Shara Yurkiewicz, a second year medical student who blogs at This may hurt a bit, describes what happens when doctor-patient boundaries are unintentionally blurred.
At the very end of the exam, I tested his cerebellar function. Touch your nose and then touch my finger, I directed him, as I moved my finger. I told him he was doing well as he hit his marks. Then–probably out of boredom–he decided to touch my nose instead of my finger.
It was such a minor gesture, I doubt he even remembers doing it. But my face flushed as I realized its significance. A literal boundary had finally been crossed. Somehow, in the hour we had been together, I had let things decline so that this gesture seemed appropriate and natural for the patient. How had this happened?
Has this happened to you? Ms. Yurkiewicz’s point about how she’s perceived (young and female) is well taken. We’re often told that acting professionally eliminates awkwardness and inspires trust. At the same time, we frequently enter the room looking younger than a patient’s son or the same age as the patient herself. And so the author’s point rings true – acknowledge what you can’t change about the patient encounter, and practice, practice, practice to bring the rest to perfection.