Hugging patients

[wideopenspaces]

I'm curious if patients try to hug their male doctors or if this is mostly something only female doctors have to deal with. I don't want to hug my patients. On a professional level it's a boundary issue for me ( I'm a psychiatrist). Hugs mean different things to different people, plus I would never want anything sexual or inappropriate taken from a hug. On a personal level I only feel comfortable hugging my immediate family members, I don't even really like to hug good friends! So it's always awkward for me when a patient gives me a hug. I'm caught off guard, I allow it and then I have to go back at the next appointment and discuss the reasons for not hugging. Worst is when I discuss it repeatedly with a person and they continue to do it. I'm curious if others run into this issue and how y'all handle it.

[Lithium]

It doesn't happen that often, but fortunately my patients are short-term so I don't worry about the implications that much.  Not worth sending a message of rejection their way.  I'm much less comfortable with the personal questions patients ask me (whether I'm religious, where I'm from, stuff about family) and still haven't figured out a satisfactory way to shut it down.

[Dicast]

Generally the only hugs I give are to family members of very sick or dead patients. I have had the occasional hug from happy patients but it is rare. I work in an emergency department and I don't get to close to hug my psych patients.

Generally speaking though, I haven't felt any hugs to be inappropriate in my setting.

[Antares]

I get the occasional hug. They are almost always fine with me. It would be an issue if I were getting hugs I didn’t want. I can think of two patients that regularly want a hug. They are both women medication patients with whom I have a very positive warm relationship, and with whom there is a mutual feeling of good helpful work. I would certainly have to address it were it occurring in a therapy relationship (not that there are no psychological complexities or enactments in psychopharm relationships), or if it made me uncomfortable, or if I felt there were awkward or sexual overtones. There is sometimes a hug at termination. My male patients don’t seem to want to hug me. While I don’t initiate any hugging, I will occasionally utilize a fleeting light touch on the shoulder or back as a patient of either gender is leaving, if it feels appropriate, after a difficult conversation about a very difficult time the patient is having.

As for personal questions, for me these usually occur in an ongoing treatment -medication or psychotherapy - and I will inquire as to the meaning, intent and motivation behind the question. My usual type of response will be that if I thought it would be helpful to the patient to answer, I would. But that I suspect it is more germane to try to understand what this question means to the patient, and what their ideas are about the potential answers.

[DoubleMDs]

So long as you are not the initiator, it’s ok. That could easily be deemed as inappropriate or unprofessional. If a little older lady wants to give you a brief hug for helping her husband or her grandchild, I don’t think there’s much harm in that. If a patient about the same age as you of the opposite sex wants to give you a long hug, probably should shy away from that. That could probably very easily be misconstrued or misinterpreted.

I think every situation is different, as with anything.

[G]

EM here.  I receive an occasional hug, but never initiate.  Although I guess I should be more concerned about boundaries/professionalism, all I can think about is the fact that they are covered with germs and could be trying to murder me.

[q-school]

I usually get about 5 hugs per clinic.  usually 3 woman hugs and 2 half man hugs.

usually I have about 4 criers per clinic

I'm in the Midwest and I think it's an acceptable social thing.

in my last job I (and everyone) had hug training.  level 5 hugs are unacceptable--those are like full body contact and faces close and arms pulling bodies together.  level one two and three are professionally acceptable.  space between bodies.  try to remain sideways as possible.  use your own arms to keep from being pulled too close.  end quickly.

 

[ticker]

I'm a man.  Got an unsolicited hug, a kiss, and an "I love you" this week (and I'm not even psych!).  I signed off asap.

I rarely initiate a hug if someone is dying/just died and a widow or child I've gotten to know over several days is in tears.  In those cases, I always ask permission first.

I try to keep hugs initiated by female patients/family members very brief, and/or turn them into a side-hug.  The exceptions are if the patient is old (Nana can have whatever hug she wants) or if someone just died.  Thankfully, as I work in the hospital, I'm essentially never alone with a patient behind a closed door, so I think the risk of being accused of some kind of sexual malfeasance is minimal.

I did note when working at a VA hospital that a lot of those patients (95% men) were really prone to initiating hugs with their female doctors/nurses.  Short of an institution-wide policy against it, I'm not sure how to protect women healthcare workers from such creepery.

[Wiscoblue]

I’m in a small town in the Midwest. Hugs everyday and it’s not just from patients and their families. There’s a female OB doc, French, who is very generous with her hugs and kisses. She’s 65. I quite like running into her. She brightens my day with a hug and a smooch.

[EMscout]

It’s not your fault.

[Hatton]

Ob/Gyn here.  I have received lots of hugs.  I rarely initiate them.  I have been known to cry with patients when their baby is dead. I find that some patients hug me because they have been through a bad experience years ago that I helped them with.

[pulmdoc]

Hugs in clinic are rare, usually older, female, long time patients. I don't initiate those but I don't shy away either. Hugs in hospital are more common, usually right after the "I'm sorry, your husband couldn't be revived" or "I'm sorry, but removing the ventilator is what you say your husband would have wanted" conversations. Those are the half-hug, "we're here for you in this tough time" hugs, which seem to be helpful.

[treesrock]

I think it depends on specialty too. I’m a 30ish male, academic oncologist in the mid-Atlantic, I get hugged by multiple patients every single clinic. Split evenly between men, women, and their families. Always patient initiated and I always hug back. I’m not sure how I would even stop this.

Part of it is my age and demeanor, but part of it is the job. During fellowship my older attendings, male and female, would get hugs all the time, so I figured this was just a part of it.

[Dr. Mom]

I'm in the South and in pediatrics.  Hugs are how we greet, say thanks, show appreciation, show condolence, and say good-bye.  I would find it strange if patients weren't hugging me.  But, I appreciate that in other areas of the country it is not the norm.  And with psychiatrists, I can see how it can be confusing.  In flu season I do limit it, though.

[Zaphod]

Probably depends a lot on specialty. Also in the setup of the clinic room and how your encounters are logistically. I am always on the lookout for that kind of thing and try to make the setup of it all so that even if they really want to, theres a certain 'awkward zone' they'll have to cross that is usually too much real estate by the closing of the encounter for them to consider. I often see them thinking and wanting, but they look at how far it is and usually just profess a bunch of nice things with a smile, and Im out.

Only every now and then do you get a tricky one that goes for it during the exam portion where you're closer. That is very awkward and uncomfortable. Again, specialty specific, but its something we try to be on guard against having occur.