Issue 12 - September 2004

Ask the Attorney By Todd Crabtree, DC, JD, MBA
Romancing the patient: A dangerous dance for a DC

I am very attracted to one of my patients. If I want to have a romantic relationship with this person, do I need to protect myself legally?

Romancing a patient is potentially one of the most damaging things you can do to your clinic, your reputation and your ability to practice your profession. It can lead to suspension of your license to practice chiropractic for months or even years.

It can also lead to a civil action by the patient seeking money damages.

Why are the consequences of having a romance with a patient so severe? The essential issues are power and consent. The role of being a chiropractor to a patient puts you in a position of power. You can, and indeed are, required to ask your patient questions of the most intimate nature in order to reach a proper diagnosis and treatment plan.

You hold the knowledge and skills necessary to accomplish relief of your patient’s suffering. You have the power to ask your patient to disrobe. You are permitted to touch your patient. Your patient does not have the power to do any of these things to you.

When a power differential exists to the extent caused by the doctor-patient relationship, a patient cannot give true consent to a romance. You have too much power. However, some limited circumstances would allow for a romance without legal consequences.

If a decent interval extends between the ending of the doctor-patient relationship and the start of the romance, you can avoid legal fallout. The decent interval essentially must be long enough to eliminate the power differential.

Some psychologists say the decent interval should be no less than five years. However, time is not the only factor to consider. Depending on the circumstances, the power differential could be eliminated quicker or take much longer. Other factors to consider include:

• The extent of the power differential to begin with;

• The education level of the patient;

• The maturity level of the patient;

• Prior sexual abuse either party has experienced;

• Ages of the doctor and patient;

• Sexes of the doctor and patient (generally there is less of a power differential if the chiropractor is female); and

• Psychological counseling received by either party to understand the issue.

STILL ENAMOURED? TAKE THESE STEPS
If you are intent on having a romance with a patient, you should take the following steps:

• Terminate and document the termination of the doctor-patient relationship.

• Maintain no physical contact with the former patient that could be construed as sexual in nature (such as hugging and holding hands).

• Allow a cooling off period of no less than six months before both of you seek psychological counseling.

• The counselor must reach a written opinion that the power differential has ceased and that the patient can give informed consent.

• Send a copy of the counselor’s opinion to the state chiropractic board with a cover letter explaining that you intend on dating unless they tell you otherwise.

Obviously, this would be a very strange way to start a romance. However, if you really care about your patient, you should not want him or her to start a romance without true consent.

Todd Crabtree, DC, JD, MBA, is the founder of Crabtree Law Firm PA, specializing in personal injury, and Clinic Doctor Inc., an outsource business service provider offering chiropractors customized marketing, practice management consulting, billing and claims denial management. He can be reached at 800-899-5859 or by e-mail at Todd@CrabtreeLawyers.com.

LEGAL DISCLAIMER: This column is provided for educational purposes only. The accuracy or timeliness of the information presented herein is not warranted. The information presented is not intended to be advice as to a specific fact pattern with which you may be presented. Accordingly, please note that the information contained herein is not being presented as legal advice with respect to any matter and that no attorney-client relationship is established.