Physicians hugging patients — empathetic or inappropriate?

Mackenzie Bean (Twitter) -

A strong patient-physician relationship requires a certain level of trust and intimacy, but how much intimacy is too much?

While some physicians believe hugging patients is appropriate in certain circumstances, other members of the healthcare community say the physical gesture can be unwarranted or make patients feel uncomfortable, according to an op-ed article in Medscape.

Lucy Hornstein, MD, a family physician in Phoenixville, Pa., sees hugs as a physical sign of caring. "How much more viscerally and subliminally can you express that you care about someone?" she told Medscape. "You can say, 'I care about you,' and touch them on the arm or shake their hand, but that's not the same as putting your arms around someone. It's the most primal way of expressing care."

Opponents of hugging patients say the action may violate a patient's personal space and right to deny specific physical contact. Patients consent to physicians touching them during a clinical exam, but may be uncomfortable with other forms of contact. The hug could also be misinterpreted as a romantic gesture or sexual advance, potentially exposing the physician to sexual harassment charges. Other physicians believe the hug could be culturally offensive to some patients or come off as unprofessional.

Ultimately, the hug's appropriateness will depend on a physician's specialty, the clinical scenario, the length of the patient-physician relationship, cultural factors, and the patient and physician's personal preferences, according to Dr. Hornstein.

"As doctors, it's our responsibility to read the nuances of a situation and err on the conservative side," she told Medscape.

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