RELATIONSHIP?


so, you must take care to follow the relevant guidance and it is advisable to discuss the matter first with an MDDUS adviser.


Judgement call It is clear that pursuing a relationship with a current patient or their relative is not a good idea but what about a former patient, one who has left the list? The answer is: it depends. And it depends on a combination of factors such as the length of time since the professional relationship ended; the nature of the professional relationship; whether the patient was particularly vulnerable at the time you were seeing them as a doctor; and whether you will be caring for other members of the patient’s family. There is no magic number of days or weeks since a patient left your


practice that constitutes an acceptable timescale for you to pursue a relationship. The key factor to consider is whether the relationship you are pursuing is, or can be seen to be, an abuse of power and your position of trust. Common sense would suggest that if you start a relationship with a patient you have seen once, there is far less chance of you being accused of abusing your position than with someone you have seen repeatedly over a period of years. An abuse of power is more likely to be an issue when the patient is


vulnerable. Some patients are more vulnerable than others, particularly patients with mental health problems.


Raising concerns It is also important to be aware that if a patient discloses to you that a fellow doctor has made inappropriate advances towards them you must promptly report your concerns to the relevant person or organisation who will investigate the allegation. Bear in mind that sexual behaviour


does not exclusively involve touching and would include inappropriate sexual comments. Equally, if you think a sexual assault has taken place then this should


be reported to the police. The best approach is to first discuss the matter with the patient and encourage them to disclose the information themselves. If they refuse and you believe there is a public interest in making the disclosure, you should seek their consent to do so. In exceptional cases, where a patient withholds consent but you believe a disclosure should be made to protect other patients/the public from risks of serious harm, this can still be done without permission. In these instances, only the minimum information necessary should be disclosed and the patient should be informed. (See the GMC’s Confidentiality guidance.)


Trainee dilemma So what should our GP trainee do about Mark’s dinner invitation? Well the guidance is clear that doctors should not pursue a


relationship with a patient, nor should she ask him to leave the list so that she can do so. However, she did meet him first socially, before he became her patient, and she was due to leave her training practice in two weeks’ time. Considering these circumstances, she was advised to check how long Mark has been a patient with the practice to make sure he did not register there specifically to make contact with her. She should also check that he is not vulnerable. Assuming both of these factors were in order, she could reasonably accept his dinner invitation after finishing her placement at the practice. She would also have to be clear that she could not see him as a patient again.


Dr Susan Gibson-Smith is a medical adviser at MDDUS


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