Control

I have had exactly 3 patients in my career that have made me uncomfortable. I have seen thousands of patients, some of which have even brought their 40 ouncers with them in the office. I have had patients ask me out that knew that I also saw their girlfriend and their children (I know, like I would really get messed up in that situation). I have taken care of prisoners, people in gangs, and many other situations that have NEVER made me uncomfortable.

So, it makes me wonder what it is about the 3 patients that have made me uncomfortable. Each situation I guess was for different reasons. The first patient was when I was starting working as a nurse practitioner, and he used to see me for many medical problems including sexual dysfunction. This patient then proceeded to call me in between visits and ask inappropriate questions. I then refused to see him and made my boss who was a man see him from then on.

The second patient that made me uncomfortable was an 18 year old male in for allergies. Once the visit was over, the patient got up and stood next to my chair and leaned over me so I really could not move, and then proceeded to ask me about movies. I really think the problem with this situation was the fact that he had invaded my space, but I had been in many other situations that were more dangerous per se, so I cannot explain other than a feeling that I had with this particular patient.

The third patient was today, and I really felt bad that he made me uncomfortable. He was a 21 year old male for a sports physical. He asked questions that are pretty routine such as how long have I been doing this, where I went to school, etc, that a lot of people ask. He then proceeded to ask about hobbies, and what TV shows I like. I mean really, who asks that of their health care provider who they just met! Now, I have been "hit on" many times by patients, but this made me uncomfortable because I am the one that asks the questions in my position.

The most likely factor in these situations is control. The balance of control had moved from my favor to the other person's. In my many other patient encounters I had not lost that position of power if you will, and in these situations that position seemed compromised. In all situations, I had been able to gain control, whether it was refusing to see that patient, or having my medical assistant in the room, or opening the exam door as soon as possible during the visit, which is a way to regain control without compromising the patient-provider relationship.

With all of my patient contacts over the years, I am just thankful that these situations have been limited to only three, and I am sure unfortunately, it will not be the last.