The patient-registrant relationship is a fiduciary relationship based on honesty, respect, and trust, where the registrant prioritizes the patient’s care and well-being. This relationship forms the foundation in which good medical care can occur, however, it can become fractured.
Breakdowns in a therapeutic relationship can occur for a variety of reasons. CPSBC acknowledges the difficult environments registrants are currently working in, especially as demand continues to increase.
Additionally, CPSBC recognizes the importance of clinical judgement and treating patients based on what is most medically necessary in that moment. Striking a balance between promoting patient autonomy, active listening, and strong communication, while also setting boundaries about what is medically necessary based on clinical expertise, becomes vital in preserving the therapeutic relationship.
Situations do occur where relationship breakdown can become a safety risk. Safe practice environments are a priority, and should a patient pose an imminent danger to a registrant or their colleagues and staff, measures must be taken to de-escalate. Focusing on clear communication while also considering the patient’s unique situation can help both preserve the relationship and reduce the risk of escalation. Registrants should have a plan in place to keep staff, colleagues and other patients safe from harm.
If it becomes necessary to end the therapeutic relationship, registrants are reminded to refer to the Ending the Patient-registrant Relationship practice standard to ensure they are aware of CPSBC’s expectations.
Other resources from Doctors of BC and the CMPA may also be helpful.
- CMPA:
- CMPA:
- Doctors of BC: