'Keep romance out of the surgery'

VIEWPOINT Dr Emma Cuzner Medico-legal advisor, Medical Defence Union

In Mistresses, Sarah Parish's character Katie had an affair with a patient

Tempestuous relationships between doctors and patients often feature on the big and small screen.

But in this week's Scrubbing Up health column, Dr Emma Cuzner says such pairings should never translate into real life.

In the first series of BBC television series Mistresses, one of the lead characters - a GP - had an affair with a married patient who is diagnosed with cancer.

Despite this, she continued to treat him and was eventually suspended by the General Medical Council for her relationship with her patient and for assisting in his death.

On the small and big screen it is often love (or lust) at first suture

Fortunately, she is back at work in time for series two.

The story made for compelling drama for viewers but in the real world, it's unlikely the doctor would have been allowed to keep her registration, let alone get back to work.

'Love seldom conquers all'

Given the potential for keeping viewers on the edge of their seats, it's perhaps no surprise that relationships between doctors and their patients often feature on the small and big screen where it is often love (or lust) at first suture.

However, in cases that come to the MDU's attention, love seldom conquers all.

The only relationship a doctor can have with a patient is a professional one

The main reason is that the professional status of doctors confers a certain power in relation to their patients.

Doctors are often trusted confidants; they can hold the key to making us feel better, and the ability to relieve pain.

Patients may already be emotionally vulnerable and if things turn sour in any relationship, the fallout could be extremely damaging for the patient and undermine the patient's trust in their doctor.

Doctors who pursue a relationship with a patient risk an investigation by the GMC and if their fitness to practise is found to be impaired, they may be given a warning, suspended or removed from the medical register.

In nearly all cases, it will be a significant, if not fatal, blow to their career.

'Fantasy affairs'

The GMC, doctors' professional regulator, says doctors should not exploit their professional position to establish a sexual or improper emotional relationship with a patient or someone close to them.

Even if a prospective partner has not been a patient for many years, any intimacy may still be inappropriate if he or she was or continues to be vulnerable or, for example, if the doctor continues to treat the rest of the patient's family.

The GMC expects doctors to exercise their professional judgment.

Real-life romantic liaisons between doctors and patients are rarely appropriate and usually doomed Read your comments

But in some situations, doctors may find themselves pursued by a patient with amorous intentions.

Doctors are often given gifts such as chocolates or flowers to say thank you for the care they have received.

However, in some circumstances, a gift may indicate something more troubling and may escalate to text messages, letters and phone calls.

A few patients have created a fantasy affair of which their doctor is entirely unaware - until it is too late.

'No choice'

In the last three years, the MDU has opened more than one file each month from members concerned about a patient who appears to want an inappropriate relationship, while many more sought help through our telephone advice line.

Our general advice is for the doctor to gently but unambiguously ask the patient to stop.

They need to explain that their feelings are not reciprocated and because they have a professional relationship with the patient, any other type of relationship is not possible.

This often has the desired effect, particularly if done at an early stage, but in some cases if the patient persists and this makes it difficult to continue to treat the patient, the doctor is left with no choice but to transfer care of the patient to another doctor.

In extreme cases, members have consulted us about the possibility of taking legal action to stop harassment by a patient who is threatening them or their family.

For those seeking a happy-ever-after ending, I'm afraid this article is going to be something of a disappointment.

Real-life romantic liaisons between doctors and patients are rarely appropriate and usually doomed.

However, at least for patients and doctors alike, there may still be the consolation of an entirely imaginary encounter with their favourite fictional medic.

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