Explore this issue:August 2013
The lesson for fledgling doctors comes early in medical school: Getting romantically involved with a patient is forbidden. Verboten. A definite “don’t” in any physician’s playbook.
The problem is that not every patient plays by the rules, and a patient prone to flirtation can create a dicey ethical dilemma for a doctor—or at least make office visits uncomfortable for physicians and staff.
While physicians vary in their approaches to managing flirtatious patients, many agree that nipping the behavior in the bud is critical to maintaining professionalism and upholding ethical standards. “It’s flattering to have a flirtatious patient,” said Kenneth W. Altman, MD, PhD, director of the Eugen Grabscheid MD Voice Center and associate professor of otolaryngology at the Icahn School of Medicine, both at Mount Sinai Hospital in New York City. “But, we have an obligation to protect the integrity of our profession, and to our marital contracts, to act professionally at all times.”
Dr. Altman finds it helpful to put some professional distance between himself and a flirtatious patient. “I have no problem saying to a patient: I appreciate what interests you may have, but I have to draw the line to take proper professional care of you,” he said.
Laura T. Hetzler, MD, a facial plastic and reconstructive surgeon at Our Lady of the Lake Regional Medical Center in Baton Rouge, La., and assistant professor in the department of otolaryngology at Louisiana State University School of Medicine in New Orleans, said she derails flirtatious behavior from patients by deflecting their unwelcome comments. “I’ve learned not to act sheepish about it,” said Dr. Hetzler, who has had patients who weren’t shy about commenting on her clothes, shoes, figure or recent weight loss after pregnancy. When a patient’s remark crosses the line from complimentary to something uncomfortable, she either curtly laughs it off or ignores it. “I don’t acknowledge the statement and immediately move the conversation into something clinical,” Dr. Hetzler said. “That puts the rest of the visit in a serious tone.”
Take a Team Approach
Dr. Hetzler also instructs her nurses to have another staffer accompany them into an exam room when a patient known for being flirtatious is waiting to be seen, and to leave the door open. Dr. Hetzler said she also brings a nurse with her during an exam with that type of patient.
Likewise, other physicians use a “more is merrier” approach for themselves and their staff as a defense against flirtatious behavior. “It is a problem we avoid by having our physicians never see patients alone,” said Robert Sataloff, MD, DMA, FACS, professor and chairman of the department of otolaryngology–head and neck surgery, senior associate dean for clinical academic specialties at Drexel University College of Medicine in Philadelphia and a physician with Philadelphia Ear, Nose and Throat Associates. “There is always a nurse or medical assistant [in the room with the physician], even if we have to see somebody in the office on call after hours,” he said. “We have a call schedule for the nursing and medical assistant staff. And that includes patients of both genders, regardless of gender of physician, since flirtatious behavior can be same-sex flirtatious behavior.”