EMERGENCY PHYSICIANS AND SEXUAL INVOLVEMENT WITH PATIENTS - AN ONTARIO SURVEY

Objective: To describe Ontario emergency physicians' knowledge of coll eagues' sexual involvement with patients and former patients, their ow n personal experience of such involvement, and their attitudes toward postvisit relationships.Design: Mailed survey. Setting: Ontario. Parti cipants: Emergency physicians practising in Ontario. Results: Of 974 e ligible mailed surveys, 599 (61.5%) were returned. Of these respondent s, 52 (8.7%) reported being aware of a colleague in emergency practice who had been sexually involved with a patient or former patient. When describing their own behaviour, 37 respondents (6.2%) reported sexual involvement with a former patient. However, of this group, only 9 (25 .0%) had met the patient in an emergency department. Thus, of the tota l number of respondents, only 1.5% (9/599) reported sexual involvement arising out of an emergency department visit. Most respondents (82.4% ) agreed that it is inappropriate behaviour to ask a patient for a dat e after an emergency assessment and before the patient's departure, an d 66.4% felt that it is inappropriate to contact the patient after dis charge. However, only 10.6% believed it to be unacceptable to request a social meeting after encountering a patient previously cared for in the emergency department in a nonprofessional setting. Most respondent s (96.5%) did not believe that sexual involvement could ever be therap eutic for the patient. However, only 66% felt that it was always an ab use of power and 62.4% supported zero tolerance of all sexual involvem ent between physicians and patients. Conclusions: Vague regulatory gui delines currently in place have failed to dispel confusion regarding w hat is acceptable social behaviour for physicians providing emergency care. Our results support the need for clarification, and suggest a ba sis for guidelines that would be acceptable to the emergency medical c ommunity: that an emergency visit should not form the basis for the in itiation of personal or sexual relationships, yet neither should it pr eclude their development in nonmedical settings.