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    Maryland Department of Health
    State Board of Chiropractic Examiners

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    Recent Board Policy Clarification regarding Personal Patient Relationships

    It is incumbent on every licensee and registrant to avoid boundary violations involving intimate or romantic or fiduciary relations with individuals while the latter are patients/clients. Both the chiropractic and massage professions regulations prohibit such conduct. Occasionally, licensees/registrants seek a clarification on when it is appropriate to date or develop a personal relationship with an individual after the professional status ends. The following is offered as clarification to this issue.

    MD Code Ann. Health General Section 1-212 establishes guidelines regarding relationships with a patient. Under this section, no personal relationship is authorized while an individual is in an active patient/client status.

    Situations where a relationship initially arises after the patient status ends: Once official patient/lient status ends, the licensee/registrant is free to develop a personal relationship with the former patient or client. The practitioner must insure that healthcare services have officially ended and not resumed before a personal relationship begins.

    Situations where a relationship arises during patient status: If the practitioner believes that he/she and the patient are developing a personal relationship, the practitioner is advised to counsel the patient, terminate the relationship; and document the termination.

    Significantly, every set of circumstances is different. Accordingly, even if the patient status terminates, the practitioner may wish to engage in a “cooling off period” to avoid the appearance of a perceived conflict of interest or boundary violation. The length of such a period should be prudently determined by the practitioner to avoid any appearance to a 3rd party of conflict or violation. If in doubt, impose a lengthier period.

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