- In order to be an effective clinician, a doctor must be able to develop and maintain a professional relationship with both their patients and their colleagues.
- By being polite, considerate, honest, trustworthy as well as treating each patient with dignity and as an individual, a doctor will be able to effectively communicate with the patient, obtain their trust and subsequently address the individual patient needs.
- Good communication requires listening to the views and questions of the patient, providing information in an accessible way and collaborating to come up with a shared plan.
- Within the clinical environment, it is also important to work in teams. A doctor should act as a positive role model and be a supportive and encouraging influence to others involved in patient care.
- In order to do the above, a doctor should; respect the skills and contributions of others, encourage and support each member, communicate effectively and review each situation regularly.
Maintaining A Professional Boundary
In a successful doctor-patient relationship a professional boundary should exist between doctor and patient. If this boundary is breached, it can undermine the patient's trust in their doctor, may compromise the quality of patient care, as well as the public's trust in the medical profession.
Clinical examples of when this could happen are 9:
- Imbalance of power
- This could arise if a doctor has access to expertise and healthcare resources which the patient needs, or the if the doctor takes advantage of possible vulnerability - emotional or physical - of a patient seeking healthcare
- Sexual/Improper relationships11
- An example could be the use of a home visit to pursue a relationship
- A doctor must not pursue a sexual relationship with a former patient, where at the time of the professional relationship the patient was vulnerable, for example because of mental health problems, or because of their lack of maturity
- Intimate examinations
- Intimate examinations can be embarrassing or distressing for patients
- Whenever examining a patient, doctors are required to be sensitive to what the patient may perceive as intimate (examinations of breasts, genitalia and rectum)
- A chaperone MUST be offered
- Sexualised behaviour
- Sexualised behaviour has been defined as 'acts, words or behaviour designed or intended to arouse or gratify sexual impulses and desires'
- A doctor must never make an advance on a patient
- If a patient displays sexualised behaviour, wherever possible, a doctor should treat them politely and considerately and try to re-establish a professional boundary
- GMC: Duties of a Doctor
- GMC: Valuing Diversity - Guidance for Doctors
- GMC: Personal Beliefs and Medical Practice (March 2008)
- Janaway v Salford Health Authority All England Law Rep 1988 Dec 1; 3:1079-84
- GMC: Conflicts of Interest (September 2008)
- Medical Act (1983)
- Public Interest Disclosure Act (1998)
- Health Service Circular (1999/198)
- GMC: Maintaining Boundaries - Guidance for Doctors (November 2006)
- GMC: Raising Concerns about Patient Safety - Guidance for Doctors (November 2006)
- Kerr/Haslam Inquiry (2005)