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August 12

Inappropriate visits to the doctor

Imagine this scenario, a 'gentleman' has a physician who is an attractive young woman. This gentleman keeps scheduling appointments with this doctor (or her colleagues who are similarly attractive) with repeating complaints about mysterious ailments of a sexual nature, all of which 'require' examination. How do doctors deal with this? On one hand, they can't turn away patients because they feel grossed out...on the other hand it's blatantly obvious what the patient is up to! — Preceding unsigned comment added by 123.218.95.243 (talk) 08:31, 12 August 2016 (UTC)[reply]

Not sure what you mean by "they can't turn away patients because they feel grossed out". Unless the doctor is the only one in town or it's an emergency situation, I don't see any reason why they can't turn away a patient who they feel is requesting unnecessary exams or otherwise behaving inappropriately with them. In fact medical ethics would probably suggest it if the patient can't be convinced to stop. E.g. [1]

If a patient is attracted to you and his or her behaviour is threatening the sexual boundaries of the doctor-patient relationship, you need to take measures that put a stop to this behaviour

If possible, try to discuss the patient’s feelings and attraction in a constructive and helpful manner that explains the inappropriateness of a relationship. If this is not possible, it is best to transfer the care of the patient to another doctor.

Of course, without intending to provide legal advice, presuming the patient isn't doing stuff such as repeatedly disrobing unnecessarily etc, perhaps the doctor will simply deal with the patiently professionally, doing their best to ensure the doctor-patient boundary is clear to the patient, asking the patient whether they'd accept a chaperone etc.

Nil Einne (talk) 09:33, 12 August 2016 (UTC)[reply]

See also [2], [3] and [4] although the ~~later~~last only really deals with more clearly inappropriate behaviours. Nil Einne (talk) 09:33, 12 August 2016 (UTC)[reply]

Note also these sort of things aren't solely theoretical, e.g. see [5]. Maybe also [6] and [7] (the later surveyed doctors about patients inappropriately exposing themselves, but doesn't seem to have separated these results, however it does give some info on the ways doctors deal with the variety of often more inappropriate behaviour). Nil Einne (talk) 09:44, 12 August 2016 (UTC)[reply]

A doctor (or therapist) can absolutely refuse to see a patient because they are being vexatious or inappropriate. They can insist on having a chaperone of the opposite sex to the patient in the room with them. They can refer to a therapist/doctor of the same sex as the patient. The therapy practice I run has a sexual harassment policy which states that such instances will be dealt with by reporting to the police. Personally I had a client who wanted me to massage his perineum because he said he was a road cyclist and they get problems in that area. I googled it and found it is A Thing, so I agreed. Just the once. I now refuse to see him and have referred him to a male masseur. --TammyMoet (talk) 10:13, 12 August 2016 (UTC)[reply]

About the chaperone thing, my understanding from the sources I've read (mostly above) is doctors could ask a patient if they'd be happy with a chaperone or maybe even make it a matter of policy that there's a chaperone. However if a patient refuses, they'd have to either continue to assess the patient without the chaperone or refuse to and tell them to seek out another provider. (Even always requiring a chaperone can be controversial from what I saw.) This may appear the same, but in cases where it's not possible to refuse to treat (as several of us including you have mentioned this is rare but I think it can arise), they'd generally have to continue to treat the patient without chaperone.

Remember from an ordinary patients POV, turning down a chaperone isn't exactly surprising. It may be bad enough having to let another doctor see and hear something your embarassed about, let alone a third party who may be putting the doctor at ease but definitely isn't you. Especially in certain circumstances, e.g. this [8] notes that it's fairly common in the US that chaperones in GPs are female even with male patients. (In fact as I saw a commentator point out, some of the more concerning patients would actually be the ones who'd enjoy having that.) Not really relevant to the question, but adolescents in particular are mentioned as one (and it's easy to imagine) who are often especially uncomfortable with a chaperone.

Without intending to provide legal advice, medical ethics would generally require a doctor to treat a patient if they're the only one available. And I guess there may also be contractual issues e.g. if the doctor isn't self employed or perhaps has a contract with either some governmental service or an insurer. (However these these people will also have a responsibility to the doctor in nearly all cases, so I'm not suggesting they can insist the doctor has to treat everyone.) There would be similar issues if in a tiny village where there are no other doctors nearby or I guess if doctor is a specialist and there's no one else suitably close because it's something very rare. Which is not to say doctors are require to ignore their own safety or wellbeing or the needs of other patients. (E.g. even if it's a possible emergency, if the doctor is really so uncomfortable they feel they can't do their job properly perhaps a forced chaperone is the lesser evil.)

Incidentally these sort of conflicts arise in other cases. E.g. one of the other respondents raised the issue of other inappropriate behaviour like violence. Hypochondriacs or patients who come to the doctor with every single minor issue because WebMD told them it's a sign of cancer would be another [9] [10]. And besides a patient inappropriately seeking some sexual outlet, some patients may be trying to use the doctor to fulfill some sort of emotional support or similar need.

Nil Einne (talk) 12:52, 12 August 2016 (UTC)[reply]

See hypochondria, Munchausen syndrome, GOMER. --Jayron 32 15:31, 12 August 2016 (UTC)[reply]

Note: A large section of this thread was removed because it was started by a long-time indefinitely banned user. Apologies to those that were baited into an argument with him. In the future, please check here if you suspect you're being baited into a tangential argument with an IP user; if the range matches known ranges she uses, please disengage and seek help from an admin. --Jayron 32 15:36, 12 August 2016 (UTC)[reply]

Well done. ←Baseball Bugs ^{What's up, Doc?} carrots→ 15:42, 12 August 2016 (UTC)[reply]