Love in a small town

Dr Patel’s dilemma

Dr Patel has been working in a small rural town for three years. She loves hiking, belongs to a local book club, and enjoys playing hockey for the region. She’s single, and keen to meet someone who shares her interests. But everyone she meets seems to be a patient of the only local GP practice where she works. Tim plays in her hockey team, but she saw him regularly as a patient after a motorbike accident and subsequently treated his PTSD. Brian loves hiking and attends a practice out of town, but he regularly brings his two children in for care following an acrimonious divorce. More recently she got chatting to Xavier, who is not a patient of the practice, but attends the practice’s flu clinic each year.

The code of conduct

According to Good Medical Practice: a code of conduct for doctors in Australia, good medical practice includes “… never using your professional position to establish or pursue a sexual, exploitative or other inappropriate relationship with anybody under your care. This includes those close to the patient, such as their carer, guardian, spouse, or the parent of a child patient.”

The Medical Board has developed guidelines, Sexual boundaries in the doctor–patient relationship, which indicate that breaching these boundaries can be harmful, given the inherent power imbalance that exists in the doctor–patient relationship. When these boundaries are broken, it can lead to issues with patient safety and the quality of care provided, as well as public confidence in the medical profession.

There’s no place for a consensual relationship with current patients (including with those close to the patient) and it’s the doctor’s responsibility to maintain the professional boundaries. It may also be unethical for a doctor to engage in a relationship with a former patient, depending on the circumstances.

When these matters come to the attention of the Medical Board, as they often do after the demise of a relationship, the Board considers a number of factors in determining whether the doctor has breached the code of conduct – such as the duration, frequency and type of care a doctor has provided in the past; the vulnerability of the patient; the time since the professional relationship ended; and the context of the start and end of the relationship.

So, what does this mean for Dr Patel?

She contacted MDA National for advice, and felt more confident in her choices after reading the guidelines and exercising her personal judgement. She ran into Xavier at the local bakery, they caught up for a coffee, and are now happily dating.

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