Harassment and Stalking by Patients

Case 1

In June 2014, a 43-year-old man was sentenced to three years and two months in jail after pleading guilty to making explosives with the intent to injure an Ophthalmologist.² Acting on an anonymous tip-off, the police contacted the Eye Hospital to try to identify the person involved. The hospital's enquiries revealed a man who was obsessive about an Ophthalmologist as he blamed him for his incurable eye disease. This led police to raid the man's home where they found the bombs.

Case 2

In March 2011, a 46-year-old man was sentenced to 12 months in jail for stalking a Surgeon whom he believed had removed one of his testes without consent.³ The man had stalked the Surgeon for almost a year. Upon searching his home, the police discovered a cache of firearms, along with a quantity of strychnine and cyanide.

Case 3

In February 2014, a Neurosurgeon was stabbed several times in a hospital foyer as he arrived to commence work.⁴

Types of harassment

In broad terms, there are two common motivations among patients who harass and stalk their doctors:

• “lovelorn” patients who develop romantic or child-like attachments and entertain hopes of a personal relationship with their doctor. These are usually female and rarely make threats.
• patients who develop resentment against the doctor, generally due to a perceived injury or wrongdoing on the part of the doctor. These are usually male patients and their behaviour is more likely to escalate and include threats against the doctor.⁵

Reactions to harassment

Denial and minimisation are common reactions of doctors to harassment by patients. Denial allows doctors to ignore the threats and continue to work. Some doctors may fear that this victimisation may be seen to be the consequence of their own actions. As a result, doctors can be left feeling alone, fearful, anxious and helpless.

Strategies to minimise harassment, stalking and violence

• Maintain personal privacy – such as not disclosing personal details to patients, and having privacy settings on your social media accounts. Avoid giving home contact details to professional organisations that may allow public access to the information.
• Implement appropriate security measures in consultation and waiting rooms, which may include the installation of duress alarms.
• In the case of a “lovelorn” patient, the message must be conveyed that the relationship is, and always will be, a professional one. Never suggest that a personal relationship is precluded because you already have a partner.

When you have identified harassing, stalking or violent behaviour

• Carefully document the patient's behaviour and actions. This can be done in conjunction with assistance from MDA National’s Medico-legal Advisory Services team who can also advise you on the best way to end the doctor–patient relationship.⁶
• Retain all relevant evidence such as letters, text messages, emails and telephone calls. Do not return correspondence to the patient as this ongoing communication will “reward” the patient's efforts to maintain contact.
• Make family and colleagues aware of the patient's behaviour. In particular, it is essential that administrative staff are appraised of the situation so they do not inadvertently assist the patient's efforts to pursue you, and can also adopt their own personal safety measures.

A police report and restraining or intervention order should be considered if the harassment and stalking involves threats and/or violence, or where there is a known history of violent behaviour. You are entitled to assistance under your MDA National policy for any legal costs involved (with our prior consent) in seeking an Apprehended Violence Order or equivalent relief where there is a threat to your personal safety or that of your immediate family members.⁷

Summary points

• Any doctor can become the victim of harassment and stalking by a patient.
• Seek advice early from MDA National's Medico-legal Advisory Services.
• Your policy entitles you to assistance in obtaining a restraining or intervention order against a patient who has made threats against you or your family.

Dr Sara Bird
Manager, Medico-legal and Advisory Services
MDA National

1. McIvor RJ, Petch E. Stalking of Mental Health Professionals: An Under-recognised Problem. Br J Psychiatry 2006; 188:403-4.
2. Hero Cop Detective Sergeant Jeffrey White’s Gut Instinct Saved Sydney from a Two Potentially Horrific Bombings. Available at: dailytelegraph.com.au/news/nsw/hero-cop-detective-sergeant-jeffrey-whites-gut-instinct-saved-sydney-from-a-two-potentially-horrific-bombings/news-story/010ec90dda2baed9bb10c418d80e9e42
3. Buchanan K. Testicle Removal Patient Jailed for Stalking Surgeon. Available at: abc.net.au/news/2011-03-01/testicle-removal-patient-jailed-for-stalking/1961536
4. Medew J. Surgeon Speaks out About Being Stabbed at Footscray Hospital. Available at: theage.com.au/victoria/surgeon-speaks-about-being-stabbed-at-footscray-hospital-20140711-zt4wn.html
5. Pathe MT, Mullen PE, Purcell R. Patients who Stalk Their Doctors: Their Motives and Management. Med J Aust 2002; 176:335-8.
6. See MDA National’s Defence Update Winter 2016 edition for more information on ending the doctor-patient relationship. Available at: mdanational.com.au/advice-and-support/library/articles-and-case-studies/2015/05/end-dr-patient-relationship 
7. MDA National. Professional Indemnity Insurance Policy: Combined Financial Services Guide, Product Disclosure Statement and Policy Wording V 11, Clause 11. Available at: mdanational.com.au/~/media/Files/MDAN-Corp/Insurance/PIIP-Combined-FSG-PDS-and-Policy-Wording-Version-11.pdf