Professional boundaries are the ethical, legal, and relational limits that define the interactions between healthcare professionals and their patients. They protect the therapeutic relationship by ensuring that it remains focused on the patient’s health, safety, and well-being. Maintaining these boundaries is crucial for fostering trust, preserving professional integrity, and avoiding conflicts of interest.
Professional boundaries that healthcare providers should consider include physical, emotional, financial, communication, social media, and relationship.
- Physical Boundaries
Respect the patient’s personal space. Maintain appropriate draping and only expose parts of the body necessary for examination, care, and treatment. Avoid unnecessary physician contact that could be misinterpreted as inappropriate. Explain your examination and treatment of the patient and why you are doing it. If a patient is uncomfortable with the examination or treatment or if examining or treating a sensitive area, ask a staff member the patient feels comfortable with to be a chaperone.
- Emotional Boundaries
Emotional boundaries help to strike a balance between professional compassion and personal involvement. Maintaining emotional boundaries allows healthcare providers to focus on providing quality care and helps prevent healthcare provider burnout by separating personal and professional lives. Validate patients’ feelings without taking them on as you own. Only share personal stories if they benefit the patient’s care, not to meet your emotional needs.
- Financial Boundaries
Keep finances structured, transparent, and consistent. Make sure your patients know your practice’s billing policies and clearly explain charges, insurance coverage, and out-of-pocket costs prior to treatment if possible. Do not let patients run up unpaid balances without following proper billing and collections procedures. Avoid providing “extra” services for free. Do not loan money to a patient, instead refer them to a financial assistance program. Conversely, healthcare providers should not accept a loan, large gifts, or financial favors from a patient as they can create a sense of obligation.
- Communication Boundaries
It is important to establish clear guidelines with your patients regarding how and when communication may occur with you and your staff, such as by phone, email, or secure messaging platforms, and when they can expect a response. Patients should also be educated on how to contact you in case of an emergency or urgent situation. Maintain a professional relationship with patients by not interacting socially via text, email, or phone. Keep patient interactions within professional settings and agreed hours.
- Social Media Boundaries
It is best to not accept or ask for invitations to connect on social media with your patients. Your patients’ privacy must be maintained. Be aware that even if the patient’s face is not included in a photo, there may be other ways a patient could be identified such as tattoos, birthmarks, scars, or other identifying information. Do not post pictures of patients on social media without explaining how the patient’s picture will be used and why you are posting it. Then obtain the patient’s written consent for such use.
- Relationship Boundaries
Romantic or sexual interactions between healthcare providers and patients are unethical and put both the patient and the healthcare provider at risk. Such interactions can compromise the provider’s ability to make objective decisions about the patient’s healthcare and may exploit the vulnerability of the patient. Inappropriate behavior includes discussing intimate or personal issues with a patient, flirting, keeping secrets with or for a patient, spending more time than is necessary with a particular patient, suggestive comments, meeting a patient in settings other than those used to provide direct patient care.
Set Clear Boundaries with Patients
Set clear expectations with your patients at the beginning of care by letting them know your role and limitations. If you find it difficult to maintain boundaries with a particular patient, consider referring the patient to another provider.
Maintaining professional boundaries is a continuous process that requires vigilance, self-awareness, and adherence to ethical guidelines. Healthcare providers who fail to maintain professional boundaries not only put their patients at risk, but they also put themselves at risk for possible disciplinary action from their licensing board, civil lawsuits, termination of staff privileges, or even criminal charges.
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Disclaimer: The information contained on the PICA Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. In the event any of the information presented conflicts with the terms and conditions of any policy of insurance offered by ProAssurance Insurance Company of America, the terms and conditions of the actual policy will apply. All information contained on the blog is subject to change.