of worms, and yes, you will able to prove that you weren't, but is it worth the potential hassle? Life is a series of choices. I'd be really leery of this one. Even a co-worker probably isn't worth it. I dated a lot before I got married, and actually dated a co worker once. Then I found out what a b*tch she was and kicked her to the curb, problem was, she turned the whole office against me. Going to work became painful. Anyway, this is your life, and you will have to live with the choices you make. Just think carefully, and try to make the wisest choice. Link to comment Share on other sites More sharing options...
user1234556 Posted December 27, 2011 Share Posted December 27, 2011 the only ethical dilemma i see here is the fact that, if you even have the ability in the first place to "reach out and contact her" but no longer work at the practice, you would've had to have exchanged numbers or gotten contact info from her chart etc while you were still an employee. Link to comment Share on other sites More sharing options...
Cideous Posted December 30, 2011 Share Posted December 30, 2011 the only ethical dilemma i see here is the fact that, if you even have the ability in the first place to "reach out and contact her" but no longer work at the practice, you would've had to have exchanged numbers or gotten contact info from her chart etc while you were still an employee. Good point. Dating a co-worker is 100% different then dating a patient. It's just not worth it. Link to comment Share on other sites More sharing options...
jmj11 Posted December 30, 2011 Share Posted December 30, 2011 Okay, this story is true but I'm throwing it into the mix as an interesting ethical discussion. About 15 years ago I was employed by a hospital in Ishpeming, MI. They had surgeon there (I think it was a surgeon) who was a practicing nudist. So he would have these big parties at his cabin (in the remote woods) that was completely nude. Everyone had to shed their clothes in a hut by the road. He invited many of the nurses and patients to come. To my surprise, many did go. The nurse that worked with me said she had gone several times. I just know it was nude, alcohol, hot tubs and saunas. I don't know what else went on. They said it was his philosophical view that being nude in nature was a good, therapeutic thing. I thought it was inappropriate to invite patients to such a party. What do you think? Link to comment Share on other sites More sharing options...
physasst Posted December 30, 2011 Share Posted December 30, 2011 Okay, this story is true but I'm throwing it into the mix as an interesting ethical discussion. About 15 years ago I was employed by a hospital in Ishpeming, MI. They had surgeon there (I think it was a surgeon) who was a practicing nudist. So he would have these big parties at his cabin (in the remote woods) that was completely nude. Everyone had to shed their clothes in a hut by the road. He invited many of the nurses and patients to come. To my surprise, many did go. The nurse that worked with me said she had gone several times. I just know it was nude, alcohol, hot tubs and saunas. I don't know what else went on. They said it was his philosophical view that being nude in nature was a good, therapeutic thing. I thought it was inappropriate to invite patients to such a party. What do you think? HIGHLY, HIGHLY inappropriate, and if reported would engender some serious repercussions from the state medical board. At least here in Minnesota it would. Link to comment Share on other sites More sharing options...
Just Steve Posted December 30, 2011 Share Posted December 30, 2011 Okay, this story is true but I'm throwing it into the mix as an interesting ethical discussion. About 15 years ago I was employed by a hospital in Ishpeming, MI. They had surgeon there (I think it was a surgeon) who was a practicing nudist. So he would have these big parties at his cabin (in the remote woods) that was completely nude. Everyone had to shed their clothes in a hut by the road. He invited many of the nurses and patients to come. To my surprise, many did go. The nurse that worked with me said she had gone several times. I just know it was nude, alcohol, hot tubs and saunas. I don't know what else went on. They said it was his philosophical view that being nude in nature was a good, therapeutic thing. I thought it was inappropriate to invite patients to such a party. What do you think? We have a saying in whitewater kayaking that "It's all class III if you're on line". In other words, it's a fun, non threatening situation that is pretty user friendly...if you're in the right spot. If you get off line...or in the wrong spot..it can kill you. An accusation of sexual inappropriateness can destroy careers, marriages, social relationships...not many people want to befriend a person who is being investigated for possible sexual assault. If the reported victim is a patient, that brings in license reviews, maybe sanctions or revocations...is the risk worth the reward? I am sure the party host had a "feel" (pardon the pun) for who was good to go for an invite and who was not...but make a mistake with a patient and it could cost you everything. A coworker...am not so worried about that. As others have noted, coworkers mate, marry, divorce, cheat, swap, and any other number of combinations all the time. There is something sacred about the patient/provider situation that needs to be kept sacred I think. So in my risk to fun ratio...risk is too high for me to invite a patient. If the doc really believed in the therapy of nudity in the woods..prescribe it. I've lived in several states where nude campgrounds, colonies, beaches exist. Recommend those places to your patients if that is what the provider feels that would be beneficial...not to your own place. Link to comment Share on other sites More sharing options...
Contrarian Posted December 31, 2011 Share Posted December 31, 2011 GREAT POST Steve... Interesting story JmJ11. This bring up a related issue... It was once posited that part of the healthcare provider shortage in RURAL America is due to the ethics rules. Since most physicians are/were single by the time they finished training... they were/are NOT going to move out to BFE where the chances of meeting a mate were/are slim to none. Even if there happens to be a few attractive, eligible folks around... they are, or soon to be that provider's patients. Now couple this with the typical schedule a rural provider works... then figure out how and when this person has time to drive 50-100 miles away to look for a date/potiental "life-partner" that doesn't land this provider in front of the BOM ethics panel...? Just thoughts... Link to comment Share on other sites More sharing options...
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