Physician boundary violations in a physician's health program: a 19-year review

Managing and treating physicians with professional boundary violations is of paramount importance with vast implications for public safety. Physician Health Programs (PHPs) evaluate and monitor many, if not most, physicians receiving care for these abuses. We conducted a chart review of 120 physicians monitored for boundary violations. We made intergroup and intragroup comparisons (i.e., examining nonpatient, patient nonsexual, and patient sexual offenses). The violator group as a whole differed from the general PHP population, in that more were men between 40 and 49 years of age. More of the violators were mandated for evaluation and reported an abusive history. The rate of psychiatrists exceeded that typically seen by the PHP. Other differences were found according to the type of violation committed. Post hoc analysis revealed that physician-patients with a history of prior boundary violations were more likely to commit violations of a sexual nature. No further incidents were reported for 88 percent of the cohort.