How might a patient manifest fantasies toward medical professionals and how does the physician community view intimate patient relationships?
⚠️ Reader Discretion: Mature dialogue.
Medical Professional Attraction
Most fantasies remain within one’s head. But sometimes they migrate into reality. A few patients might have a paraphiliac proclivity towards doctors or nurses that exaggerates their perception of beauty and mutual attraction. The uniform may trigger exigent sexual attraction.
Inappropriate Conduct
The American Medical Association (AMA) clearly states that sexual contact that is concurrent with the doctor/patient relationship constitutes sexual misconduct. But it takes a fuzzier position on relationships that might develop later.
According to the 2020 Medscape Internal Medicine Ethics Report, 60% of more than 5,000 physicians surveyed, outright condemn a romantic or sexual relationship with a patient. Only a tiny minority (1%) give romance with current patients a green light, but a sizable share (30%) say that a romantic relationship with a former patient may be acceptable, at least 6 months after the professional relationship terminates.
It gets murkier when some weigh the type of medical care. Eye exams are considered by some professionals to carry less weight than oncology, gynecology, or psychology. But the white-coat fetish may eschew boundaries.
Unmasking the Physician
A common occurrence of white-coat attraction is a patient who is flirtatious with medical professionals. They may be doctors, nurses, or dental hygienists.
Let’s dissect a fictitious encounter between a female doctor and a male patient. From the moment the physician enters the examination room, the patient’s heart races. She introduces herself and, to confirm the patient’s identity, asks: “What is your date of birth?”
The patient notices a coy smile as the doctor lowers her head with uninterrupted eye contact to jot down the answer. The patient pauses as his fantasy begins. He complements the doctor’s appearance, which widens her smile. She gently slides a lock of hair behind her ear with a raised eyebrow and asks the next question. “Are you sexually active?”
The conversation, to him, seems like questions in a pick-up bar. Surprised by the context, the patient replies, “I don’t know. It depends on the extent of the examination.” The female doctor smiles and says, “I’ll put that down as a ‘yes.’”
“It’s time for your vaccination,” the doctor says. “First I need to check your heart rate to see if you can handle it. Lift your shirt please.” She places the stethoscope on his chest while reaching within a drawer for a huge syringe. When she turns back around her lab coat exposes her bra. “Pardon me. That wasn’t intentional. I hope you aren’t distracted.”
“No apology necessary. It’s not a problem. You can fasten that when we’re done. Where are you going to inject the needle?” he asks. “It needs to go into your large muscle. Can you lower your underwear please?” He grabs the waist of his underpants, but is interrupted by a question.
“What is your date of birth?” The patient realizes she is fully dressed, with him wearing a standard gown. She inquires with more insistence, “Please confirm your date of birth.” He now realizes that the last few moments occurred only in his imagination. Wondering if any part of this fantasy became audible causes his heart to race.
He anxiously responds before being asked again. “I’m a leapling. It’s February 29, 1984.” But the reverie is all too familiar to this patient. It happens each time he sees a female doctor, nurse, or dentist. And the notion of her coming on to him follows long after his visits end.
A Step Beyond Sex Addict
The preceding is a fictional example of mild episodic paraphilia (erotomania). While some medical professionals distinguish between fetishes (lifeless objects) and paraphilias (animate beings), MedicineNet categorizes fetishes as a subset of paraphilias.
The broader definition of fetishes identifies obsessions and problems with controlling impulses. These are characterized by amoral recurrent and intense sexual fantasies, urges, and behaviors involving unusual objects, activities, or situations not considered sexually arousing to others. The general public may view the behavior as distasteful or perverted.
Objects or situations can become arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. Twenty times more common among men than women, paraphiliac urges and behaviors can cause significant distress (anxiety, depression) and/or personal, social, or career problems. A long list of celebrities, politicians, and athletes have gone into rehabilitation centers for deviant behavior.
To be most effective, professionals recommend long-term paraphiliac treatment with diligent patient compliance. There is no single unifying theory that adequately explains the pathogenesis of sexual impulse disorders.
Currently, doctors may prescribe two distinct classes of psychopharmacological agents: antiandrogens and serotonergic antidepressants. People with paraphilia of an illegal nature must receive professional help before they harm others or create legal repercussions for themselves.
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To support the writing of useful articles about mental health, ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may sponsor specific articles or remit a small donation.
ClinicalPosters sells human anatomy charts, scientific posters, and other products online to offset expense of the writing useful articles about mental health. Slide extra posters into DeuPair Frames without removing from the wall.
ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may remit a small donation.
You can support the writing of useful articles about mental health by sponsoring specific articles or remitting a small donation. Visible content is optimized for device size.
