Do Doctors Treat Attractive Patients Differently

The truth is there’s no hard data here to answer this question with any degree of confidence. It’s mainly just anecdote or opinion, given how difficult it is to define and measure.

Majority of physicians have favorite patients, study finds

Despite having favorites, physicians report striving to provide the best care for everyone

Date: July 20, 2016 Source: Johns Hopkins University Bloomberg School of Public Health Summary: Physicians like the majority of their patients, but a majority like some more than others, a study indicates. This study is thought to be among the first to explore the positive aspects of physicians’ attitudes towards their patients. Share:

Physicians like the majority of their patients, but a majority like some more than others, a study led by researchers at the Johns Hopkins Bloomberg School of Public Health finds.

The study, published online in the journal Patient Education and Counseling, is thought to be among the first to explore the positive aspects of physicians’ attitudes towards their patients. Of the 25 physicians interviewed, 22 respondents reported having favorite patients, with some characterizing them as a type of patient they regularly encounter in their practice and others as several standout patients they had treated over the course of their career.

The researchers say that understanding this aspect of physician-patient relationships sheds light on how patients and physicians might best work with each other, from patients making sure they see their doctors regularly and doctors appreciating the rewards of their practice, thus avoiding burnout.

“For patients, these findings highlight the importance of having a usual source of care, a primary care doctor with whom they can establish a relationship,” says study leader Joy Lee, PhD, MS, a postdoctoral fellow in the Department of Health Policy and Management at the Bloomberg School. “Favorite patients might not be consistently sick, but when a crisis comes they have an existing relationship to work off of.”

Surprisingly, Lee says, many physicians reported that their favorite patients were not necessarily the most compliant or those who were most similar to them. Rather, they were patients who the physician had known over a period of time — anywhere from one year to several decades — and who were or had been very sick, which meant the physicians saw them more frequently and spent more time with them.

Three of the respondents reported not having any favorite patients, and voiced concerns that the label suggested preferential treatment. The other physicians in the study, those indicating they had some sort of favorite patient, voiced the same concern. In their responses, physicians often used the term “it’s not about me” to convey that instead of thinking about how they felt about their patients they were endeavoring to provide them their best care regardless of their feelings about them — favorable or otherwise.

“This concern demonstrates that physicians are striving to be fair and to give all their patients the best possible care,” Lee says. “We discovered that doctors really thought about their relationship with patients, which is encouraging from a patient perspective. Their thinking really humanizes the patient-physician relationship.” Some of those with favorite patients, for example, indicated they were mindful of the boundaries around the physician-patient relationship, and did not socialize with patients outside of their practice or connect with them on social media channels such as Facebook.

For the study, a researcher interviewed 25 primary care physicians working in clinical settings across the Johns Hopkins medical system. Participants were mostly white (21, or 84 percent) and just over half were female (14, or 56 percent). The interviews were open ended but mainly centered around eight questions about participants’ perceptions of a favorite patient — a term for which there is no consensus definition. All but three of the interviews were recorded and transcribed for analysis. (For three, the recordings failed and the interviewer relied solely on detailed notes.) The responses were coded, and three themes around favorite patients emerged: physicians’ perspectives, characteristics of favorite patients and effects of the favorite patient relationship.

From a policy perspective, the findings highlight the importance of health insurance and consistent access to health care where patients can see the same doctor or practice over time. Uninsured patients tend to see a variety of practitioners, often seeking treatment at emergency rooms, instead of developing relationships with a specific doctor.

In fact, the most tangible perceived benefit for favorite patients might be that their physicians, having spent significant amounts of time with them, are best suited to care for their patients because of their knowledge of their cases. Otherwise, physicians did not identify substantial benefits favorite patients had over others except that they were better known to them. Though one did observe, “There is a truth to the fact that my favorite patients probably hear back from me more rapidly than my less favorite patients.”

“I think it would be surprising if doctors didn’t have favorites,” says Albert Wu, MD, MPH, a professor in the Bloomberg School’s Department of Health Policy and Management and senior author on the paper. “Doctors are human too, and as humans we like some people more than others — in both our personal and professional lives. We want our doctors to be humanistic, and patients benefit from positive regard. It is good to recognize it, to avoid playing favorites, which is different than having favorites.”

While physicians reported that their favorite patients enriched their professional experience, a fourth theme, about challenging patients, emerged in the responses, largely unprompted by the interviewer. Many challenging patients, the respondents said, lacked an understanding of the limits of what physicians could do. Many respondents reported that formerly challenging patients often became their favorites over time, reinforcing the benefits of patients seeing the same physician when possible. Observed one participant: “Patients who I never thought I would even come to like grow into some favorites [through the] shared experience of knowing them for over a decade.”

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    Do Doctors Treat Attractive Patients Differently?

    Professional doctors don’t treat attractive patients differently from any other. Unprofessional ones, however, might well give them some extra attention. But the answer also depends on what these doctors find “attractive” in the first place.

    Personally speaking, from my position shadowing and observing lots of doctors as a med student, I haven’t noticed doctors changing their treatment style much in many of the consultations I’ve seen. But maybe I’ve just been lucky! I’m not saying it doesn’t happen or those doctors aren’t out there.

    My conversations with doctors (and soon-to-be doctors) however, shows one common thing in regards to this question. Doctors are humans too. And by being humans they’re not without sexual drives or impulses.

    But even when they do find some patients attractive (which I almost guarantee happens), the job calls for professionalism always. Treating them differently; asking more personal questions, performing unduly clinical exams etc., could all be construed as malpractice. Doing these things could rightly jeopardise a doctor’s job too.

    One thing that could make such a problem easier, based on my research? The fact that hospitals and clinics aren’t the most romantic of places. While the work; blood taking, catheters, cannulas and the like, is usually far from arousing either (unless you’re kind of weird).

    Rules On Doctor-Patient Romantic Relationships

    According to the American Medical Association’s (AMA) Code of Medical Ethics 9.1.1 (ironic number), romantic or sexual interactions between physicians and patients are considered “unethical”.

    Ignoring that code, so says the text, could make patients “vulnerable” or impair the physicians ability to make “objective judgements” about their welfare.

    But aside from being a code of conduct, is there a real risk of being fired as a doctor by falling foul of this ethical quandary? This Texas-based doctor, who fell in deep with a patient, only faced a fine and 10-hours ethics education for example.

    What’s interesting here is the fall-out from the case. Many saw the result as an unfair example given the number of unpunished medical mistakes (ones that actually physically hurt patients) that go without reprimand.

    So while the code of conduct says no to doctor-patient romantic relationships, there’s a lot of people (doctors included) who think otherwise. Some, it seems, don’t see it as too much of a big deal.

    I guess it depends on the circumstances.

    What Happens If A Doctor Has A Crush On A Patient?

    The quick answer here is nothing. A doctor with a crush on a patient is supposed to leave it at exactly that.

    Of course that’s in the ideal world where the aforementioned code of ethics rules with an iron fist however.

    The truth is, as we’ve seen in real-world cases where doctors have gotten into relationships with patients initiated on their own accord, that sometimes a doctors crush can escalate.

    How it escalates though is an entirely different matter. But, as I know from personal observation, there’s nothing to stop a patient and a doctor exchanging private contact numbers. Nor can each be physically restrained from meeting up outside for a coffee or drink either.

    99 times out of 100 though I’d assume doctors don’t act on their crush. To many, it’s just not worth the risk to their professional career (or family life).

    Real life isn’t some wacky rom-com.

    Can A Doctor Have A Relationship With A Patient?

    The AMA’s code 9.1.1. of ethical conduct again says no. But there is a key word; concomitant. Meaning a doctor can’t have a relationship with a patient they have now.

    This doesn’t specifically rule out a doctor having a relationship with a patient from the past.

    Interestingly, in a Medscape ethics survey from 2012, 22% of respondents said that romantic relationships with former patients would be acceptable (as long as 6 months had passed between the end of the professional relationship). So “no” is not a resounding answer.

    As the survey helps to highlight; relationships are complicated. The real answer requires checking your country or state of work’s code of ethics and laws. But then even they (as this US-case shows) might not provide a concrete answer.

    My personal advice however is no. You shouldn’t have a relationship (romantic or otherwise) with any one of your patients (past or future).

    Besides, that’s what dating apps are for right?

    How Common Is It For A Doctor To Be Physically Attracted To Their Patients?

    Doctors are real people. It’s as common for them to be physically attracted to patients (people) as it is anyone else. So I guess it broadly comes down to libido – and what they deem “attractive” of course!

    Physical attraction is a complicated thing however. And it manifests in each of us in different ways (not just the obvious tell tale signs). You also have to physically see patients too in order to be attracted to them.

    Something not every pathologist, certain surgeons or other specialists always have the opportunity to do!

    The truth is there’s no hard data here to answer this question with any degree of confidence. It’s mainly just anecdote or opinion, given how difficult it is to define and measure.

    So if it’s that you want; here’s what I think. How common is it for doctors to be physically attracted to their patients? Not that common.

    Most “healthy” people fit and in shape? Don’t need to see a doctor.

    They just get you on the routine check-ups.

    Summary

    The subjects of “attraction” and “attractiveness”, in terms of doctors and patients, are hard to quantify. Although being a doctor exposes you to people, your specialism often determines what demographic of people you most see – just ask my friends in geriatrics!

    Whether doctors treat attractive patients differently or not depends on the doctor. Professionally they’re not supposed to, but we all know how unconscious bias plays out.

    The older you get though the more all this becomes less of a worry. Another pro for going into medicine after the age of 30.