Nov-Dec 2002 Table of Contents

BALANCING ACT

How to Cope if You Feel Attracted to a Patient

Developing romantic feelings for a patient may be a symptom of burnout.

Fam Pract Manag. 2002 Nov-Dec;9(10):92.

One of the most disconcerting experiences a physician can have is realizing that he or she is strongly attracted to a patient. Many physicians believe they should be above such emotions or that their professional objectivity should neutralize these feelings. What many physicians don't realize is that being attracted to a patient is often a symptom of burnout. A physician whose work has consumed his or her life may have few, if any, healthy relationships away from the office, and the intimacy of the doctor-patient relationship can begin to fill needs that should be filled elsewhere. As a psychologist, I've treated many physicians whose burnout has manifested in attraction to a patient, and while there is no vaccination to prevent it, there is a protocol of care.

Don't ignore it

If you find yourself attracted to a patient, accept your feelings as important information about your overall well-being. Often, people are attracted to qualities in others they wish they could more fully develop in themselves. Try to determine what it is about the patient that attracts you.

Share it

It may help you to confide in someone. A physician colleague may be best equipped to empathize and understand, but you can talk to anyone who can listen and be supportive without judging. Writing about your feelings for the patient may also help. For example, by keeping a journal, one doctor noticed that her attraction for a certain patient was stronger on days when she saw many chronically ill geriatric patients. She recognized her neediness was fueled by her feelings of depletion and helplessness.

Affirm boundaries

Every physician knows the ancient proscription against romantic or sexual liaisons with patients. But an ethical principle will not become a source of strength and comfort until you can articulate it in terms of your own life. For example, a statement such as “Sexual or romantic interactions between physicians and patients detract from the goals of the physician-patient relationship, may exploit the vulnerability of the patient, may obscure the physician's objective judgment concerning the patient's health care, and ultimately may be detrimental to the patient's well-being”1 may not be as meaningful to a physician as the following: “It's important to me not to become romantically involved with Patient X because I don't want to exploit or harm her or obscure my judgment regarding her care. I also don't want to lose my job.” This personalized restatement of a valuable ethical principle brings it much closer to reality.

Examine vulnerabilities

The richness of the physician-patient relationship can lay fertile ground for romantic attraction. In addition, some vulnerabilities may arise from the physician's psyche. The overworked, stressed-out, burned-out, anxious, lonely professional may feel intoxicated by a patient's gratitude and affection. As you deal with your patients, be conscious of these vulnerabilities and guard against them.

Channel your energy

The romantic impulse is surely one of the most energetic forces in the universe. It is important that you channel this energy into self-care, not into more hours at the office. Increase activities that you find comforting and rewarding. Use this experience to reassess your personal and professional priorities. Ask yourself, “What part of me has this patient engaged that I need to express more fully?”

Stay rational

Feelings of attraction can be particularly disconcerting to a physician, who values his or her self-control and rationality. The steps presented here can help you deal with these feelings in a healthy, rational manner that puts the patient's welfare first and preserves your professionalism.

Dr. Spickerman is a psychologist in private practice in Marshall, Mo.

Conflicts of interest: none reported.

Send comments to fpmedit@aafp.org.

1. American Medical Association, Council on Ethical and Judicial Affairs. Sexual misconduct in the practice of medicine. JAMA. 1992;266(19):2741–2745.

Copyright © 2002 by the American Academy of Family Physicians.
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