The relationship between a doctor and patient is considered to be professional and not a personal one. However, some argue that a doctor can also be friends with a patient. This article will explore the key considerations around whether doctors should or can be friends with their patients.
The ethical concerns around doctor-patient friendships
The main concern around doctor-patient friendships is the potential for ethical issues to arise. Doctors have a duty of care towards their patients and must make objective medical decisions in their best interests. Being friends with a patient could create a conflict of interest for the doctor that may compromise their professional judgement.
For example, a doctor who is friends with a patient may be reluctant to deliver bad news or recommend an unpleasant but necessary treatment. They may prioritize preserving the friendship over providing optimal care. Similarly, romantic relationships between doctors and patients are considered unethical due to the inherent power imbalance in the doctor-patient dynamic.
Confidentiality is another concern. Doctors gain private knowledge about their patients’ health and personal lives. This information must be kept confidential as part of the doctor’s professional duties. However, it may be harder for a doctor to keep things confidential if they have a dual relationship with the patient as both doctor and friend.
Arguments in favor of doctor-patient friendships
While ethical considerations are paramount, some argue there are potential benefits to doctor-patient friendships in certain circumstances. One view is that a friendship with a doctor may improve the care experience for the patient. For example:
- The patient may feel more comfortable disclosing sensitive information relevant to their health.
- The doctor may gain insights into the patient’s lifestyle and habits, allowing more personalized care.
- An ongoing friendship where the doctor provides care over many years may enable deeper knowledge and trust.
Additionally, some point out that in smaller or rural communities, close doctor-patient relationships are inevitable due to proximity and limited medical resources. An outright ban on friendships could make accessing healthcare difficult in these areas.
Professional guidelines on doctor-patient relationships
Medical professional bodies provide guidance to doctors on managing relationships with patients. For example, the American Medical Association (AMA) Code of Medical Ethics states:
“A physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a patient.”
The AMA does not prohibit friendships outright but advises doctors to consider the risks. The code states doctors should avoid social contacts that may undermine public trust, and to transfer care of the patient if the social contact interferes with professional judgment.
The British Medical Association advises doctors to take care when accepting gifts from patients and avoid allowing any obligation to the patient to arise from use of their services outside the healthcare setting.
Establishing professional boundaries
While most doctor-patient relationships should remain strictly professional, limited exceptions for friendships may be acceptable provided appropriate professional boundaries are maintained. Strategies to establish these boundaries include:
- Avoiding overly personal self-disclosure to the patient
- Abstaining from making negative comments about other patients or colleagues
- Seeking a chaperone when meeting the patient socially
- Monitoring personal feelings to ensure objectivity is not compromised
- Transferring the patient’s care if necessary to avoid conflicts of interest
Doctors should also be alert to warning signs like gifts from the patient and inform the patient if they feel boundaries are being crossed.
When doctor-patient friendships may be appropriate
While caution is required, some situations where a doctor-patient friendship could be permissible include:
- The professional relationship has ended and a sufficient amount of time has passed.
- The friendship predates the professional relationship.
- The patient requires support during a life-threatening illness and has no other social support.
- The doctor practices in a small community with limited healthcare options.
Even in these cases, the doctor must evaluate risks to professionalism and medical ethics. Both parties should recognize the friendship is secondary to the professional relationship and required standards of care.
Maintaining public trust
Ultimately, doctors have an obligation to avoid any situation that could undermine public trust in the profession. Most patients expect a high degree of professionalism from their doctors. Friendships that create actual or perceived conflicts of interest can damage the doctor-patient relationship.
Therefore, while limited friendships in specific circumstances may be unobjectionable, doctors should be very cautious about engaging in dual relationships with patients. Clear professional boundaries and sound ethical judgement are imperative.
Conclusion
Close doctor-patient friendships are generally inadvisable due to ethical considerations around patient care and confidentiality. However, more casual social contact may be acceptable provided professional boundaries are maintained. Doctors must evaluate the risks of dual relationships with patients and prioritize their professional responsibilities. While limited exceptions exist, doctors should avoid friendships with current patients in most circumstances to preserve public trust in the profession.