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When a Friend Crosses a Professional Boundary

Ever had a friend ask for medical advice outside the privacy of an office setting? Here's what you can do when a friend crosses that professional boundary.

Sometimes friends or acquaintances ask for medical advice in inappropriate settings and outside the privacy of an office setting. What do you do when this happens to you?   

Consider this scenario: Debbie is your friend and your patient. She is having issues with situational depression and anxiety. Based on information she shared with you at a recent visit, you have referred her to a psychiatrist. She likes you—her friend—but doesn’t follow your medical advice and never makes an appointment with the psychiatrist. She is inconsistently taking the medications you have prescribed.

While shopping at the local grocery store, Debbie’s husband approaches you to talk about his wife. The conversation sounds like, “She is getting worse. You’re her friend, what should I do?”

Next, you see Debbie at a neighborhood party, and she corners you in the kitchen to “catch up” on her medical issues. You become increasingly uncomfortable and tell Debbie that you can’t talk about her situation at the party. You ask her to call the office to make an appointment. She continues talking about her medical issues while you try to extricate yourself from the conversation. Debbie gets annoyed with you.

After the party, you decide Debbie has crossed a professional boundary and you want to terminate her from your practice. Monday morning you call a colleague who is willing to assume her care. You have your staff reach out to Debbie to schedule time to talk with you in the office. How should you proceed when you meet with her?

  • Be clear about the reason she is being terminated from your practice (crossing a professional boundary).
  • Remind her that in the future, regardless of where she approaches you, you will not discuss her medical issues or provide medical advice.
  • Have her sign the authorization for release of records and offer to forward them to your colleague or a doctor of her choosing.
  • Encourage her to continue treatment as previously recommended.
  • Provide her a copy of the termination letter. Place a copy of the letter in her chart.