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Research ArticleRegular Article

Physician Boundary Violations in a Physician's Health Program: A 19-Year Review

Elizabeth Brooks, Michael H. Gendel, Sarah R. Early, Doris C. Gundersen and Jay H. Shore
Journal of the American Academy of Psychiatry and the Law Online January 2012, 40 (1) 59-66;
Elizabeth Brooks
PhD
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Michael H. Gendel
MD
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Sarah R. Early
PsyD
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Doris C. Gundersen
MD
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Jay H. Shore
MPH, MD
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    Figure 1.

    Violator diagnoses. (Note that diagnostic frequency is greater than 100 percent due to multiple diagnoses.)

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    Figure 2.

    Physicians' explanations for violation.

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    Figure 3.

    Sources of referral to the PHP program.

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    Table 1

    Participant Characteristics

    CharacteristicPhysician-Clients with Boundary ViolationsGeneral PHP Populationp
    n%n%
    Gender
        Female9732631.000
        Male1119375469
    Age ranges, y
        30–39121029028.000
        40–49574835533.002
        50–59322724923—
        60–69119666—
    Marital status
        Married/cohabitating766364362—
        Single9819419.002
        Divorced/separated332819519.023
        Widowed225<1—
    Specialty
        Family practice221822521—
        Internal medicine181515414—
        OB/GYN108555—
        Psychiatry2622727.000
        Other443757453.001
    Mandated
        No474054851.013
        Yes726153249
    Abuse history
        No587087381.035
        Yes233020719
    • Because of missing data, not all categories equal 100%, and rounding causes some percentages to sum to more than 100%.

    • View popup
    Table 2

    Violation Categories

    Category/Type of Violation% of Category% of All Violations
    Nonpatient
        Prescribing6525
        Sexual harassment228
        Other135
    Patient, nonsexual
        Prescribing123
        Inappropriate examination behavior3510
        Dual relationships185
        Bartering31
        Religion31
        Hugging62
        Other247
    Patient, sexual
        Sexual intercourse3311
        Sexual activity134
        Former patient, sexual intercourse4314
        Multiple incidents104
        Other21
    • Percentages summing to more than 100% are due to rounding.

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    Table 3

    Violation Consequences

    NonpatientPatient NonsexualPatient Sexualp
    n%n%n%
    Legal action on license1739154434850.00
    License status
        Cleared to work419131913385—
        Probation/restricted/revoked2439615*
        Lapsed240000*
    Outcome
        No further violations349024832890—
        Further violations411517310*
    • ↵* Not applicable because of small sample.

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Journal of the American Academy of Psychiatry and the Law Online: 40 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 40, Issue 1
1 Jan 2012
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Physician Boundary Violations in a Physician's Health Program: A 19-Year Review
Elizabeth Brooks, Michael H. Gendel, Sarah R. Early, Doris C. Gundersen, Jay H. Shore
Journal of the American Academy of Psychiatry and the Law Online Jan 2012, 40 (1) 59-66;

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Physician Boundary Violations in a Physician's Health Program: A 19-Year Review
Elizabeth Brooks, Michael H. Gendel, Sarah R. Early, Doris C. Gundersen, Jay H. Shore
Journal of the American Academy of Psychiatry and the Law Online Jan 2012, 40 (1) 59-66;
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