The Sexually Seductive Patient: How Should Doctors React? Chapter 2

 

On my other threads on patient modesty and why doctors are hated, there is much concern and worry about sexually seductive doctors. Such concerns are warranted even though I am sure most doctors will treat patients professionally and keep to the professional and legal boundaries of behavior. However, physicians have their own concerns. One of their concerns is the behavior that the patient will bring into the office. There are the angry, disruptive and frankly belligerant patients. Medical students are taught to expect such patients and to react by trying to understand what is motivating these patients to these behaviors since such understanding may provide a therapeutic approach rather than the physician simply reflecting anger back to the patient. One of the more subtle and difficult patient behaviors for physicians to deal with is the sexually seductive patient. Such a patient, often a female relating to a male physician enters with the expression of obvious greater attention and interest with respect to the physician's personality and appearance than true concern about her own symptoms. Her actions may be sexually provocative. The patient may expose her body to the physician during the interview or exam to an extent which is clinically unnecessary. Female physicians are not free of seductive male patients.

Psychologists explain these patients' behavior as expressions of transference--where psychologic unmet needs are attempted to be met by engaging physicians who seem to resemble and reflect critical persons in the patients' emotional life. Of concern is the issue of counter-transference--where the physician may respond to this situation in a manner to support the physician's unmet needs based on the physician's emotional life. This can lead to physicians responding to the seductive patient in a manner beyond the professional boundaries of sexual attention.

How should physicians react to the seductive patient? Should they consider the patient has a psychologic or psychiatric problem in addition to their other disease and seek out evaluation, patient education and treatment for this disorder? Or should the doctor go ballistic and spell out the established rules of further behavior? Medical schools find that the need to educate students regarding how to deal with the seductive patient an important topic. I would like to read the views of my visitors on the subject of the seductive patient and what they think would be the very best approach to deal with the issue if it arises. One point I don't want to read from my visitors is that there is no such person as a sexually seductive patient or that the way patients behave is simply a reflection of the doctor's unprofessional behavior at the onset of the relationship. You have to be in medical practice yourself to see that this conclusion applied to all is not true! ..Maurice.

NOTE: THIS TOPIC WAS FIRST PRESENTED TO MY VISITORS IN 2007   bioethicsdiscussion.blogspot.com/2007/08/sexually-seductive-patient-how-should.html   WITH THE MOST RECENT VISITOR POSTING IN 2008 BUT STATISTICS SHOW MANY HAVE VISITED THAT TOPIC IN THE INTERIM PERHAPS NOT CONTRIBUTING IN LATER YEARS BECAUSE OF CONCERN THAT NO ONE WOULD BE READING. SO I AM RESTARTING THE TOPIC HERE NOW IN 2021 AND LOOKING FORWARD TOWARD MODERN DAY VIEWS OF THE SUBJECT WHICH I CAN''T IMAGINE HAS DISAPPEARED BUT NEEDS THE INPUT OF DOCTORS AND POTENTIAL PATIENTS.

Preserving Patient Dignity (Formerly Patient Modesty) Volume 118

 

If hugging or praying together is unacceptable in bringing the healthcare provider and patient to the necessary "togetherness" of a medical relationship then perhaps the simply holding of hands provides the route.  ..Maurice.

Graphic:  https://www.tru-caring.co.uk/ via Google Images

Preserving Patient Dignity (Formerly Patient Modesty) Volume 117

 

A primary care physician writing an article in 2010 on the
"Health Care Blog" wrote the following and much more. Read it and read the interesting back and forth discussion by the responders to the article.

Here is one paragraph from the writing. JR and others: will this view be acceptable to you coming from a physician?


I am not sure why people bristle at calling patients consumers; that’s what they are. They are also customers, participants, autonomous, and humans in need. This is not an “or” proposition. If we forget the humanity of patients and just treat them as customers, they lose. But they also lose if we forget that they are paying us and demand our respect and our attention to their needs. We are as much servants as we are professionals. Signing up to be a doctor means you agree to give yourself to your patients. All of them. It’s hard, and it’s complicated. It’s a human-human relationship.

..Maurice.

AS OF APRIL 21 2021, THIS VOLUME WILL BE CLOSED FOR FURTHER

COMMENTS .  COMMENTS CAN CONTINUE ON VOLUME 118

bioethicsdiscussion.blogspot.com/2021/04/preserving-patient-dignity-formerly_21.html

Preserving Patient Dignity (Formerly Patient Modesty) Volume 116

Let's get started on Volume 116 with this video from YouTube.  

It's about 4 minutes or so in length but clearly shows a potentially upsetting relationship between a patient and his physician and physician's office.  On completion of the story,  consider whose dignity has been preserved and which has been degraded.  If degraded, then tell us: by whom?  ..Maurice.  P.S.- You can click again when the first video is completed to see more patient-doctor  relationship issues as presented on YouTube.

TIME TO MOVE ON  TO VOLUME 117 https://bioethicsdiscussion.blogspot.com/2021/02/preserving-patient-dignity-formerly.html.
I HAVE COPIED MY LAST POSTING REGARDING "HEALTH CARE BLOG" ARTICLE TO START THE NEW VOLUME AND WE CAN CONTINUE THE DISCUSSION THERE. ..Maurice.

Preserving Patient Dignity (Formerly Patient Modesty) Volume 115

 Oops! I just noticed that the title of Volume 114 was wrong  (missed "Formally Patient Modesty) and didn't follow the recent Volumes correct sequence titles.  I hope that error didn't prevent visitors to join our conversations. With this Volume, we are back to our correct title which continues the specific "modesty" issue which started this discussion from 2005. Obviously patient modesty and its apparent ignorance by some members of the medical profession, Bantering's suggestion to enlarge the scope and thus title to "Dignity" was certainly important when discussing how the medical system interacts with their patients.

I would like to continue a discussion I began on Volume 114 and to which JF responded: This was followed by another issue I presented related to citizen's freedom in self-decision making. ..Maurice.

NO FURTHER COMMENTS WILL BE PUBLISHED ON VOLUME 115. CONTINUE TO VOLUME 116 https://bioethicsdiscussion.blogspot.com/2021/01/preserving-patient-dignity-formerly.html

I want to present here a general issue which stimulated me which I read on a clinical ethics listserv. It led me to consider the issue about whether employers had or should have a public health responsibility to require their employees, particularly those who interact with patients or closely with the public to accept being vaccinated with the COVID-19 vaccine or, if one their refusal being removed from their occupation. Is the employer responsible for the health of their employees and to the public who are exposed to those employees? ..Maurice.

JF said...

I'll let you know if I'm required to get vaccinated. I've been wondering the same thing.

Maurice Bernstein, M.D. said...

Another legal-ethical question which was raised by the clinical-ethics lisserv to which I subscribe: Should all patients entering the hospital who have not been recently previously tested for COVID be legally compelled to be tested? Would that be Constitutional under that specific circumstance? In general, should COVID testing be not personally voluntary but be considered a legal requirement, symptomatic or not? ..Maurice.

 

Preserving Patient Dignity (Formerly Patient Dignity) Volume 114

 I find that Volume 113 will accept NO further posting.  Please continue here on Volume 114.. Please do not write further messages to 113, I cannot get them published.  ..Maurice.

AS OF TODAY DECEMBER 10 2020, NO FURTHER COMMENTS WILL BE PUBLISHED

ON VOLUME 114 BUT WILL CONTINUE ON VOLUME 115.

Preserving Patient Dignity (Formerly Patient Modesty) Volume 113

This is the misunderstanding that I agree, at times, is an unfortunate consequence of treatment of patients by all phases of the medical profession.  This sick patient may need to be "fluffed" as part of effective treatment for the underlying disease but, unlike the bed pillow, the profession should always keetp in mind that such "fluffing" may be unwanted and unacceptable by the p1 11amatient and that unlike a pillow, an object, it is as a person, a human subject, the patient, who should be first informed and consulted for permission.
And, if the professional fails in this regard, well.. the patient or the family should "speak up"!  (p.s.- I  hope this analogy meets our blog thread discussions, but feel free to correct me. ) ..Maurice.

Graphic: From Google Images2

AS OF SATURDAY NOVEMBER 14 2020, NO FURTHER COMMENTS CAN BE

PUBLISHED HERE.. MOVE ON TO VOLUME 114.

https://bioethicsdiscussion.blogspot.com/2020/11/preserving-patient-dignity-formerly.html

  ..Maurice.

Preserving Patient Dignity (Formerly Patient Modesty) Volume 112

The ongoing anguish being presented by the participants on this web blog topic is whether being a patient who doesn't conform ("be yourself") with the behavior and requests or even demands of the medical system itself  will provide harm to the patient. This patient concern may be the basis for many patients to hesitate to "speak up!".

It is my opinion that patients entering into the medical system should indeed "be themselves" and the challenge for the medical profession should always be beyond making a clinical diagnosis and performing a treatment to understand their patient as a individual, a unique individual to which the diagnosis and treatment and overall attention should be crafted for that patients personality and goals as well as the clinical diagnosis.

Unfortunately, in many relationships between the patient and members of the medical system it is the clinical diagnosis and treatment which overrides consideration of the patient as a unique individual who presents as "himself" or "herself". This defect in the system as expressed to the patient leads to  forcing the patient into personal non-conformity toward themselves in order to get diagnosed and treated and does limit the option or, if attempted, the volume of "speaking up" to the system.  

Remember, patient dignity involves the patient as a unique human and not just a named disease or when hospitalized a room number. So.. "BE YOURSELF".  ..Maurice.

Graphic: Provided by a reader of this blog thread.

Starting September 12 2020, Volume 112 will be CLOSED FOR  COMMENTS.
HOWEVER COMMENTS WILL CONTINUE ON Volume 113.