How to Handle Romantic Advances from a Patient

Robert H. Maisel, MD, a professor of otolaryngology–head and neck surgery at the University of Minnesota in Minneapolis, said that while he has never recognized a problem with a flirtatious patient in his clinical practice, he rarely has a clinical encounter without a medical student, surgical resident or nurse in the room during the examination.

Recognize the Signs

While it’s important that physicians don’t act on a flirtatious patient’s advances, it’s equally critical to recognize subtle flirtatious signs from a patient. A patient who maintains unusually long eye contact with their doctor, engages in a lot of talk not related to their visit or makes a habit of touching the physicians when not medically necessary may be flirting.

Additionally, otolaryngologists can protect themselves when performing some common procedures, such as flexible laryngoscopy or nasal endoscopy, both of which put the physician in close proximity to a patient’s face. That closeness could turn a clinical exam into a flirtatious event, said Dr. Altman. He wears a mask to perform each of these procedures, and not only for the purposes of infection control. “It does give you the added benefit of establishing some personal space and protection, to avoid any potential misunderstanding,” he said. Dr. Altman said he also listens to patients’ lungs through their shirts, not underneath their shirts, and calls an assistant into the room with him before he does that type of exam on a young woman.

“I don’t acknowledge the statement and immediately move the conversation into something clinical.”

—Laura T. Hetzler, MD

Potential Outcomes of Flirtatious Behavior

Although flirting may seem innocent in most situations, it can have serious consequences if it persists and escalates between a physician and patient, particularly if the physician becomes sexually involved with that patient.

For starters, physicians who become romantically involved with patients may lose sight of their professional obligation to be objective in treating them, said David Fleming, MD, chairman of the department of internal medicine at the University of Missouri, director of the university’s Center for Health Ethics, both in Columbia, and a physician specializing in internal medicine. “When you’re biased in your decision making, or so emotionally attached to a patient that you can no longer be objective, then you’re no longer on your game, and you’re no longer able to provide the best quality of response that the patient deserves,” Dr. Fleming said.