How Physicians Can Deal With Patient Stalkers

Ever had a patient call your personal phone number repeatedly - both day and night? How about a patient who frequently shows up at your office bearing inappropriate gifts or expectations? Or a patient, who suddenly starts attending your gym at the same time as you, stops by your home because she is “just in the neighborhood,” and shows up at the community pool when she knows your family will be there? 

Stalking can mean many different things to different people and the legal definition of stalking varies state-to-state. For the purpose of this blog, I’ll characterize it as inappropriate behavior presented by a patient that is directed at you and makes you feel uncomfortable and continues to occur repeatedly despite your warnings that it should stop.

Unfortunately, patients demonstrate such stalker-like behavior more often than you might expect.
According to preliminary findings from a recent survey of physicians at Penn State University Medical Center in Hershey, Pa., and Thomas Jefferson University Hospital in Philadelphia, 20 percent said that on at least three occasions, one of their patients had demonstrated stalking behavior, according to MedPage Today. The most common behaviors reported were unsolicited phone calls, letters, faxes, and e-mails.

Yet, what’s more disturbing is that 80 percent of the physicians surveyed said they had no training in dealing with such behavior. If you’re one of those physicians, here are some tips for how to cope if a stalker patient heads your way:

Don’t Make It Easy For Them:

Stalkers often harass physicians - as represented in the survey - through e-mail, phone calls, and letters. Though it sounds simple, keeping your personal information private may minimize such behavior, or prevent it from escalating.

In an article appearing in Canadian Family Physician, family physician Donna Manca, a victim of patient stalking herself, writes that physicians should avoid listing private numbers where patients can access them, such as in telephone books. Also, block your telephone number when contacting patients from your personal line.

Of course, the Internet further complicates things. If you use social networking sites, keep as much of your information as private as possible.

Keep in mind that patients might be able to access your personal information, such as a home address and phone number, by conducting simple Google searches.

In an article appearing in MDNG Primary Care, family physician Enoch Choi recommends conducting three Google searches: one on your name with “Dr.” or “MD,” one on your home address, and one on your personal phone number. If you find a site that lists your personal information, Choi suggests e-mailing the webpage administrator (contacts are often located at the bottom of a webpage) and asking them to delete the information.

Other things he recommends looking into:

• If your state license information is posted, make sure it does not include personal information;
• If you registered your business with your local chamber of commerce; make sure personal information is not available on a public page;
• If you registered your practice’s website URL using your personal name and/or phone number, stalkers may find it by inputting your web address intothis website.

Be Firm and Document

As soon as an individual begins presenting stalker-like behavior, address it, advises StalkingBehavior.com, which provides resources to stalking victims. Also be firm that the behavior is inappropriate.

“Avoid using tones or phrases that could be misconstrued as implying a second chance or playing hard to get,” the site advises.

Guidance issued by The Massachusetts Medical Society and ProMutual Group (currently Coverys) for a 2006 CME course suggests explaining that your relationship with the patient is strictly professional and must remain so. Also, let the patient know that if his stalking behavior does not change, you will need to contact the police and/or dismiss him from your practice. Consider asking a member of your staff to join you in the room during this conversation to serve as a witness.

In general, it’s also a smart policy whenever encountering a patient that presents problem behavior (such as stalking) to thoroughly document any conversations you have with him regarding the behavior, and document any incidents that occur.

Dismiss When Necessary

In some cases, you may decide that dismissal is the appropriate course of action when dealing with such a patient - especially if the patient is threatening to you or if he refuses to change his behavior.

Make sure, however, that you dismiss the patient the right way (i.e., provide him with an adequate notice period, if warranted; provide him with a copy of his medical record, etc.).

In some cases, disgruntled discharged patients may choose to file a complaint or claim against you. This is one reason thorough documentation is important. It will show that you had a valid reason to discharge the patient.

If the stalking continues, the guidance issued by The Massachusetts Medical Society and ProMutual Group recommends notifying the police and requesting a restraining order. Also, consider seeking legal advice.

It may also be a good idea to contact your medical malpractice insurer for guidance on how best to handle the situation.

Use Your Best Judgment

Promptly notify the police if the stalking behavior is threatening and/or abusive and you fear for your safety, your family’s safety, and/or the safety of your staff.