Resident Handbook - UC Davis Health System

Addressing Patients’ Perceptions:Patients may perceive misconduct if proper communication does not occur or if extra measuresare not taken to protect their privacy. The California Medical Board has received numerouscomplaints regarding improper physician conduct that could have been avoided with propercommunication and use of safeguards, including the following:1. Proper explanation ahead of time regarding the scope, nature, or necessity ofexaminations which included touching private body parts.2. Allowing adequate private time for the patient to undress and cover properly.3. Limiting examination to required areas of focus based on patient complaint and insuringadequate covering during the examination.4. Using appropriate chaperones during examination of private body parts, especially duringbreast and pelvic examination.5. Carefully considering language and questions during the interview and examination.6. Behaviors should not be pursued that would not pass the “colleague disclosure test”.Addressing Sexual Tension:Erotic undercurrents may occur between patients and physicians and need not end the physician–patient relationship. Although sexual undercurrents are not uncommon in the doctor–patientinteraction, sexual behaviors are always inappropriate and may result in disciplinary actions forsexual misconduct. Ways to address sexual tension include:1. Explaining reasons for sexually related examinations or questions and encouragingpatient questions, while maintaining appropriate boundaries.2. Responding to patients who express erotic feelings in a matter-of-fact manner,emphasizing the doctor–patient relationship, the importance of objectivity, and thephysician's desire for it to remain that way.3. Explaining that rejection of the patient’s inappropriate requests or comments does notmean the physician does not care for the patient or does not wish to work with them.4. If a patient persists with inappropriate requests, or comments, or becomes extremelyanger, the physician should respond calmly and with sincere regret that this behaviorwill cause termination of the relationship.5. Physicians should seek to understand their personal reactions and attitudes towardsexual issues.6. Patients who persist in acting out erotic feelings should be transferred to anotherphysician and, pending transfer, sexually related issues should be avoided.7. The physician should explain the change as related to the persistence of the behaviorand the physician's decision that it is in the patient's best interests not to continue.8. Admitting attraction or other feelings for the patient is discouraged as inappropriatedisclosure on the part of the physician.Page 109 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.doc