Thinking about professional boundaries: what would you do?
14 July 2021
It can be tricky sometimes knowing what to do in a particular situation. GOsC Policy Manager Steven Bettles shares the first in his series of scenarios for you to think about
We are continuing to receive a number of concerns about breaches of boundaries from patients. These might encompass emotional, professional or sexual boundaries and for practitioners, it can sometimes be difficult to know how to exercise appropriate professional judgement when these issues arise. Standard D2 and the associated guidance of the Osteopathic Practice Standards (OPS) can help.
I have put together a number of scenarios, the first is included below. Our aim is to help support you in the application of the OPS in practice.
You could have a think about the situation yourself, but you will probably find it very helpful to discuss this and future scenarios with another colleague or two, or with a group, and consider how the OPS might help to inform your response. Sometimes the response to any given scenario will be 'it depends', but we are keen to encourage osteopaths to think about the challenges, and use the OPS to navigate a way through these.
We will share another scenario plus our response to this one next month – watch out for it in the August ebulletin – so you will be able to go back to your colleague or group and compare your discussions, reflect on your practice, and record as CPD if you wish.
If you would like to share your reflections with us in advance of the next ebulletin, we would be pleased to receive your thoughts. Please do email us at: email@example.com
A note on CPD
Discussing cases like these are a useful way to explore and develop your practice, gain reassurance and feedback that you have acted appropriately, as well as give you ideas about how to deal with potential situations in the future. They can also cover Communication and consent and the four themes of the Osteopathic Practice Standards (OPS) depending on the nature of the discussion.
Keeping records of these discussions will eventually allow you to count this towards your objective activity requirement, should you wish.
A male osteopath has been treating a female patient regularly over a year-long period for complex health issues. This period has coincided with the patient separating from and divorcing her husband, and the osteopath has also undergone a relationship split during this period. The osteopath and patient have discussed this during treatment sessions. Over the past few weeks, the patient has started to bring in homemade cakes for the osteopath at each consultation. They tend to book the final treatment session of the morning, and share a coffee and cake afterwards. Now the patient has asked the osteopath round to dinner to see her new flat.
Q: Some questions for you to consider:
- What are the boundaries issues in this case?
- What are the relevant OPS and areas of guidance to support decision making?
- If a colleague reported this case to you and asked for your guidance, what would you say/do?
- If you were presented with a similar scenario, how would you manage this?
Watch out for the second scenario and our thoughts on this one next month.
Remember, we would be pleased to receive your thoughts if you would like to share your reflections with us in advance of the next ebulletin. Please email: firstname.lastname@example.org