?

Same doctor or choose another?

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  1. StarFyre

    StarFyre Member

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    Doctor Dating

    Discussion in 'Science Fiction' started by StarFyre, Oct 2, 2017.

    Not sure if this goes in 'general', 'research' or in another fourum but . . .

    I've got this character who happens to be a new species (I call it Plantae Homo Sapiens, basically meaning 'Plant Humans').
    She gets seriously injured by muggers and winds up in a hospital.
    She winds up having to tell one of the doctors about her 'condition'.
    When she eventually gets out about two weeks later, she'll be slowly drawn towards dating him because he's extrememly caring . . . unlike her last boyfriend, who was the first of the human test subjects (the woman was the second and they are the only ones of their kind, so far).
    She winds up marrying the doctor later.
    But here's the problem: I've read that, if you date someone who has been or still is your doctor, you need to change doctors. However, not only is she extrememly reluctant to tell another, he's also the next best to her at treating anything that may come up with the species (being the only other with medical training that knows of the species and how they differ from humans).
    So my queston is . . . what should be done . . ?
     
  2. The Dapper Hooligan

    The Dapper Hooligan (V) ( ;,,;) (v) Contributor

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    Relationships between patients and physicians are generally looked down on as pretty unethical, but given the peculiarities of her condition, he would probably have to report it and it would probably go before an ethics committee as to what would be the proper course of action.
    Also, not to be a knob, but if your characters species is an offshoot of Homo Sapiens, then her taxonomical classification would likely be Homo Plantae rather than putting her in a different kingdom or family. Whatever you feel best with though.
     
  3. StarFyre

    StarFyre Member

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    So you're saying he'd have to tell a lot of other people . . . that'd be interesting for the story . . . and work perfectly with the plot . . . almost . . .
    And about Homo plantae, thanks for the suggestion but, technically, they switched kingdoms as they're basically, now, plans that look human.
    Thanks for the reply.
     
    Last edited: Oct 2, 2017
  4. The Dapper Hooligan

    The Dapper Hooligan (V) ( ;,,;) (v) Contributor

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    Yeah, like I said, a doctor dating a patients is looked down on, but not entirely forbidden. If he hid their relationship, then it could put them in a lot of compromising situations. For example, if she were seriously injured and he was the attending on duty, he would be put in a problem that would be emotionally compromising. If they were in a relationship and it was public knowledge, then such a situation could be avoided. If they hid their relationship, then he could get in way lots of trouble. If he told the senior staff at his hospital, then they'd probably get together the ethics committee (probably made up of esteemed doctors and a couple of lawyers) to decide what would be the best course of action would be for the patient. It's at this point he's have to reveal the particulars of her condition, which if they didn't already know about would be something else that could end his career. After he pleaded his case, they'd debate as to whether the benefits of him staying her doctor outweighed the problems and potential conflicts of interest.
     
  5. StarFyre

    StarFyre Member

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    You have really good knowledge . . .
    Also, while he's the main (currently non-Plantae) who knows, there are about three nurses who also know because they're assigned to her. Also, he's technically a backup doctor for her as she tends to be stubborn about don't what she can herself, such as she'll put her on stitches in if she's able to.
    But, yeah, in all technicality, he's still basically her doctor.
    Thanks for all this help.
     
  6. The Dapper Hooligan

    The Dapper Hooligan (V) ( ;,,;) (v) Contributor

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    Yeah, I dated a doctor for a bit. They weren't allowed to write me prescriptions. It was definitely interesting. Glad I could help.
     
  7. KevinMcCormack

    KevinMcCormack Senior Member

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    My wife is an MD. I can offer some thoughts:

    1. the main concerns are for the patient's quality of care: the possibility of patient exploitation, and risk of physician blindness by being too close to the patient and losing objectivity

    2. depending on jurisdiction, the College may have rules about what kind of relationships are OK versus not OK to remain in good standing; general medical care, and follow up that does not actually require medical expertise (such as postoperative recuperation support, which is really a nursing skill that an MD can also coincidentally offer) would not normally be considered problematic.

    3. often it depends on specialty - for example, a psychiatrist should not be treating an immediate family member or romantic interest, period, flat out, no debate. But a psychiatrist can absolutely stitch up a gash in her kid's forehead after her husband watches the little guy do a faceplant off the junglegym. (Not admitting to anything here, just sayin'.)

    4. another factor is prescribing controlled meds - writing a scrip for narcotics for friend or family leads to disciplinary measures in most jurisdictions, if not actual criminal charges;

    5. as for non-controlled meds, this is allowed in most jurisdictions I'm aware of, but per #1 and #2 and #3, an MD should find somebody else to ensure they're not losing perspective. Just as an example, I had a friend whose father was handling his epilepsy medications, but was prescribing outside his scope of competence when he became an adult. The dad was a pediatrician, did not know how to monitor efficacy and adjust prescriptions for adults. He did not realize the prescription would become ineffective, and my friend ended up having avoidable seizures.
     
    Last edited: Oct 2, 2017
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  8. StarFyre

    StarFyre Member

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    Y'all are so helpful; thank you.
     
  9. Clementine_Danger

    Clementine_Danger Active Member

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    Also, besides the whole doctor thing but still relevant, a trope to watch out for:

     
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  10. StarFyre

    StarFyre Member

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    Thank's for the warning, I'll make sure to check for that whenever I'm writing someone.
     
  11. StarFyre

    StarFyre Member

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    Hey, um, The Dapper Hooligan mentioned an ethics committee . . . but I'm not sure how to go about writing one . . . Could anyone help . . ?
     
  12. archer88i

    archer88i Banned Contributor

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    My mom is a physician assistant, and she's been my dad's primary care physician for decades. In the real world, I genuinely don't think most people will give a shit.
     
  13. Cave Troll

    Cave Troll It's Coffee O'clock everywhere. Contributor

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    I do believe this is an ethics question. Also I think that they will prevent
    emotionally attached medical staff from treating their spouses/partners.

    https://www.researchgate.net/publication/50852503_All_in_the_family_How_close_is_too_close_The_ethics_of_treating_loved_ones
    http://kindethics.com/2009/03/should-a-doctor-treat-their-own-family-members/

    But you might get away with basic care, but beyond that you start walking off the deep end.
     
  14. Clementine_Danger

    Clementine_Danger Active Member

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    Medical ethics aside, it sounds like she will depend on this person for her life, health, secrecy and safety. Being in a relationship as well is verging on all kinds of icky territory. Suppose she wants out. It's not like she can decide to break up with the guy and get another doctor. Honestly the more I think about it, the creepier this gets. I don't think I could ever root for a character who would be comfortable dating someone he has that much power over, doctor or not.
     
  15. archer88i

    archer88i Banned Contributor

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    At least in the US, a general practitioner provides only basic care, referring the patient to a specialist for pretty much everything else.
     
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  16. Cave Troll

    Cave Troll It's Coffee O'clock everywhere. Contributor

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    That is what the things I have read have said (well I kinda got the gist
    that it is more of the surgical side of things, to be more precise). Only
    way I will disagree with you is if one party is a psychologist/psychiatrist,
    then there would be an ethics dilemma.
     
  17. archer88i

    archer88i Banned Contributor

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    Specialists in the US are not limited to surgeons. If you present with a common cold, sure, your doctor will treat you. If you present with a rash, your doctor will give you some cream or other. However, if you come back in two weeks with the same rash, your doctor will likely refer you to a dermatologist.

    Don't know a thing about psychology/psychiatry--which is why I only said what I know about doctors. /shrug
     
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  18. KevinMcCormack

    KevinMcCormack Senior Member

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    The term covers a lot of possible bodies. If the physician in your story works in a hospital, the hospital probably has an on-call ethics/legal advisor for the physicians to discuss any situation as it comes up. It's not really a committee.

    If the patient files a complaint, it would have to go through possibly several bodies, starting with the hospital's ethics team, and possibly ending up in the College if it's a violation of one of their published ethics guidelines. My wife is on the BC College of Physicians & Surgeons ethics committee, and MDs have been disciplined for inappropriate relationships with patients. Again, the primary concern is patient care, but secondarily, there's the issue of prescribing controlled substances.

    There are also ethics committees for overseeing research. These may or may not overlap with a hospital ethics board. At UBC, they overlap, because the hospital is part of the university. When I did research medicine, I submitted my research proposals to the UBC ERB (ethics review board). Link: https://ethics.research.ubc.ca/
     
  19. The Dapper Hooligan

    The Dapper Hooligan (V) ( ;,,;) (v) Contributor

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    Like I said earlier, the doctor I dated was on a specific no prescription ban for me. It was a concern that I could use the relationship to influence them into giving me drugs I didn't need that I would then either use or sell. If it was something simple, I could get stitched up, but they always asked another doctor (if available) if it was alright first. They were also not allowed to diagnose me with anything. Another doctor had to do that and advise me in the course of action. The reason being that if they gave a bad diagnosis and I had to chose a course of treatment, I might be emotionally influenced into receiving treatment that might be ineffective or dangerous.
     
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  20. KevinMcCormack

    KevinMcCormack Senior Member

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    I couldn't locate BC's ethics guidelines, but here's the version maintained by the Ontario College of Physicians and Surgeons: http://www.cpso.on.ca/Policies-Publications/Policy/Treating-Self-and-Family-Members

    Relevant passage:
    "
    Physicians must not provide treatment to a spouse, partner, or anyone else with whom they are sexually or romantically involved, beyond the circumstances of a minor condition or emergency, and where no other qualified health-care professional is readily available. In addition, physicians must be mindful that providing treatment that exceeds the circumstances set out in this policy may give rise to a physician-patient relationship16and, as a result, the sexual abuse provisions of the Regulated Health Professions Act, 1991 would apply.17

    For further guidance, physicians are advised to contact the Canadian Medical Protective Association (or other professional liability provider) or obtain independent legal advice.
    "

    As mentioned above, an institution's ethics prime is usually also a lawyer. MDs do get disciplined, and sometimes criminally charged if there's evidence of patient exploitation.


    Here's the CMA's (Canadian Medical Association) guidelines: http://www.cma.ca/code-of-ethics . I would expect minor variation by region within the West.
     
    Last edited: Oct 5, 2017
  21. StarFyre

    StarFyre Member

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    Thanks everyone.
     
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  22. Genghis McCann

    Genghis McCann Active Member

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    I'm a physician in Ontario, Canada. Here there is a complete ban on physician /patient relationships. Even if it was a single office visit ten years ago you are deemed to have had a physician/patient relationship and any romantic relationship is forever forbidden. You can and will be struck off the register if you try. This poses great problems for single physicians in small towns, where they obviously know everyone and must treat them in an emergency. This rule was adopted after a very public inquiry after a handful of doctors (the same names cropped up again and again) were sexually-abusive to patients and this was the political solution - a complete over-reaction in my view to criminal activity on the part of about 5 doctors out of 20,000.
    The whole essence of abuse is that it is done in secret. Before the rule was changed I knew several physicians who married former patients. All of them, without exception, transferred their care to another physician before any romantic interaction occurred and the relationship was completely out in the open, and all but one resulted in marriage. Only one relationship that I know of failed, and it ended amicably. Now of course, there would be the eternal possibility of a report to the college.
    Unfortunately female physicians are more affected by this than male. It is hard enough for a female physician to find a suitable partner without crossing off everyone she has treated her lifetime. There have also been several cases of same-sex relationships reported to the college too, when a relationship has turned sour.
    We were always taught in medical school that no matter how ugly you are or how pathetic your personality, some patients will fall in love with you, and it's usually because they see a person who is helpful and caring. In other words they're not falling for you, they're falling for who you are in your role as physician. (The same goes for nurses, social workers, policemen, firemen etc). But sometimes it really is love. You just have to be very careful you realize the difference. In Ontario, of course, it doesn't matter.

    Kevin's post above is correct as far as treatment of one's own family is concerned. There have been several doctors disciplined because they have treated their own spouse / child. Again, I think this is overkill.

    <added later>
    As far as your specific story is concerned, the whole dilemma of whether a relationship is ethical or not could be a source of tension in your story, with several nurses already knowing about it. Will they inform on your MC or are they sympathetic? Do they give advice to the MC for continuing or dissolving the relationship. Do they have to get married, or will the tension be better if they are single and the relationship is hidden from the authorities? Could there be a human rights aspect to it? IOW, do their right to each other supercede the rules imposed by the College? And do the rules even apply if the relationship is interspecies?
    Lots of good stuff in your story and many ethical questions with no clear solution. Good luck.
     
    Last edited: Oct 6, 2017
  23. StarFyre

    StarFyre Member

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    Genghis McCann,

    I thank you and everyone else who took their time to respond and help.
     
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  24. GingerCoffee

    GingerCoffee Web Surfer Girl Contributor

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    I'm a nurse practitioner. I treat my son when he has an infection that needs treating. But I most definitely asked his regular doctor to address testicular self exam when he was a young teen.

    Generally speaking, if you seek out what we call hallway medicine, that is asking the provider to treat you without an exam, one can get poor care. It's one thing to treat something simple, but if one is forgoing labs like a chest x-ray or a proper exam, you will not be giving good care. This is one reason not to treat people you have a relationship with.

    The physician-patient relationship is considered unethical, in other words doctors should not date patients. But if your characters meet or know each other outside the patient encounter you could ethically work around the problem. You don't want the doc asking the patient out after only having seen her during her exams. That is a definite ethical breach of standards.

    Have the two meet somewhere unrelated to the medical encounter. If I run into a patient somewhere besides in an exam, the fact I have seen them as a patient might be awkward, but if it isn't, then I can see a relationship developing despite the ethical problem.

    As for treating the person on a regular basis, I say yes, get another doctor. The doctor she has begun a relationship with could find a friend/colleague he can confide in to be her doctor. And that, of course is where the confiding stops, the new doctor needs to be confidential, whatever happens in the patient encounter is not to be shared with the partner doctor.
     
    Last edited: Oct 7, 2017
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  25. StarFyre

    StarFyre Member

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    What happens is the doctor starts to like her and then when he learns she's still scarred somewhat from her boyfriends 'attempt at rape' (mind you, new species + different way of reproducton + scientific curiousity...) he gives her his personal phone number, even knowing it's likely against policy, as he's really the only one who knows anything about her situation... they start to meet outside of his office to talk, both just for her to clear her head of anything going on and because they're both falling in love...
     

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