We have all had patients who push some special button. We need to be aware of our buttons, our reactions and our limits. Often, we can maintain our professionalism simply by becoming aware of these buttons. Professionalism also requires us to be aware of our limits. At times, we may become overwhelmed and find it difficult to maintain physician-patient boundaries.
Dual relationships present a special problem in physician-patient boundaries.
A dual relationship exists when physicians and patients share a strong, nonprofessional relationship. A classic problem exists when a physician attempts to treat a family member. Dual relationships are problematic for physician and patient and in this case, where mortality is the issue, great caution is advisable. It would seem that the nature of this dual relationship, although known only to the physician, poses a serious risk to the physician's objectivity. When a physician's limits have been exceeded or when issues arise that threaten the integrity of the physician-patient relationship, the professional response is to facilitate the transfer of the patient to another physician.