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Dear Dr. Saltzman,

Not being in the medical profession, I'm not sure what is considered to be appropriate behavior from a physician, and what is not. I know that it is a little different than other professional relationships. I'm looking for some input on my situation from someone in the medical field.

I started going to my current doctor a few years ago. I had only gone to two other doctors at that point - a pediatrician, and a doctor who treated me in late teens. I switched to the clinic where my current doctor works (for insurance reasons). I was 20 years old at the time. I rarely went to the doctor until that age, when I became slightly underweight. I've seemed to get sick more easily since. The first time I went to him was for mono. I later had complications from that, so I had a few repeat visits. He made a couple comments that I didn't think much of at the time. He asked if I was in a relationship. I said no, not currently, and he said, well, that's surprising. He's not the only doctor in the clinic I go to, though is recorded as my doctor--most have fewer patients than he does, so I can get in to see them easier. So, in the past couple of years, I've only been in to see him once or twice.

I've recently gone through a tough time--several bad events have happened that have left me stressed and anxious. I went in to my doctor for this. We talked about what's been going on, and also talked about anti-depressants. He mentioned he was going through a divorce, it's been rough, and he's been taking anti-depressants for it. I got teary-eyed through part of the conversation because it's tough to go over this stuff, and I rarely discuss it with anyone. He says I'll get through it, I'm young and attractive, and have a lot to be happy about, etc.

Near the end of the appointment, when I was feeling much better, he told me to give him a hug. I did, though I felt awkward about it. It wasn't a quick hug--we held each other for a long time--but, I have been seeking affection lately, I guess. Normally, I'd have pulled away after a few seconds. It's not that I felt uncomfortable with it, but I'm a little. . .confused. Granted I'm not really a warm and affectionate person, and he is my doctor, but I haven't been going to him for a long time. I had gone to him when I felt depressed this time last year, and was upset then too, but no hugging or anything happened. He was straightforward and rather distant, not really listening to my concerns--just wanted to prescribe me something and be done. It was completely different this time around.

I mentioned to my mom that he'd said he was divorced because she was talking about how he's always at the clinic. She thought it was strange that he'd bring that up. I said given the context, I don't think it was weird. But, I don't know, when I was leaving the office, it was awkward. He seemed bothered, like he felt he'd done something wrong. It didn't bother me--it was just unexpected. It brought out a rush of emotions. I'm supposed to go back in to see him soon is why I'm thinking of this now. What do you think?


Maggie, age 25, United States

Dear Maggie--

To answer your question, I think I should quote from the Hippocratic Oath, put forth around 2400 years ago, by Hippocrates, the ancient Greek father of medicine. This oath is traditionally taken by physicians pertaining to the ethical practice of medicine. It has several parts, but the salient one is this:

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

To me it seems clear, and I think you already really suspect, that your doctor was turned on by you sexually during the exam, and was hinting that he wanted to know you beyond the boundaries appropriate to a doctor-patient relationship.

In my opinion, your doctor should not be discussing his personal life with his patients, and should not be hugging them either. I am sure that he knows this, and probably that is why he seemed bothered after the hug when you were leaving the office.

It seems to me that you have two alternatives here. Either refuse to see this doctor, and ask for a different one when you go to the clinic, or, if you like and respect this doctor, you could tell him on the next occasion that you are not comfortable hearing about his private life or being hugged. If he understands that (an apology would be a good sign), then you might continue consulting him.

Tell your mom that her instincts are correct.

Be well.

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