New and Evolving Dimensions in the Pediatrician-Family-Patient Relationship: Maintaining and Managing Boundaries: Clinical Report.

Abstract

Maintaining and managing boundaries in relationships with patients and their family members remains extremely important for the practicing pediatrician. Technological innovations that facilitate communication and information sharing, such as social media, have created new dimensions within the pediatrician-family-patient relationship. Shifts in patient and family expectations of the medical profession that have occurred over time, such as a greater desire among patients and families to have increased access to their pediatrician, also present novel challenges to traditional professional boundaries. Further, social and political issues that have bearing on the practice of medicine have raised questions about pediatricians' role as advocates for individual patients and child health within the pediatrician-family-patient relationship. The 2009 AAP policy statement, "Pediatrician-Family-Patient Relationships: Managing the Boundaries," offers guidance for pediatricians in navigating several key scenarios regarding professional boundaries, including accepting gifts, dual relationships, and romantic relationships with patients or caregivers. Since the content in this 2009 policy statement remains relevant, the intent of this clinical report is to complement the 2009 statement and provide guidance for navigating new and evolving dimensions of the traditional pediatrician-family-patient relationship, including advocacy within the pediatric clinical encounter, self-disclosure, and social media relationships with patients or caregivers.