Professional Boundaries Flashcards
Summary of GMC guidelines on professional boundaries?
Drs should not treat themselves or their families
Confidentiality – inc after a patient has died.
Whistle blowing – protect patients from risk of harm posed by another colleague
Integrity – you must not pursue a relationship with a patient or someone close to them.
Personal health – must be registered with a GP outside of your family, consult if you suspect you have a serious illness.
Probity – must act with beneficence, and you must not allow any of your personal interests alter a course of treatment
but if you do then you must make the patient aware of this involvement
What are professional boundaries and why do we have professional boundaries?
Professional boundaries=effective, appropriate interaction
Boundaries protect both the professional and the client, violations harm the patient and the professional
Barriers for doctors disclosing health problems?
Fear lack of confidentiality
Embarrassment
Potentially, a conflict of interest may arise, between himself and his doctors, if his health threatens the health of his patients
Stigma of mental health problem
What kind of health issues do doctors face?
What are some negative actions doctors take to manage their health?
Historically hay dependence in doctors – esp those w controlled drug access e.g. anaesthetists.
Practitioner health- confidential service for doctors and dentists in England who have mental health addiction problems.
Unhealthy culture of self reliance regarding health.
May use inappropriate consulting– e.g. corridor consultations with colleagues.
Self treatment is not objective
Reduced dr health linked to poorer patient care
How do we manage the situation when a peer is underperforming?
GMC: report dangerous practice
First try speaking to the doctor concerned
Be supportive but mindful of performance impact, If concerned, seek help from manager
Any illness relates underperformance can be managed by sick leave until recovery.
Beware of gossip and chat about colleagues which can create an atmosphere of distrust.
What issues are raised when health professionals are trying to facilitate the care of friends and family?
aka u are a dr, your colleague comes to you with his friend/relative asking for treatment advice or consultation
Patient may ‘lose control’ of the consultation and their own agenda, may feel excluded
Professionals may be immune to the impact of illness, may inadvertently badly ‘break bad news’
Professionals may assume treatment is a good thing, patients may disagree.
SOLUTION: Consult with the patient, check how they would like their relative to be involved, avoid using medical jargon
Are drs allowed to have relationships w patients?
Must not allow personal relationships to undermine patient trust
Esp dont pursue a sexual relationship w a patient or someone close to them= abuse of power
Any prior patient knowledge= potential exploitation of power.
Esp harsh on doctors who exploit vulnerable patients e.g. depressed or bereaved
Consultant renal physician suspended for 12 months following relationship with a patient
How should drs use socials?
GMC: Must maintain patient confidentiality. You should remember when using social media that communication may become widely known.
Using social media has blurred the boundaries between public and private life, and online information can be easily accessed by others.
Doctor suspended for 12 months for disseminating misinformation about Covid
Private communications are not exempt from forming part of disciplinary proceedings
Practice nurse: My cousin is over from America for four months and has run out of her medication for diabetes and hypertension. Please could you prescribe some more for her?
What are the professional issues for Dr Morgan?How should she respond?
Hard to be objective.
Must treat them as a doctor (history, examination, appropriate prescribing and note keeping). Just issuing a prescription is not acceptable.
Aunt is not entitled to NHS treatment.
In UK, hay countries where residents are allowed access to NHS care, other countries must pay.
Solution: See her privately, consult appropriately, and issue private prescription for medication (ensuring medical indemnity covers this).
Should doctors see Drug Reps?
Big Pharma and it’s reps influence prescribing and set a different agenda from the docs
Prescribers are naïve; the psychology is overlooked and the manipulation is sophisticated
Patients expect prescribers, to rely on information about drugs from unconflicted sources
