Friendly Doctors Find It Harder To Be Honest To Patients They Like, Hurting Objectivity

doctor hugging patient
Doctors who are young and friendly aren't often aware that they're over-stepping professional boundaries when it comes to caring for their patients. Photo courtesy of Shutterstock

Being a nice doctor and being a good one might be two separate things, according to a new study. Published in The Lancet Oncology, the study found that doctors who are young, friendly, and naïve might not be as good at carrying out objective, truthful decisions — particularly to patients they like.

The researchers analyzed 338 oncologists under the age of 40 and found that 60 percent of them felt that being too close to their patients could prevent them from making objective decisions about that person’s care. In addition, some two-thirds of doctors under the age of 30 struggle with being completely honest with patients they like.

“Oncology is a specialty that can be enormously rewarding but is fraught with many challenges,” Lesley Fallowfield of Brighton and Sussex Medical School, and an author of the study, said in the study. “Young oncologists have to master dealing with anxious patients who are facing a life-threatening disease; conveying the true prognosis; discussing the complexity of modern treatments; and explaining the unavailability of some drugs, the side effects of treatment, and likely therapeutic aims.”

About half of the doctors in the study had given patients their personal cell phone numbers, and about 14 percent had accepted patients as friends on Facebook. “The difficulty, if you hug and kiss patients, if you allow them to call you by your first name, is that quickly the relationship can become confused as a social one rather than a professional one,” Fallowfield said. “Doctors become confused, ‘I really like this person, how can I bear to tell them that they’re going to die?’ They find it more difficult to be objective.”

But most people certainly don’t want their doctors to be cold, detached, and careless, either. In the 19th and early 20th century, doctors would come to patients’ houses and treat them at home, in a far more relaxed and informal environment. The relationship between doctor and patient wasn’t so aggressively watched and regulated as it is now — as most doctors now work at large, bureaucratic health institutions and the stakes are higher. The General Medical Council offers doctors guidelines in maintaining a boundary between them and their patients, in particular focusing on the downfalls of a sexual or financial relationship. But what if acts of kindness to patients are smaller, and more subtle? Such as doctors occasionally paying for a $30 prescription the patient couldn’t afford, or even accepting a gift from the patient themselves.

“Kindness to friend and duty to patient: Are they one and the same? Or separated by a barbed-wire fence? Opinion is all over the map,” Dr. Abigail Zurer wrote in The New York Times. Indeed, doctors are polarized on the issue, with some believing that professional boundaries shouldn’t be crossed at any point — and others believing that compassion shouldn’t be boxed and regulated.

When it comes down to it, it's better to be safe than sorry, Fallowfield believes, noting that too friendly of doctors could lead to a harmful impact on a patient's health care. Fallowfield points out that patients who are friends with their doctors might “feel intimidated about complaining” or refrain from raising issues about treatment, and that doctors need to be especially careful in the age of social media.

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