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The mismanagement of professional boundaries in medicine can significantly impact your career trajectory and progression, registration as a doctor, your ability to practice medicine or work as a doctor in any capacity and your ability to earn an income. It’s assumed that doctors understand their obligations and responsibilties on this topic but we know that often this is not the case and errors in judgement occur, more often than you would think. How do we know this? Every year we support doctors at all career stages whose career and ability to practice medicine is significantly impacted because they have not managed professional boundaries adequately. It’s a big deal and cause significant financial hardship, reputational damage, distress and mental health challenges.
We want members to never experience this. Therefore, have asked our legal partner Kennedys to provide their top tips on professional boundary management to help you avoid these issues. Some tips seem obvious, but it is surprising every year how often these boundaries are blurred and crossed!
Professional boundaries: top ten tips
- Don’t get into a sexual relationship with a patient.
That is the boundary violation likely to cause the most acute problems, and most often ends up before the Medical Board. But there are many other boundary issues that can start off as small things and grow into real professional dilemmas and problems.
- Keep relationships with patients at a professional level – ALWAYS!
“Going above and beyond” in patient care does not include following patients up to see how they are going once you are no longer directly involved in their clinical care, and it does not include communicating with patients on social media at any time.
- Respect the patient’s boundaries.
A team meeting with the Registrar over coffee in the hospital cafeteria is not the best place to discuss interesting or difficult patients. You can be overheard by other patients, hospital visitors, or other members of the public.
- Control your private space.
Managing your personal privacy is essential. For example, if you are calling patients on your own phone regarding results or appointments always set your phone on “no caller ID” so that the patient does not have access to your mobile number, and start to treat you as a friend, rather than as their doctor.
- Keep relationships with your professional colleagues professional.
Scenarios that end up as bullying complaints or sexual harassment complaints frequently start off as blurred professional boundaries that get out of control. Consider how much of your personal life you should talk about and share with your professional colleagues. Less is usually better than more.
- Effectively manage the boundary between work and life.
Be conscious of the boundary between your work life and your personal life, and try to maintain harmony between them. Managing workplace stress requires paying attention to personal non-work needs such as sleep, nutrition, exercise, and interactions with family and friends.
- Social media management
Be very cautious about anything you post on social media. Doctors have lost their jobs, and their medical registration, because they have not understood that the boundary between the professional and the private on social media is at best only a dotted line.
- Responding to feedback
Be conscious of the boundary between your professional life and personal life as you develop in the profession. Take on board feedback about performance, even if it feels like negative criticism, as an opportunity to learn as a doctor, not as a judgment about you as a person.
- Role scope and competence
Be conscious of the boundary between what you are competent at and what you are not yet competent at (and specialty areas that you may never be competent at). Knowing your limitations, and when you should ask for help, is in your best interests and the patient’s best interests.
- Don’t treat your family and friends.
When family or friends ask you to look at their rash or lumps, or what to do about their coughs or headaches, the best advice you can give is “go and see your GP” (except, of course, in a genuine emergency). The doctor / patient relationship is a complex one. Mixing in friendship and family relationships can be a recipe for disaster.
Rod Felmingham
Senior Associate for Kennedys
