Can doctors be friends with former patients?

Violation of the professional code as a reason for an official complaint

The behaviors listed below represent a violation of the professional regulations of psychological or medical psychotherapists and can give rise to an official complaint:

  • If the therapist does not provide the patient with sufficient information about the psychotherapy approach and the costs involved at the start of treatment. He should provide information about why the treatment is necessary, what type of therapy is being carried out, what methods are being used, how long the therapy is likely to last, what risks may arise and what alternatives there are to this type of treatment. Furthermore, he should also provide information on practical aspects, such as how long a session lasts, how often the sessions take place and which rules apply if the patient has to cancel an appointment - in particular, when cancellation fees are due and how high they are.
  • If psychotherapy is not carried out professionally and to the best of our knowledge and belief, e.g. mistakes are made in diagnosis or treatment. Professional practice also means that the therapist regularly takes part in further training and supervision in order to ensure a high quality of therapy. However, a treatment error does not necessarily have to be present if the therapy does not lead to the desired improvements - because even with a professionally performed therapy there is no guarantee of success. If, as a patient, you have any doubts about the way the therapy is carried out, it is best to speak to your therapist or contact an expert advice center.
  • When unrealistic hopes or promises of improvement or cure are made to the patient.
  • When a therapist does not behave respectfully and with dignity towards the patient and his relatives and, for example, insults or insults them.
  • When the therapist indoctrinates the patient politically, ideologically or religiously.
  • When a therapist disregards the principle of abstinence, that is, when he / she enters into a private relationship with the patient. The background is that therapists are not allowed to abuse the psychotherapeutic relationship of trust to satisfy their own interests and needs. They must not take advantage of the trust, ignorance or helplessness of patients or derive any personal or economic advantages from the relationship with the patient. Therapists should therefore maintain a professional distance from their patients and should not enter into a private relationship with them. Furthermore, the practice rooms must also be separated from the therapist's private living space.
    Therapists are not allowed to go out to dinner with their patients or do other private activities. You may not accept any gifts, gratuities or inheritances from them, request or accept any services and not be in a business or employment relationship with them. It is particularly serious when a therapist makes sexual offers or when sexual acts occur. Section 174 c of the Criminal Code prohibits therapists from engaging in sexual acts with clients and patients.

    Conversely, it can sometimes be the case that a patient feels and expresses affection for the therapist. A professional therapist should respectfully but firmly reject such behavior and show the patient the limits of the therapeutic relationship.
    The therapist's rule of abstinence also applies to people who are close to the patient - to children and adolescents who are in therapy, especially to their parents or legal guardians. Finally, the abstinence requirement also applies after the end of therapy until the patient has broken away from the therapeutic relationship - in any case at least one year after the end of treatment.
  • When a therapist breaks confidentiality. He is not allowed to give any information to third parties about the patient and the content of the therapy - unless the therapist has released the therapist in writing from his duty of confidentiality. There is also a breach of confidentiality if therapy reports from other patients are lying around openly during the therapy session.
    An exception to the duty of confidentiality only applies if a patient puts himself or others at risk and the therapist considers measures to protect the patient or other people to be necessary. Another exception applies when it comes to the protection of a higher legal interest - for example, if a patient reports in therapy that he is planning a criminal offense.
  • When a therapist does not allow the patient to see the treatment records. An exception is only possible if there are substantial therapeutic reasons against it or if the therapist suspects that the inspection would seriously endanger the patient's health. If a therapist refuses to view the treatment documents, he must justify this to the patient.
  • If therapy sessions cannot be carried out smoothly, for example if the phone rings repeatedly during therapy sessions or there is knocking on the door or if a therapist repeatedly starts or ends the sessions too late. A session usually lasts 50 minutes, and the therapist should fully devote this time to his patient.
  • If a therapist sets unreasonable conditions for paying cancellation fees or charges an unreasonably high cancellation fee for therapy sessions that are not canceled by the patient in good time. As a rule, the therapist should clarify questions about the fee with the patient at the beginning of the psychotherapy and put them in writing in a treatment agreement. Furthermore, the therapist must give the patient the opportunity to cancel an appointment with a reasonable notice without incurring a cancellation fee. According to the law, a patient has to pay a cancellation fee if he does not cancel the therapy session up to 24 hours in advance. Statutory regulations also apply to the amount of fees that privately insured patients or self-payers have to pay. The amount of the fees is based on the fee schedule for psychotherapists (GOP). If a therapist sets fees that deviate from these fees, he must agree this in writing with the patient at the beginning of the therapy.
  • If a therapist does not respond to patient queries in a timely manner while treatment is ongoing. If he is unable to do so, he must provide the patient with an alternative contact option.
  • When a therapist videotapes or tapes therapy sessions without the patient's consent. If the therapist wants to record therapy sessions, he must first obtain the patient's consent.

The professional code of conduct for alternative practitioners is not legally binding and does not include a list of possible misconduct that can give rise to an official complaint to the competent chamber in the case of psychological or medical psychotherapists. Nevertheless, this list can also be a clue for patients of alternative practitioners as to which behavior of their therapist is no longer acceptable.

Limitation periods for professional misconduct

For all professions - doctors, dentists, psychotherapists - the procedures are regulated in the so-called Health Professions Act. These health professions laws are a matter for the federal states, i.e. they are regulated differently in each federal state. There is a limitation period, but it differs from state to state and can be found in the respective health professions law of the state.

  • For Bavaria e.g. (HBG, Section 66, Paragraph 2, Sentence 1) the period is 5 years.
  • In Schleswig-Holstein, on the other hand, the limitation period for professional misconduct is regulated in Section 56 of the Medical Professions Act (HBKG) and is three years:
    Section 56 HBKG (limitation period) -Excerpt-
    “The prosecution of a professional offense expires after three years. If the act violates a criminal law at the same time, the prosecution does not expire earlier than the prosecution of the criminal act; the statute of limitations for prosecution is suspended until the criminal proceedings have been finalized. ...
  • The PTK Rhineland-Palatinate refers to § 12 HeilBG RLP, according to which the board of the Chamber of Psychotherapists no longer conduct professional proceedings if more than five years have passed since the breach of duty.