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Avoiding unwanted attention from patients – guidance for doctors

At this time of year, many doctors will be receiving gifts and thank you cards from grateful patients. While it’s nice to be appreciated, occasionally gifts and cards can leave doctors feeling uneasy because they believe the patient may want more than a professional relationship.

The MDU has helped around 100 members over the last five years with advice on how to deal with patients making amorous advances. One trend we have noticed is that with the availability of social media, doctors are more accessible to patients wanting more than a professional relationship. Amorous advances made via social media can be particularly intrusive and if they are not nipped in the bud, or even unwittingly encouraged, things can get out of hand.

On rare occasions the situation can even escalate to the doctor being stalked or harassed. One case to hit the headlines involved a GP who called for an increase in sentencing for stalking offences, after being stalked by a patient for seven years.

Amorous advances by patients, can range from receiving unwanted letters and gifts and more commonly now text or social media messages. In more extreme cases, patients have turned up at a doctor’s work or home and this has the potential to develop into stalking and harassment, with some patients creating a fantasy affair that the doctor is completely oblivious to.

Some patients can be very distressed if they feel their advances are being ignored or rejected, and their behaviour can become aggressive, or vindictive. The MDU has seen cases of doctors referred to the GMC by patients alleging a fabricated sexual relationship, or even complaints to the police of sexual assault.

See defence union advice

Your medical defence union can support you if facing this difficult situation so involve us early on if you have reason to believe that a patient wants a personal relationship with you. If this happens, it’s important to make it clear to the patient that their behavior is inappropriate and must stop.

If that fails and your professional relationship with the patient has broken down, you may need to transfer the care of the patient to a colleague. Explain why you have decided to do this to the patient.

The MDU has issued advice on dealing with amorous patients in our latest Journal which includes:

  • Contact your medical defence organisation for advice as soon as you become aware of a potential difficulty with a patient.
  • Ensure you inform your line manager of the situation.
  • Keep a log of all inappropriate contacts from the patient.
  • If you continue to care for the patient, then it is advisable to use a chaperone for all consultations.
  • Accepting gifts from patients can be misconstrued, so consider very carefully whether it may be better to politely refuse a gift.
  • Do not use personal email addresses or mobile number for work purposes. Withhold your telephone number if you must use it to contact a patient.
  • Review your social media privacy settings.
  • You may need to consider reporting the patient to the police if you feel threatened or in danger.

The following anonymised example shows the type of scenario which can develop.

Doctor stalked by patient on social media

A doctor saw a patient in relation to a knee injury, and shortly afterwards he delivered a box of chocolates and a thank you card. He included his address and telephone number in the card, but at this stage the doctor was not concerned.

Shortly afterwards, the doctor received a Facebook message  from the patient, asking why she hadn’t contacted him, as he had strong feelings for her and would like to meet for a drink. The doctor ignored the message and told her colleagues so that all future appointments would be booked with her male colleagues.

The patient wrote to her at work, saying he loved her and wanted to meet up. The next day he sent multiple messages via social media, insisting that she respond to him. The doctor contacted the MDU for advice at this point, as she was frightened by the intensity of contacts.

The MDU adviser agreed that the doctor should not respond directly, or see the patient in consultation. If she had to see the patient in an emergency, it would be best to have a chaperone present.

The MDU adviser also suggested that a manager should write to the patient, making it clear that the behaviour was inappropriate and causing distress, and that it must cease. The letter should explain what would happen if he tried to contact the doctor again, such as police involvement.

The doctor was advised to keep copies of all contacts from the patient, as well as ensuring her social media security settings were at an appropriate level.

Unfortunately, even after the warning letter was sent, the patient’s behaviour escalated, and the doctor was forced to involve the police as she was concerned for her safety.

The police warned the patient that further contact would result in a charge under the Protection from Harassment Act 1997 and the contact then ceased.

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