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Love, Boundaries, and the Patient-Physician Relationship
Neil J. Farber, MD;
Dennis H. Novack, MD;
Mary K. O'Brien, PhD
Arch Intern Med. 1997;157(20):2291-2294.
Abstract
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Physicians often use their relationships with patients to promote specific therapeutic goals. Because of their personal histories, values, and biases, patients may react to physicians in ways that inhibit or enhance the relationship. The feelings that are aroused may induce physicians to become overly distant, engendering patient and physician dissatisfaction, or to become overly involved emotionally, which can have serious psychological and clinical consequences. We explore how a balance between clinical objectivity and bonding with the patient is optimal and achievable. The nature and origin of personal boundaries are described. Boundary transgressions on the part of the patient are discussed, and the means of preventing transgressions by both patients and physicians through medical education, the process of self-awareness, and an exploration of family-of-origin issues are proposed. Through attention to communication with patients, the physician can maintain an empathetic yet objective relationship with the patient.
Arch Intern Med. 1997;157:2291-2294
Author Affiliations
From the Department of Medicine, Veterans Affairs Medical Center (Dr Farber) and Allegheny University of the Health Sciences (Drs Farber, Novack, and O'Brien), Philadelphia, Pa. Dr Farber is now with the Christiana Care Health System, Wilmington, Del.
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