GMC: Maintaining a Professional Boundary Between You and Your Patient: Summary

SJT Textbook: Maintaining a Professional Boundary Between You and Your Patient

Professional Boundaries between Doctor and Patient GMC MSRA Guidance

This professional boundaries between doctor and patient GMC MSRA guide explains how doctors must avoid personal, romantic, financial and emotional relationships that exploit the power imbalance in MSRA SJT scenarios.

🎥 Video Lesson (YouTube)

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🎯 THE CORE PRINCIPLE

The doctor–patient relationship is inherently unequal. Patients depend on doctors for care, expertise, and safety. Any emotional, romantic, or sexual pursuit — even subtle — exploits this imbalance. GMC guidance makes clear that sexual or improper emotional relationships with current patients are always unacceptable, and relationships with former patients are usually inappropriate, especially when vulnerability is involved.

The MSRA SJT regularly tests recognition of boundary crossings, inappropriate communication, risky social media interactions, mishandled advances from patients, and the need to safeguard vulnerable people. High-scoring choices prioritise professionalism, distancing, documentation, senior advice, and safe transitions of care.

The professional boundaries doctor patient GMC guidance strictly prohibits romantic or emotional involvement with current patients.

🧩 KEY PRINCIPLES (MSRA SJT Interpretation)

1. Trust is the foundation

Professional boundaries allow patients to seek care without fear of exploitation.
Any blurring of boundaries threatens this trust and is unsafe.

2. Absolutely forbidden: relationships with current patients

Never:

* Flirt
* Exchange personal messages
* Engage in sexualised talk
* Arrange dates
* Respond positively to advances
* Initiate contact outside clinical context

If a patient behaves inappropriately:

* Set clear boundaries
* Stay professional
* Document
* Seek senior advice
* Consider transferring care if trust is compromised

3. Do not use the professional role for personal gain

You must never:

* Attempt to date a patient
* End the professional relationship to start a personal one
* Pursue someone close to a patient (e.g., partner, sibling, carer)

Ending the relationship solely to justify a personal relationship is misconduct.

4. Former patients: extreme caution

Relationships with former patients may still be abusive or harmful due to:

* Power imbalance
* Recency of care
* Dependency
* Vulnerability

High-risk factors include:

* Mental health conditions
* Learning disabilities
* Addiction
* Trauma
* Paediatrics or psychiatry
* Recent treatment

The more recent the interaction, the more inappropriate the relationship.

5. Vulnerability greatly increases risk

The more vulnerable the patient or former patient, the more serious the breach.
Psychiatrists, paediatricians, and safeguarding roles require heightened caution.

6. Social media increases boundary risks

Risks include:

* Overfamiliar chat
* Private messaging
* “Following” patients
* Sharing photos from social settings
* Responding out of hours
* Emotional disclosure

Direct patients to official channels; do not interact socially online.

7. Seek impartial advice

Boundary concerns require early:

* Senior input
* Defence organisation support
* HR/employer advice
* Transfer of care where necessary

Many MSRA SJT questions test breaches of professional boundaries doctor patient GMC standards through social media or gift-giving.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Politely but firmly decline any inappropriate advances.
2. Maintain a strictly professional tone and demeanour.
3. Document concerning interactions objectively.
4. Seek advice from seniors or defence bodies when unsure.
5. Transfer care if trust has broken down.
6. Avoid personal communication channels (e.g., WhatsApp, Instagram).
7. Avoid dual relationships (clinical + romantic/social).
8. Act protectively for vulnerable patients.
9. Maintain boundaries even after hours or off-duty.
10. Never end a professional relationship to pursue romance.

Failure to follow professional boundaries doctor patient GMC rules can lead to safeguarding risks and GMC investigation.

Boundary breaches are always low scoring in the SJT.

Doctors must actively manage and document concerns under professional boundaries doctor patient GMC guidance.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I cannot engage in personal or romantic communication.”
* “I’d like to arrange for another clinician to continue your care.”
* “I will document this interaction and seek senior advice.”
* “We can only communicate through official channels.”
* “This behaviour risks undermining the doctor–patient relationship.”

Social media interactions are a common trigger for professional boundaries doctor patient GMC violations.

B – Boundaries must be firm
O – Overfamiliar behaviour avoided
U – Use professional channels only
N – Never pursue patients
D – Document concerning behaviour
A – Assess vulnerability in former patients
R – Refer/transfer care if trust damaged
Y – Your role is protective, not personal

📋 QUICK FAQ

Can I date a current patient?
No — strictly prohibited. Can I date a former patient?
Possibly, but usually inappropriate — depends heavily on vulnerability and time elapsed. What if a patient develops romantic feelings?
Set boundaries, document, seek advice, and transfer care if needed. Can I interact with patients on social media?
No — direct them to official channels. Can I treat someone I’m in a relationship with?
No — transfer care to another clinician.

📚 GMC ANCHOR POINTS

* Maintaining trust
* Professional boundaries
* Safeguarding vulnerable patients
* Ending relationships with patients
* Social media professionalism
* Duty of care
* Documentation

💡 MINI PRACTICE SCENARIO

A patient begins making flirtatious comments during appointments and sends a message to your personal social media account thanking you for “being so kind.” Best action: Politely reinforce professional boundaries, document the interaction, seek senior/defence advice, and transfer care if trust has been compromised. Why: Protects boundaries and prevents escalation while maintaining patient safety.

🎯 KEY TAKEAWAYS

✓ Never pursue relationships with current patients
✓ Extreme caution with former patients — always consider vulnerability
✓ Maintain strict boundaries online and offline
✓ Document and seek advice early
✓ Transfer care if trust is compromised
✓ Never use professional position to initiate personal relationships

Breaching professional boundaries between doctor patient GMC guidance places patient safety and your registration at serious risk.

🔗 RELATED TOPICS

* → Ending professional relationships
* → Social media
* → Intimate examinations
* → Safeguarding
* → Maintaining trust

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

A patient begins bringing small gifts and asks if you will meet them for coffee outside the clinic.

Options:
A. Thank them and accept the invitation to maintain rapport
B. Politely decline and reinforce professional boundaries
C. Document the interaction objectively
D. Seek advice from a senior or defence organisation
E. Continue seeing the patient without addressing concerns
F. Give the patient your personal phone number to clarify boundaries
G. Immediately remove the patient from your list
H. Explain that the gift cannot be accepted

Example SJT — Rank 5 (best → worst)

A former patient you treated six months ago asks you on a date. They previously had significant mental health issues but have been well recently.

Options:
A. Seek impartial advice before deciding
B. Consider the patient’s vulnerability and decline
C. Agree because the professional relationship has ended
D. Ignore the message
E. Immediately block them without explanation