Increasing numbers of patients are making amorous advances to doctors through Facebook, Twitter and text messages in order to try to strike up a relationship.
Figures compiled by the Medical Defence Union (MDU) show that the number of cases of doctors seeking its help because they are being pursued by a lovestruck patient rose from 73 in 2002-06 to 100 in 2007-11. Patients are increasingly using social media rather than letters or flowers to make their feelings clear, such as following a doctor on Twitter, "poking" them on Facebook or flirting with them online.
"Members report being bombarded with messages to their mobiles or email, and Twitter or Facebook accounts can, in some ways, be even more intrusive than receiving a stream of letters," said Claire Macaulay, a medico-legal adviser with the MDU, which advises doctors about their professional conduct.
"The Facebook cases involved inquiries from doctors about what to do about a patient who had sent them a friend request via Facebook or had somehow managed to view their profile.
"Sometimes the patient had already been 'overly familiar', for example asking them out for a drink, or sometimes it was out of the blue, for example a friend request from an ex-patient which they didn't know if they should accept or respond to."
One patient who had sought friend status then requested an appointment over a doctor's Facebook page.
A female GP was asked out for a drink by a male patient as she left her surgery. When she declined, he began to pester her via Facebook and sent her a bunch of lilies, which she had listed as her favourite flowers on her Facebook page. On MDU advice, she changed her security and privacy settings on the site so that only chosen friends could view her postings.
In another case, a male GP began receiving gifts and amorous letters from a patient with mental health problems. The woman continued to approach the doctor, even though he had explained that such contact was inappropriate, then sent him repeated friend requests on Facebook.
Another GP at the practice assumed responsibility for the patient's care. Soon afterwards, she complained to the General Medical Council (GMC) about the first GP, claiming they had had a sexual relationship, which he denied. The GMC cleared the doctor of wrongdoing, but only after a six-month investigation.
"Such contact involving Twitter tends to be the same sort of thing as Facebook, with patients following doctors or sending them messages about meeting up, or sending flirty/sexual messages or asking personal questions," said Macaulay.
One of the UK's leading GPs warned that obsessive contact from patients could lead to doctors being stalked. "In an increasingly litigious culture, doctors are very careful to maintain very clear professional boundaries," said Dr Richard Vautrey, deputy chairman of the British Medical Association's GPs committee. "It can become very distressing when a patient tries to step across these boundaries, and in particular should that move to a stalking or abusive situation."
In guidance issued in July on use of social media, the BMA advised doctors and medical students not to accept Facebook requests from current or ex-patients because of the "difficult ethical issues" and also to adopt "conservative privacy settings" on their Facebook pages. The 100 cases of unwelcome advances by all methods involved 72 male and 28 female doctors. Family doctors were the most common targets. Among the 100 doctors, 72 were GPs and 28 hospital clinicians, including psychiatrists and gynaecologists. The MDU handles between 10 and 30 such cases a year.
Dr Clare Gerada, chairwoman of the Royal College of General Practitioners, said some patients can mistake doctors' behaviour.
"Patients see doctors when they are vulnerable, and doctors are trained to maintain professional boundaries at all times. In some cases, however, where there may be vulnerable patients who have experienced traumatic events, they might misinterpret their doctor's compassion for something stronger."
The MDU advises doctors to keep a log of all such contacts and consider getting a colleague to conduct all future consultations with such patients.
"Social media presents doctors with significant dilemmas," said Dr Tim Ringrose, chief executive of Doctors.net.uk, a professional networking site for doctors. "Their careers – and in some cases personal safety – can be at risk."
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