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By Kevin Pezzi, MD

Patient attracted to her doctor; doc seems interested. Can they date?

Q: Your site had a story about patient-doctor attraction. I have a situation I am not clear about. A friend told me I am suffering from transference, but I don't think so. At first I was not attracted to this surgeon, in fact, I was annoyed with him and tried to change doctors. He was aloof, brief, and arrogant. After surgery, I noticed a real warming up. He would sit in my room and chat about non-medical things. At appointments, he spent a great deal of time with me, 20-30 minutes, and did all the dirty work like cleaning incisions, bandaging, etc.

I found later that others who went to him had only a few seconds to a few minutes with him during appointments, and that he sent in his nurse or PA to do the dirty work. I also notice his voice gets very soft and higher pitched when he is up close. I really feel there is a mutual chemistry there, but am afraid to say or do anything about it. I am trying to find a way to let him know I am open to a personal relationship after the doctor-patient relationship ends. I will really miss the opportunity to chat with him. He is a genius and I could listen to him for hours.

I literally could feel my eyes dilating the last time he was examining me. It was just my leg, but I found myself admiring his hands! Do you think he can tell I have these feelings?

One of my friends says this doctor is probably just comfortable with me and uses the extra time to take a little break from the routine.

Maybe I should just put this aside and assume if he is interested and available that he will find a time and a way to approach me? Or should I give him a parting thank-you note when I am released, that suggests I am open to being friends after the doctor-patient relationship ends?

I find him very attractive and I am fairly certain he is spending considerably more time with me than his other patients. What does a doctor do when he is attracted to a patient? How would I know?


Answer by , MD: Before I discuss what I think is going on, I will dismiss the alternative explanations:

Transference? Humbug! Transference is the psychoanalytic process by which emotions originally associated with one person are unconsciously shifted to another person, especially to the analyst or, according to your overly analytical friend, the surgeon. One need not invoke such a deep explanation for your response, which, as I see it, is simply the basic human tendency to like people who are kind and take the time to express genuine interest in others. Or is it genuine interest on his part? I'll return to that later on, at which time you'll realize that this matter is not as simple as it may seem.

Surgeons at work
Most surgeons aren't this friendly . . . or attractive!

Another one of your friends opined that the surgeon is “just comfortable with” you and is using “the extra time to take a little break from the routine.” I burst out laughing when I read that explanation! Let me guess . . . your friend does not work with surgeons, right? Your surgeon was initially aloof, brief, and arrogant—in other words, a typical surgeon. Genuinely nice people tend to gravitate toward pediatrics or family practice, not surgery. Offhand, I cannot think of any surgeons I know who have captivating personalities. I knew one who was the prototypical nice guy, but he disliked surgery so much that he quit practicing medicine and is now a bartender in Montana. I won't paint with a broad brush and claim that all surgeons are antisocial, but of all the arrogant, pompous, “me, myself, and I” jerks that I've known with an MD degree, all were surgeons and none were pediatricians or family practice docs. A coincidence? Not in my mind. Different specialties tend to attract medical students with different personalities, and the training they subsequently receive further molds and magnifies their innate behavior. Let's just say that surgical residencies are not conducive to producing warm and fuzzy human beings.

What could make the surgeon chat about non-medical things for a half-hour and do the dirty work that he would ordinarily delegate to his nurse or PA? One thing is clear: he wants you to like him. The question is, why? Ten-to-one, he likes you. Or, to remove any trace of ambiguity, he has the hots for you. But why wasn't this apparent attraction evident from the start? Ah, now is where it gets interesting. Ready? Take a deep breath . . . .

I have never seen your picture, but I would bet that you are attractive. However, it takes a man less than a second to determine if a woman is attractive. Surely the surgeon realized that the first time he walked into your room. Men generally do not waste any time cozying up to beautiful women. Therefore, his delayed expression of interest is a bit puzzling, at least on the surface. Could he be slow? Scratch that one—he's a surgeon and, as you noted, a genius. No, he didn't need weeks to figure out that he is attracted to you.

Do you like what you see?

Your message suggests that your surgery was on your leg. I don't know which part of the leg it was, but here is something to consider: as a patient is being prepped for surgery in the OR after anesthesia is induced, surgeons see more of you than you may realize. Perhaps he liked what he saw.

Or perhaps not. Perhaps he doesn't even like you. Recall my “ten-to-one” odds? Those weren't million-to-one “it's a foregone conclusion” odds. Nope, there is a lingering doubt that something else may explain the surgeon's 180-degree behavioral transformation. At the top of that list is a slim chance that he botched something pertaining to your surgery and his sudden warmth is his way of mitigating the chance that you will sue him. That is, if you ever discover the error. Some errors are immediately obvious, and some are not. You did not mention any surgical complications, thus minimizing the chance this explanation is correct. Yes, it was a stretch, but one must leave no stone unturned in trying to explain once-in-a-blue-moon events, such as a surgeon morphing from a brusque doctor to a sweet-as-honey man.

OK, enough waffling. If I had to commit to one explanation, I would not hesitate to guess that it is plain ol' hormones—not fear of a lawsuit—that is motivating your surgeon. However much he would like to wrap his alluring hands around your body, there is one thing preventing him from doing what men usually do in such cases: ask for a date. What's that thing? His medical license or, more to the point, his desire to keep it. State medical boards generally take a dim view of doctors becoming romantically involved with their patients. However, even the staid American Medical Association seems to give a pass to doctors who become involved with ex-patients. That, my dear, may be the green light that your surgeon is waiting for, but don't hold your breath. I was once so overly cautious and stupid that I guessed—without researching it, I might add—that doctors were ethically prohibited from pursuing romantic relationships with any patient, current or former. That overly strait-laced sense of propriety kept me from reciprocating interest in various female patients who flirted with me. I met those patients in the ER, so they were minutes away from being ex-patients. In retrospect, I probably could have called them or sent a note afterward, but instead I chose the safer alternative and went back to playing with my transistors, diodes, integrated circuits, capacitors, inductors, resistors, and other gizmos. Could be why I'm still single.

Back to your quandary. You don't know how much your surgeon knows about the ethical guidelines governing physician-patient romance. For heaven's sake, I graduated in the top 1% of my class in medical school and could tell you things about parts of your body you don't even know you have, yet I didn't know the first thing about something that mattered much more to me: if a woman who looked like a Swedish model basically threw herself at me and hugged me for the better part of an hour (it really happened; I recounted this story in Love & Lust in the ER) . . . well, could I say yes? It turns out that I did not have to go back to those friggin' transistors and whatnot, but I did not know that at the time. Your surgeon may be as uninformed as I was about this topic, so you cannot assume that he will make the first overt move if his seeming affection is real.

In other words, you must make the first move. However, if you wish to maximize your chance of success, there is something that you must do. One important preface or addendum will make him much more likely to say yes. I would preface my discussion with him by saying something along the lines of, "I appreciate the great medical care you've given me, but I am looking forward to the time when I will no longer be your patient because I would like to ask you out for a date, but I realize that you, as a doctor, are probably somewhat apprehensive about this even though the AMA doesn't prohibit doctors from dating ex-patients." Or perhaps you could say something such as, "You are a wonderful doctor and I've really enjoyed interacting with you. If I knew you were single, I'd ask you out for a date." Of course, how that message is delivered is crucial. I think smiling and a slight playfulness would be best.

Let me know how things work out!

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