Opinion ID: 1227144
Heading Depth: 1
Heading Rank: 5

Heading: Patient Relationship

Text: The Board concluded that Dr. Haley's sexual contact with M. occurred under such proximity to her relationship with him as her physician and surgeon that his sexual conduct with her constitutes a violation of RCW 18.130.180(24) as sexual contact with a patient. Because the facts do not establish that M. was Dr. Haley's patient during the time of their sexual contact, we disagree with the Board's application of RCW 18.130.180(24). [6] The statute defines unprofessional conduct to include sexual contact with a client or patient. This language prohibits a physician from having sexual contact with a current patient. It does not prohibit a physician from having sexual contact with a former patient. In the present case, the facts do not support the conclusion that M. was Dr. Haley's patient during the time of their sexual contact. Dr. Haley performed an emergency splenectomy on M. at the end of May 1986. His medical relationship with her was limited to performing that surgery and then providing postoperative care; there is no indication of any improprieties during this period. The Board stated that the contact between Dr. Haley and M. during the course of treatment and follow-up was professional and there is no evidence of any attempt to improperly influence [M.]. Furthermore, although exactly when the doctor-patient relationship between Dr. Haley and M. ended is unclear, it concluded before their sexual relationship began. Various experts testified regarding this point, one saying the doctor-patient relationship ceased on June 10, 1986 (the last postoperative visit after the splenectomy), another saying August 22, 1986 (90 days after the splenectomy), and a third saying December 1, 1986 (when M. saw Dr. Haley about her scar). Although these experts disagreed as to the exact date, however, all of them agreed that the medical relationship ended no later than December 1, 1986, and there are no facts that suggest otherwise. Yet the sexual relationship was not initiated until M. visited Dr. Haley at his office in March 1987. In short, there were no improprieties during the course of Dr. Haley's treatment or follow-up care for M., and the facts indicate that M. was not Dr. Haley's patient during the time of the sexual relationship. Therefore, there is no basis for saying that Dr. Haley had sexual contact with a patient, in violation of RCW 18.130.180(24). We recognize that the sexual relationship occurred in close proximity to the doctor-patient relationship. But proximity is not enough. In order to find a violation of RCW 18.130.180(24), the Board must be prepared to make the factual finding that the doctor-patient relationship actually existed at the time of the sexual contact. No such finding was made here. Had such a finding been made, we would accept it unless it were clearly erroneous; that is, unless review of the entire record left us with the definite and firm conviction that a mistake had been made. See Franklin Cy., at 324 (an agency's findings of fact may be overturned only if clearly erroneous). In the absence of such a finding, however, we must decide de novo whether the specific facts of the case support the conclusion that a violation of RCW 18.130.180(24) occurred. See Safeco Ins. Cos. v. Meyering, 102 Wn.2d 385, 390, 687 P.2d 195 (1984) (judicial review of agency conclusions of law is de novo). Here, Dr. Haley was a surgeon whose medical relationship was limited to performing an emergency surgery and then providing brief follow-up care. The restricted nature of Dr. Haley's medical relationship with M. does not, in our view, support the conclusion that the doctor-patient relationship continued to exist later during the time of their sexual contact, and therefore does not sustain the inference that Dr. Haley violated RCW 18.130.180(24). However, were Dr. Haley a family physician, a psychiatrist, an internist, an oncologist, or almost any other type of physician who typically has an ongoing relationship with patients, we would conclude  under facts otherwise similar to those before us  that the physician had engaged in sexual contact with a patient. We also recognize that psychological aspects of the doctor-patient relationship may continue to exist after medical treatment has ended, and that M. was probably influenced psychologically by Dr. Haley's status as her former surgeon. Indeed, we regard these facts as highly relevant to the conclusion, with which we agree, that Dr. Haley abused his professional status in violation of RCW 18.130.180(1). Nonetheless, RCW 18.130.180(24) does not proscribe sexual contact between doctors and their former patients, however much those former patients may have been influenced psychologically by the terminated doctor-patient relationship. It proscribes sexual contact between doctors and their current patients. The facts of this case do not establish that Dr. Haley had sexual contact with M. during the time she was his patient. Therefore, RCW 18.130.180(24) does not apply.