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Physicians' Experiences with Patients Who Transgress Boundaries
Journal article   Open access   Peer reviewed

Physicians' Experiences with Patients Who Transgress Boundaries

Neil J Farber, Dennis H Novack, Julie Silverstein, Elizabeth B Davis, Joan Weiner and E Gil Boyer
Journal of general internal medicine : JGIM, v 15(11), pp 770-775
01 Nov 2000
DOI: https://doi.org/10.1046/j.1525-1497.2000.90734.x
PMID: 11119168
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1046/j.1525-1497.2000.90734.xView
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

boundary transgression Original physician relationship
BACKGROUND: Boundary violations have been discussed in the literature, but most studies report on physician transgressions of boundaries or sexual transgressions by patients. We studied the incidence of all types of boundary transgressions by patients and physicians’ responses to these transgressions. METHODS: We surveyed 1,000 members of the Society of General Internal Medicine (SGIM) for the number of patient transgressions of boundaries which had occurred in the previous year. Categories were created by the investigators based on the literature. Physicians picked the most important transgression, and then were asked about their response to the transgression and its effect on the patient-physician relationship. Attitudinal questions addressed the likelihood of discharging patients who transgressed boundaries. The impact of demographic variables on the incidence of transgressions was analyzed using analysis of variance. RESULTS: Three hundred thirty (37.5%) randomly selected SGIM members responded to the survey. Almost three quarters of the respondents had patients who used their first name, while 43% encountered verbal abuse, 39% had patients who asked personal questions, 31% had patients who were overly affectionate, and 27% encountered patients who attempted to socialize. All other transgressions, including physical abuse and attempts at sexual contact, were uncommon. Only gender affected the incidence of transgressions; female physicians encountered more personal questions (P=.001), inappropriate affection (P < .005), and sexually explicit language (P < .05) than male physicians and responded more negatively to boundary transgressions. Respondents dealt with transgressions by discussion with the patient or colleagues or by ignoring the incident, but such transgressions generally had a negative impact on the relationship. Most physicians would discharge patients who engaged in physical abuse or attempts at sexual contact, but were more tolerant of verbal abuse and overly affectionate patients. CONCLUSIONS: Boundary transgressions by patients is common, but usually involves more minor infractions. Female physicians are more likely to encounter certain types of transgressions. The incidence and outcomes of such transgressions are important in assisting physicians to deal effectively with this issue.

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25 citations in Web of Science
33 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Health Care Sciences & Services
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