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Would you hire a patient

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  • #16
    We have done it the other way around, but more often taken care of employees family members.

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    • #17
      I am a small town family med doc. I have no problem working with patients but it is somewhat out of necessity. There are only so many options around.

      Also the bone doc thing almost made me spit out my drink! Bravo 👏

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      • #18
        Originally posted by nephron View Post
        I don't know the rules or ethics behind it, but I would never hire a patient. It would be super-awkward if you needed to fire them because they were doing a crappy job and they were still your patient.
        So my son came home from a house his friend was house sitting at. Two girls and him, playing games (my kid is honest, tells me when he drinks, having sex, etc. so I believe him). The girl who was house sitting got caught and my son and other friend hid out until her uncle and her left. My son comes home and tells me all about it. We are laying in bed, about midnight, laughing about how ridiculous it is that this poor girl, who is leaving for college in 2 weeks, is getting in trouble for having friends over playing games at this house (sorry... whenever we have had a house sitter... my husband and I discuss the "should we get an older 20-something family person and pay more or a teenager who will party at the house but be cheaper?"... so far we have always gone more expensive just to decrease liability for us). Anyway... as we are laughing about the situation, his phone rings. It is his friend, so he answered. An irate woman (the girls aunt) is screaming at my son, calling him names, etc... I grab the phone, listen for a bit... then interrupt her and say in a very low calm voice "This is his mother. Do. Not. Ever. Call. Him. Again." and hung up.
        Long story... she is my patient. Time to find a new doc! Ha! Things happen in small towns. Maybe use this persons firm but not them directly so you can fire if needed?

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        • #19
          Granted I'm a psychiatrist but I still think there's a power differential between any physician and any patient and I don't think it's a good idea to engage in any other relationship besides the doctor patient one. Too many ways for things to go sideways or just get weird. Surely there are other options out there that are less fraught? I'd keep looking.

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          • #20
            Come to think of it, I did hire a patient’s company to paint my old house. I guess it’s slightly different because I never had to see them again after the post op visit.

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            • #21
              Peds, so hired a dad who is a landscaper after his trailer burned in a fire and he was out of all his old clients. Don't regret it. Almost hired a dad who was a painter, but my neighbor did it for cheaper. Seems way less risky than hiring your patient as an accountant for your practice.

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              • #22
                Originally posted by StateOfMyHead View Post
                Psychiatry would have to be a hard no.
                Really? What about mild to moderate depression that you treated successfully? What if it reasonably was brought on by a specific event like postpartum depression or loss of a spouse or child due to cancer or a motor vehicle accident?

                I’m not trying to excuse the incurably schizophrenic or violent folks, but can we try not to stigmatize folks who seek help and overcome temporary setbacks?

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                • #23
                  Originally posted by Hank View Post

                  Really? What about mild to moderate depression that you treated successfully? What if it reasonably was brought on by a specific event like postpartum depression or loss of a spouse or child due to cancer or a motor vehicle accident?

                  I’m not trying to excuse the incurably schizophrenic or violent folks, but can we try not to stigmatize folks who seek help and overcome temporary setbacks?
                  Absolutely never.

                  Once a patient, always a patient.

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                  • #24
                    Hmm, I suppose there is the difference between hiring someone for an outcome (paint an office, build a deck, prepare a S-Corp tax return or revocable living trust) vs. hiring someone to be a W-2 employee under your ongoing employ and supervision.

                    Certainly it seems like less of a problem for an orthopedic surgeon or EM doc who fixes a broken bone to hire someone than for a psychiatrist who may or may not have cured someone long term to hire that (former?) patient.

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                    • #25
                      I read a medical board complaint where a patient of a family physician was hired to do repairs. The doctor rang the patient to do the job properly or on time or something and the patient complained to the medical board.

                      It usually turns out ok. But I wouldn’t. Not worth the headache. I think the trend is heading that way with Dr-patient boundaries.

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                      • #26
                        Originally posted by Hank View Post
                        Hmm, I suppose there is the difference between hiring someone for an outcome (paint an office, build a deck, prepare a S-Corp tax return or revocable living trust) vs. hiring someone to be a W-2 employee under your ongoing employ and supervision.

                        Certainly it seems like less of a problem for an orthopedic surgeon or EM doc who fixes a broken bone to hire someone than for a psychiatrist who may or may not have cured someone long term to hire that (former?) patient.
                        So would you say it is ok for a surgeon or EM doc to ask a patient out on a date after they’ve had their problem or broken bone fixed?

                        The potential medical board issue revolves around the perceived exploitation of the patient-doctor relationship.

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                        • #27
                          Originally posted by Hank View Post

                          Really? What about mild to moderate depression that you treated successfully? What if it reasonably was brought on by a specific event like postpartum depression or loss of a spouse or child due to cancer or a motor vehicle accident?

                          I’m not trying to excuse the incurably schizophrenic or violent folks, but can we try not to stigmatize folks who seek help and overcome temporary setbacks?
                          Has nothing to do with stigma. Has to do with the necessary boundaries between a psychiatrist and a patient. Nobody is saying that you or I or anybody else shouldn’t hire that patient. Just that the treating psychiatrist shouldn’t.

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                          • #28
                            Originally posted by Dont_know_mind View Post

                            So would you say it is ok for a surgeon or EM doc to ask a patient out on a date after they’ve had their problem or broken bone fixed?

                            The potential medical board issue revolves around the perceived exploitation of the patient-doctor relationship.
                            It's all areas of gray for non Psychiatrists IMO. What if the surgeon never operated and only saw the person once a year ago? What if the EM physician was staffing an urgent care and saw a person once for sniffles?

                            https://www.ama-assn.org/delivering-...ships-patients

                            I think former patients would be ok given a long enough time frame between final contact and the historical professional relationship doesn't have influence on the current personal one.

                            Current patients are right out.

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                            • #29
                              Originally posted by nephron View Post
                              I don't know the rules or ethics behind it, but I would never hire a patient. It would be super-awkward if you needed to fire them because they were doing a crappy job and they were still your patient.
                              I'm in a small town. If I didn't hire my patients I would have no local options: contractor, accountant, banker, city council member, insurance salesman.

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                              • #30
                                Originally posted by runfast00 View Post

                                I'm in a small town. If I didn't hire my patients I would have no local options: contractor, accountant, banker, city council member, insurance salesman.
                                According to popular opinion on this thread, I live everyday in the 'grey zone'.

                                However, I understand others may have feelings that are different than mine. Certainly they have different circumstances.

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