How close should you be to your patients?

The level of emotional investment depends on the doctor and the patient, but there should be a balance of feelings and objectivity.

By Damon Adams, AMNews staff. Aug. 25, 2003.

More than three years after Blanche's death, signs of her life still occupy her doctor's office, reminders of the bond the two women shared.

Carolyn Thiedke, MD, a South Carolina family physician, has one of Blanche's candy dishes filled with peppermint patties, Blanche's favorite. In a desk drawer, she keeps Blanche's prayer book, another memento given to the doctor by the patient's family.

Dr. Thiedke had a special connection with Blanche, whom she visited at home once the elderly patient became too frail to come to the office. They chatted about their children and church. When Blanche died, Dr. Thiedke went to the funeral and visited the family to help her deal with her grief.

For Dr. Thiedke and many other physicians, getting close to some patients is a natural part of practicing medicine.

Doctors and educators say a certain level of emotional investment can help build a strong patient-physician relationship. But the level depends on the comfort of the physician and patient. They warn that physicians should be careful not to cross ethical boundaries and not to form a bond that jeopardizes their objectivity.

"I've been comfortable with the closeness of patients. Sometimes, that means sending them birthday cards and communicating with them by e-mail," said Dr. Thiedke, associate professor of family medicine at the Medical University of South Carolina in Charleston. "You may find doctors who say it's OK to attend a [patient's] funeral. You may find fewer who say it's OK to go with a patient to lunch."