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  #1  
Old 02-01-2011
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Medicolegal and Ethics Ethics; Romantic Doctor-Patient Relationship

A 60 yr old male physician who is an internist has a female patient for the past 20 yrs. Both of them lost their spouses several years ago. They start spending time together outside the office. The female pt wants to begin a romantic relationship with the physician.

What should he tell her?

a. I can never do that with you ever.

b. We can be social but not sexual

c. We need the ethics board's approval first

d. I cannot date you & be your doctor. May be in the future we can date, after you get another doctor.

e. Because this is your initiative, we can begin dating.



what is the answer?
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  #2  
Old 02-01-2011
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Actually I read somewhere that the doctor-patient relationship has to be terminated for 4-5 years before a relationship is possible. The exception to this is a pyschiatrist who can never have a relationship with his patient.
B is possible as long as there is no role of the relationship of trust between doctor and patient - however that is hard to define.. however all medical boards say - DO NOT get involved with your patients.. that is the best choice.

So I think the "best" answer is the one which does not encourage the patient in any ways.... A
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  #3  
Old 02-01-2011
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going with A. The answer is always no lol.
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  #4  
Old 02-01-2011
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Arrow

cannot it be choice D?? b'coz the doctor patient relationship is terminated and Fischer's 100 cases says that doc-patient relationship needs to be terminated before any personal/sexual advancements are made...
n there's no specified time line, for psychiatrist it says they cannot have sex even with a former patients but in this question it just says internist, I don't really know if this internist can be a psychiatrist, coz no idea about a 60yr internist..
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  #5  
Old 02-01-2011
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D.
Answer A is too severe, the reality is he can date her if she is no longer his patient. So if she finds another doctor and a reasonable amount of time passes he can then date her.
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Old 02-01-2011
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Answer is D.

With the exception of a psychiatrist, if there exists no doctor-pateint relation then they can date. If i remember correctly, the time period to wait after termination of the doctor-patient relationship was 2 years.

I may be wrong.
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  #7  
Old 02-02-2011
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Arrow Ans: D

Ans: D I cannot date u & be your doctor. May be in the future we can date, after u get another doctor.

Sexual relations between a doctor & a CURRENT pt are never ethically acceptable. At the very least the pt/physician relationship must stop.

http://www.jstor.org/pss/3811516
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  #8  
Old 02-02-2011
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i think the answer.... dr. daughtery in kaplan videos clearly explains that although accoring to rules, physicians can hv a relationship with their pts after 2 years of not being their doctor... but for step 1 we hv to choose the option A., never encourage this type of behaviour.... plz tell us the source of this question, the correct answer and explaination...
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  #9  
Old 02-02-2011
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I disagree D is the Answer !!!!

it's a question from Dr. Conard Fischer Medical ethics book !!!
well the answer is D as he say ...But i remember that according to Dr.daughtery in kaplan videos clearly explains that although accoring to rules, physicians can have a relationship with their pts after 2 years of not being their doctor... but for step 1 we hv to choose the option A., never encourage this type of behavior...
but I really think it's A
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  #10  
Old 02-02-2011
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dr. conrad fischer.. hmm.. thts some1 u cant ignore.... well.. if u see 1st aid 2010.. page 61... under ethical situations... situation number 6 described is exactly the same... n according to tht too answer should be never encourage such behaviour... n it specifically says tht never answer "there can be no relationship while you are my patient".....
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  #11  
Old 02-02-2011
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i will go with D
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  #12  
Old 02-02-2011
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To be completely honest, Dr. Conrad Fischer is actually more entertaining than he is correct. I just attended his Kaplan Live Lecture course for physio in November, and he not only did he not teach us anything useful, he taught us the half of physio the other doctor was meant to do. So if he says D is the right answer...then I know that's the the wrong answer. His question is badly worded. For USMLE sake, never date a patient so A.
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  #13  
Old 02-02-2011
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Default Ans. A

its A..for sure..its strictly "no" for psychiatrist...but it shud be avoided as far as possible for any other doctor...
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Old 02-02-2011
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Show Teeth D

As much as the answer should always be NO, after she finds another physician it should be ok.
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  #15  
Old 02-02-2011
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Quote:
Originally Posted by gargabhi2 View Post
n it specifically says tht never answer "there can be no relationship while you are my patient".....
this is a very valid point.. we are basically encouraging the patient to change her physician SUCH that they begin a relationship. That is not morally right.

yes..if the patient gets the idea herself.. no probs.. but its not the job of the doctor to suggest such a thing
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  #16  
Old 02-02-2011
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AMA Guidelines say "for atleast 2 years"
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  #17  
Old 02-02-2011
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Default I would say A.

Quote:
Originally Posted by patelMD View Post
AMA Guidelines say "for atleast 2 years"
But it doesn't ask what the physician should do - it asks what he should tell the patient. Those are different questions...

I would disagree with Dr. Fischer on this one and answer A.
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  #18  
Old 02-02-2011
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Quote:
Originally Posted by Mondoshawan View Post
But it doesn't ask what the physician should do - it asks what he should tell the patient. Those are different questions...

I would disagree with Dr. Fischer on this one and answer A.

Yes, A is correct..

I was just stating for our practical use incase we ever end up with a good looking patient haha
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  #19  
Old 02-04-2011
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I'd say that A is the answer for the test and D is the answer for your life.


It's not ethical treat any person with whom you may have a more-than-medical relationship. This includes relatives in general.


I think every doctor, everywhere, has to respect the sentences above, but just AMA has a guideline that mentions anything about '2 years'.
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  #20  
Old 06-18-2011
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this is really confusing this case from dr fischer ethics book

and i choose A but the answer was D


but we all know from step 1 exam that this is not allowed never

so i am so confused but i will go for A
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  #21  
Old 06-18-2011
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Default Opinion

20 yrs (Doctor-patient)...then they started to spend time together outside office, after that the patient started to feel comfortable with "the person" not the doctor, who agreed on this to start >>> in this Q situation the answer is D.
But if the doctor instantly didn't allow the new situation to start >>>> the answer is definitely A
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  #22  
Old 04-21-2013
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for step 1, definitely A
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