As a licensed health professional, your license and career are at their most vulnerable when your patients are at their most vulnerable--specifically, when you're engaging in physical contact through examinations, and especially when examining or touching sensitive areas of the patient's anatomy. There are potentially serious ethical and legal implications involved with patient interactions, and simple missteps can quickly be misinterpreted, resulting in accusations of major violations. That's why it's critical for doctors and other health professionals to have healthy boundaries established during contact with patients--so patients can feel safe, and so you can avoid career-threatening allegations of misconduct.

This issue was recently brought front and center once again with the criminal trial of a former New York ob/gyn doctor who was convicted of sexually abusing multiple patients. The defendant, Robert Hadden, had already surrendered his medical license in 2016 to avoid jail time as part of a plea deal when facing charges under New York state law. But last month, he was also convicted on four federal counts of sex abuse as several of his victims had crossed state lines to see him. Hadden now faces up to 20 years in prison per federal count.

Protecting Yourself and Your Patients

While the evidence against Hadden was abundant, the case itself still raises tough questions about the possible misunderstandings that can occur when patients and doctors are together in vulnerable and sensitive situations. An examination of the genitalia, for example, that lasts even a few seconds longer than a patient deems necessary could potentially result in allegations of sexual misconduct. And yet, there are times when these vulnerable moments are unavoidable because such examinations are important to the patient's health. What steps can medical professionals take to establish clear boundaries so a patient is less likely to feel violated?

• Communicate intentions clearly. If you must conduct an exam of a patient's breasts, genitals, or rectal area, communicate clearly with the patient what you're doing and why it's necessary, and make sure you have their verbal consent before doing so.
• Explain the patient's rights to them. Let the patient know clearly that they have the right to have a friend in the room with them while a sensitive exam is occurring--and that they have the right to end the exam at any point if they feel uncomfortable.
• Never be alone with a patient when viewing/touching a private area. Best practices suggest doctors should always have a nurse present when examining a patient's privates. This not only may help the patient feel safer--it also provides you a witness if an accusation is made.
• Keep physical contact and exposure to the minimum amount necessary. Never view or uncover a part of the patient's body that isn't being examined, and never make contact longer than is needed to complete the examination.
• Maintain professional decorum at all times. Regardless of your normal, disarming bedside manner, being too casual or "familiar" with patients during a sensitive exam can send a mixed message.
• Document everything. Document all exams in detail, including what was done and why. Make sure to include notes on the patient's demeanor during the exam.

What to Do If You Are Accused

Despite all efforts you may make to protect your interactions with patients and make them feel safe, allegations of misconduct are still possible if a patient feels uncomfortable or simply wishes to make an accusation. If this happens, even if criminal charges are avoided, it could have a negative impact on your professional license. In such cases, taking the steps above will help you raise a solid defense against such allegations. You should also hire an experienced license defense attorney to advocate on your behalf to the licensing board and prevent or limit damage to your license or career. Attorney Joseph D. Lento helps licensed professionals nationwide who are facing allegations of wrongdoing, and he and his Professional License Defense Team will work to make sure your rights are protected. Contact us online today for an appointment or call 888-535-3686.