News

Calls for greater awareness of context in guidelines for doctor–patient boundaries


Doug Hendrie


6/04/2018 2:13:24 PM

The RACGP wants more clarity in the Medical Board of Australia’s proposed new guidelines on personal doctor–patient relationships.

The RACGP is concerned rigid interpretations of the proposed boundaries on relationships could affect rural or remote doctors, who may have a number of other roles in the community.
The RACGP is concerned rigid interpretations of the proposed boundaries on relationships could affect rural or remote doctors, who may have a number of other roles in the community.

The RACGP has called for greater awareness of context in boundaries in personal doctor–patient relationships.
 
In a submission to the Medical Board of Australia’s proposed guidelines ‘Sexual boundaries in the doctor–patient relationship’, the RACGP has warned of unintended consequences for the guidelines, such as unwarranted claims of sexual misconduct by doctors, which might lead to malpractice claims.
 
The RACGP believes that, as they stand, the guidelines could lead to, ‘routine and important procedures, such as taking a sexual history … interpreted as harassment’.
 
The draft guidelines could lead to a reduction in GPs’ willingness to conduct physical examinations due to a fear of sexual assault claims, the RACGP states. Furthermore, rigid interpretations of the proposed boundaries on relationships might impact rural or remote doctors, who may have other roles within the community in addition that go beyond their professional capacity.
 
The RACGP has called for the inclusion of case scenarios to help doctors understand exactly what constitutes inappropriate behaviour. In its submission, the college called for:

  • a statement that physical examination is often essential in clinical practice
  • guidance on doctors’ use of social media, rather than a stark recommendation that doctors immediately terminate any interactions with patients on social media, as the wording of the currently proposed item on social media suggests doctors should avoid social media at all costs 
  • the inclusion of a definition of ‘inappropriate contact’ on social media, which might include not discussing health or personal matters on social media channels.
Email qualitycare@racgp.org.au for more information on the RACGP’s submission to the Medical Board of Australia’s Draft revised guidelines ‘Sexual boundaries in the doctor–patient relationship’.



doctor-patient-relationships medical-board-of-Australia sexual-boundaries



Dr Fiona Henneuse-Blunt   10/04/2018 6:28:12 AM

I worked for ten years on a remote Scottish island before moving to Australia four years ago. Last year I started using Facebook for the first time. Many previous patients asked to "friend" me. And I accepted those I chose . I don't discuss health issues as a rule but do promote health issues (get vaccinated for example).
My life as an island GP meant I was a key person in the community(as was the harbour master,post master,head school teacher,window cleaner etc ) I joined the choir ,and the adult tap class. As we were a practice of seven GPs for a population of 7000 ,who ran the cottage hospital and ED, all the island population were our patients. If we joined a club or went to a pub or party everyone there was our patient. So if the rules are too rigid then hard working rural GPs will have even less of a life than they have currently. I agree there should be boundaries but they need to be considered for all GPs in all types of practice or remote and rural medicine will have an even tougher time recruiting .


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