Managing a doctor-patient conflict

I am a medical doctor and was dating a man for two years until we broke up mainly due to his mother’s interference. Recently, his mother and him came to my clinic but because of the breakup I believe that I was not the right doctor for them and recommended them through a nurse to go to a nearby clinic. They reported me to the Medical Council of Tanzania. What should I do?

EW, Mwanza

This may sound hillarious but is indeed serious. In our opinion, your decision to refer your former partner and his mother to another nearby clinic may be professionally defensible if it was genuinely based on concern that the prior personal relationship created a conflict that could compromise your professional boundaries. The key issue is whether you acted in the patients’ interests rather than out of retaliation or personal hostility, and whether appropriate alternative care was reasonably available. However, particular attention should be given to whether either patient required urgent or emergency treatment, because the Medical, Dental and Allied Health Professionals Act, 2017 identifies “abandoning a client who is in need of attention” as conduct capable of constituting professional misconduct.

In these circumstances, we advise you to separately prepare a dated factual chronology recording what occurred, including why you considered yourself unsuitable to treat them, what instructions you gave the nurse, and whether their clinical urgency was assessed. This is important because the Council will assess the evidence and records submitted to it. The complaint itself does not establish misconduct. Under Regulation 3 of the Medical, Dental and Allied Health Professionals (Inquiry) Regulations, the Registrar must receive, analyse and categorise complaints according to their significance and seriousness. In the end, you must be given an opportunity to appear and may be represented by a legal representative. Your response should remain factual and restrained: explain the pre-existing personal relationship only to the extent necessary to establish the potential conflict, state that the referral was intended to preserve appropriate professional boundaries and facilitate independent care, and provide evidence of the alternative care offered. You can seek further guidance from your lawyer.