Consultant appointment - we used to date

I wouldn’t hesitate to contact the department, explain the situation and ask for a different doctor.

It will be more difficult if you turn up on the day especially if he’s not comfortable to treat you.

If you go ahead with the appointment he is most likely to say I can't treat you as we have a past relationship. It would be unprofessional if him if he didn't.

My mum's friend was present for my vasectomy (not by invitation, she was a nurse 😂)
I occasionally see my GP in the pub. He's had his finger up my bum for a prostate exam. We just smile and pass the time of day quite normally.

I think he will have to pass you on to a colleague

I appreciate it is awkward to say you don’t want to see him/be treated by him (and I wouldn’t either) which is why (although I didn’t expressly say this) I suggested push it to them in flagging as a conflict matter you imagine they will want to handle, rather than expressing saying you don’t want to see him.

If they did come back after making them aware and say “oh no he is fine to continue” then I would say you really didn’t think it appropriate or professional for him to treat you in all the circumstances.

But I think you want them to make the call to move your clinician as makes it much harder for them to attempt to delay your treatment as opposed to trying to badge it as “accommodating patient preference”.

Yeah maybe you're right. I was kind of thinking it would be more ethical not to say anything. Even if he did remember her. And if she acknowledged it then respond. Otherwise just treat her like any other patient. In case she herself might not want it brought up?

But I guess I'm wrong.

In some other countries, treating friends/family is more acceptable than in the UK, both socially and professionally. In the UK, the GMC very much frowns on it, outside of immediate emergencies. They have got even stricter in recent years - it used to be tolerated to e.g. do a private prescription for antibiotics for a friend's ear infection - but now even that is not acceptable.

I'm yet another doctor here and wouldn't treat an ex, or any close friends, unless life-threatening and no alternatives. I do treat, and have been treated by, colleagues, because that's kind of unavoidable, but we always try to make sure both people are comfortable with the treating relationship.

OP asked about telling her husband - I don't think it's the sort of thing to keep a secret, especially as hopefully you won't actually be treated by this guy - but I might mention it more as a "small world" sort of thing.

I started in practice in 1975 and so far as I know in the NHS its always been as I have described it.

It's a massive no-no to treat close friends and family in the UK (has been for a long time), but completely bonkers to treat someone you've had a sexual relationship with in anything other than an immediately life-threatening scenario (and even then you'd be doing what was necessary whilst phoning a friend to come in and take over). Not only does the added cognitive load and lack of objectivity make the job higher risk (doctors are skilled professionals, but most of all they're only humans!), the consultant would be very vulnerable if the OP ever decided they weren't happy with any element of the care they'd received (and spurious allegations of misconduct definitely do occur). It's weird enough looking after people you know either from work or in a vague social context - doing an intimate procedure electively on someone you DTD with would be daft unless there's literally no alternative (and even then they'd be daft to not discuss it with their clinical lead and probably medical indemnity company so they knew what was happening and why it was unavoidable, the consent process would probably reference that this isn't ideal, and the presence of a very visible chaperone would also be absolutely non-negotiable).

Fair enough, seems like policies and attitudes have changed a lot over years.

Come from a clan of doctors so used to seeing people I know or family friends for my medical needs. Usually still do (not in the UK), I've never really thought of it this way.

The main conflict I can see is that a doctor that knows me/ is my friend will likely treat me more favourably than other patients.

My midwife was one of the mums in my daughters class at school.
She delivered one of my boys. She also delivered lots of the children in Dd's year at school.

great answer. Unless, as others have said, the treatment is both urgent and unusual ie there is no one else who could do it, then it should be easy to move the appointment and keep approximately the same timeline.

I would phone the clinic and say

• I have an appointment with Adam Smith with a view to treatment X
• I want to make you aware in advance that he and I used to be in a relationship so I am assuming he will need to recuse himself from my treatment particularly as this treatment involves intimate body parts.
• He likely doesn’t appreciate I am coming to see him as he knew me as Kate Jones but my name is now Kate Miller.

If they say (either initially or later) oh yes we will move you but then try and suggest it will be a lot longer because alternative has a long wait I would be clear that obvious the hospital cannot being suggesting that they will penalise me due to the consultant’s professional obligations and conflicts and I expect to be seen in around the same timelines.

Any BS and I would be going straight to Pals.

its not a puritan thing. For one thing, its a massive risk to the clinician. The most obvious thing would be a "revenge allegation" by the patient, but there are other possibilities,eg the patient regretting allowing the appointment to continue and then complaining to the hospital that she was upset by the situation but wasn't offered an option and felt forced into it. I used to be a clinician involved in investigating much less serious complaints so I took the training and believe me such things happen.

What is the exact issue exactly? I.e. what do you think could happen at this appointment that is relevant to the 2 of you having gone on a few dates many moons ago?

Whatever I am getting done in any capacity, if it's someone I know, it's always a plus. If it's a doctor, massage, dentist, something else physical, if I had an ex I had no issues with that would work in that specialty, that would be great. For example my uni ex is my physio and another does some car bits for me.

If the breakup wasn't dramatic, I am confused about the issue.

Unless it's some quite of puritan thing of not having contact with any former partners once married or similiar, which it sounds like it might be.

This and it would breach his code of professional conduct.

It would be unprofessional of him not to acknowledge they used to shag. Yes obviously not just "haha I've seen you naked". But he absolutely should acknowledge they have a previous personal relationship

They dated, he will likely remember her.

At an absolute push he should speak to OP and see if she is happy to be treated by him. But better to rebook her with a colleague, OP could avoid all that by just contacting the department now

Imagine there's a complication, which happens. Then questions are raised, was he distracted because of their shared history? Was he trying to harm her? Was he rushing to get her out the room? Or a complication with a later patient, did he give preferential treatment to OP because of their history?

Even if none of the above are true, the questions will still be there and it's just not ethical.

Yep, there's a good reason why many GPs - including all the ones I know - live a minimum of 7-10 miles from the surgery. They don't want their patients as neighbours!

A friend and former teaching colleague went for her smear test.

’Hello Miss’. My friend early 60s. Nurse and former pupil mid 20s.

To her credit the nurse asked if my friend would like someone else to do the smear.

But my friend said thanks but no, let’s get on with it.

There's very firm guidance for doctors regarding treating people they have a close personal relationship with - basically don't unless it's an emergency. There are also strict rules on not having relationships with current patients. Developing relationships with former patients is a bit more of a grey area though - it's discouraged generally but there are circumstances when it might be acceptable.
I would see this situation as a similarly grey area. You are not in a close personal relationship now, but you have been. He's not a doctor having a sexual relationship with a former patient but he is a doctor potentioally having a professional relationship with a former sexual partner which is similar and doesn't sit easily with me.
I would probably contact his secretary and just say something like "Dr X and I knew each other well in the past, he'll remember me as X. Could you let him know as it might be better if I see someone else".
These things are not always black and white though. I worked in a small hospital in a rural area and if every member of staff declined to treat every patient they knew we would never have got anything done. Personally I tried to avoid treating or being treated by people who were real friends but it can't be avoided in every circumstance. For instance I resuscitated a friend's baby and one of my own children was delivered by someone I see socially. If you're in a small place, he's the only one who does the procedure locally and it's urgent, it might be justifiable, but if circumstances allow an easy transfer if care to someone else that would be far better from an ethical point of view, and you'd probably both be more comfortable too.

I needed to see a Gynaecologist for something that I also didn't want/couldn't/shouldn't delay. The referral came through and it was for the Consultant Gynae that happened to be the husband of a mum friend I'd made when the children were all at junior school. Was definitely him, also unusual name, and I knew anyway as saw them often enough to know he worked there (just hoped it would be someone else). I just called and asked to see someone else - they didn't even ask why, and arranged another appointment for me. Turns out I needn't have bothered as he left the NHS and went fully private before my appointment date. But still, wasn't about to do small talk with my feet in stirrups, when I'd likely be seeing him at a dinner party or playdate soon afterwards.

He really shouldn't be treating you - I'd run a mile from having medical contact with a patient I knew socially, it's a minefield. Call the secretary, explain and ask them to swap you to a different consultant.

I'm amazed you have to ask.

Whether you tell your dh or not is irrelevant.

I think you should inform the hospital. The consultant might cancel on the day if he feels there could be any suggestion of a conflict of interest (which an awkward joke would definitely imply). That might delay your procedure. Better to get ahead of the situation now.