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Preventing Sexual Misconduct Allegations

December 14th, 2018

Jason Newton

Sexual misconduct in healthcare is a serious, sometimes criminal, offense that is often inadequately addressed during medical training. When a doctor violates sexual boundaries, this act of patient exploitation and unprofessional conduct undermines public trust in the medical profession while harming patients both individually and collectively.

The majority of physicians take their oath to “do no harm” seriously, conducting themselves in an entirely professional manner. However, when they fail to exercise the necessary sensitivity to patient boundaries, even well-intentioned physicians can be accused, and found guilty, of sexual misconduct. These misunderstandings can leave patients feeling physically and mentally violated and cause irreparable damage to the doctor’s reputation.

Respecting Patient Boundaries

To avoid the perception of misconduct, physicians should practice proper care and sensitivity during all patient encounters. A number of state medical boards have published guidelines for avoiding misunderstandings during physical examinations. For example, the North Carolina Medical Board identifies five ways that physicians can reduce potential liability:

  1. Provide adequate privacy. Patients should never be asked to disrobe in the presence of the physician, and examination rooms should be safe, clean, and well-maintained with the appropriate tools, sheets, and apparel readily available. In addition, patients should be asked to disrobe only the necessary garments for examination or treatment.
  2. Require third-party staff members to be present for physical examinations, particularly when examining sensitive areas, such as the breasts, genitalia, or rectum.
  3. Take the time to fully explain the necessity of the examination or treatment and its components, and answer any questions that the patient may have.
  4. Exercise the same degree of care whether the patient is conscious or unconscious during treatment.
  5. Take note of any suggestive or flirtatious behavior from the patient and actively avoid the development of a compromising situation.

Guidelines for Appropriate Romantic Relationships

Though rare, instances of romantic or sexual relationships between physicians and their patients do happen. The development of such a relationship is highly sensitive, and physicians should proceed with extreme caution.

This type of personal interaction detracts from the goals of a typical physician-patient relationship, and it can both exploit that patient’s vulnerability as well as cloud the judgment of the doctor. According to the code of medical ethics outlined by the American Medical Association, doctors must terminate the physician-patient relationship before initiating or engaging in a romantic or sexual relationship. Furthermore, even personal relationships that develop with former patients can introduce ethical dilemmas. These relationships may be unduly influenced by the previous professional relationship, deeming them highly unethical if the physician exploits knowledge of the patient to gain trust or manipulate emotions.

When medical boards are informed of potentially inappropriate physician-patient relationships, investigations rarely end with a positive result for the accused physician. Doctors who fail to maintain the necessary boundaries with current and former patients risk serious consequences, including loss of medical license, civil lawsuit, or criminal charges.

For most doctors, the first step to avoiding potential allegations of sexual misconduct is to simply remain aware of common mistakes and proactively integrate the necessary precautions throughout their practices.

For further guidance on this issue, Medical Mutual members are encouraged to reach out to our Risk Management Department at 800.662.7917.


Jason Newton is Medical Mutual’s Senior Vice President & Associate General Counsel, based in Raleigh, NC.

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