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by Dr Neil
Margerison and Professor Susan
Last updated: June 2020
All clinical professionals need to
comprehend and work within professional boundaries. Boundaries must
be understood, observed and respected by doctors, as all violations
pose a risk of harm to patients. Some boundary violations,
particularly those that are sexual or financial, can be career
limiting – doctors may be struck off by the GMC. Psychiatrists and
GPs are those most at risk.
All psychiatrists need to be able to specify
safe and therapeutic professional doctor-patient relationships.
Recognition of common and challenging situations is a first step
towards the prevention and management of boundary violations.
Educational supervisors are expected to raise these issues with
trainees and indeed with anyone they supervise.
Although junior doctors may run into
difficulties because they lack experience and because of the wider
use of social media, the more severe problems are usually
associated with men in mid-career. Sometimes boundary violations
occur as an abuse of hierarchical power; sometimes they occur when
individuals are more stressed at home or at work.
This module uses vignettes and interactive
material to help you identify good practice in doctor-patient
relationships, recognise and describe boundary violations and their
associated harms, and learn how to avoid and manage such
situations where they have occurred.
psychiatrists: Part 1 – introduction to dealing with poor
performance and Part 2 –
understanding and managing poor performanceby Dr Neil
professional practice: Part 1 and Part
2 by Dr Ashok G. Patel and Dr Haider Malik
bias in psychiatry by Dr Prasanna N. de Silva
Book from RCPsych Publications:
Abuse of the Doctor-Patient Relationship
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