Wachler & Associates, P.C

In the past few years there has been growing public concern about professional boundary issues in healthcare with the increase in reported cases of providers interacting inappropriately with patients. As a result, state licensing boards have become increasingly proactive in investigating such allegations. In fact, the Ohio Medical Board recently announced plans to review and potentially reopen nearly 2,000 closed cases of alleged sexual misconduct or impropriety by physicians in Ohio over the past 25 years to determine whether any credible evidence of criminal or otherwise inappropriate behavior had been previously overlooked.

The Ohio Medical Board’s review of cases that were previously closed without disciplinary action includes not only sexual assault investigations, but also allegations of improper, non-physical interactions. The relationship between a healthcare provider and a patient is a professional relationship based on trust. When a provider behaves in such a way that oversteps his or her professional role with the patient to create a personal relationship, a professional boundary has been crossed. When a provider inappropriately uses words or actions of a sexual nature with a patient, a sexual boundary has been violated. Violations of boundaries between a provider and his or her patient can include beginning a sexual or inappropriately personal relationship during or after treatment, discussing sexual matters that are not related to treatment, using “off color” or suggestive humor, repeatedly engaging in prolonged conversation about personal matters unrelated to treatment, or any words, actions or behavior that could reasonably be interpreted as sexually inappropriate or otherwise unprofessional.

The Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing, previously published a brochure titled “Sexual Boundary Awareness for the Health Professional” that lists some proposed preventive measures for health professionals to help avoid violating a sexual or professional boundary. These measures include, but are not limited to, the following: avoid relationships with patients of the agency where you are employed, avoid relationships with relatives or close friends of patients, do not accept gifts or non-monetary compensations for medical services from patients, and avoid even simple acts of kindness, such as giving a patient a ride home or offering a small loan, as this could be seen by the patient as encouraging a personal relationship.

State licensing boards have a broad range of possible sanctions at their disposal if sufficient evidence is uncovered during their investigative process to support the veracity of a boundary allegations. The severity of the discipline for violation of professional boundaries varies with the severity of the infraction, including aggravating and mitigating factors, but can include severe sanctions such as revocation or suspension of a license. Providers should also be aware that, in addition to an ethical duty, they may have a professional duty to report if they know or have sufficient reason to suspect that another provider is crossing sexual boundaries with patients. For additional information or assistance regarding this, or any other health professional licensing issue, contact Jesse A. Markos, Esq., at Wachler & Associates at (248) 544-0888.