Boundary issues: employing patients as staff?

Abstract

Mr and Mrs Smith had been registered with the practice for over 10 years. Mr Smith started working in the practice office approximately 4 years ago. Mrs Smith developed emotional problems and became depressed, which necessitated a referral to the local psychiatric team. It transpired that there were marital difficulties and Mrs Smith had an affair which her husband was unaware of. The thought of her husband having access to the clinical correspondence from the psychiatric team was of great concern to Mrs Smith and also her GP. Elaborate methods were put into place to avoid clinical correspondence passing through Mr Smith's hands. John's father is a GP, and John has been registered at his father's practice since birth. John had felt anxious and was taking illegal drugs. His parents had separated 6 months ago and were not on speaking terms. John did not want details about his family relationships covered in the correspondence from the local drug service. Kim had been registered with her GP for many years. She suffers with bipolar disorder. Kim's behaviour has at times been challenging. Kim's mother worked at the practice as a receptionist. It was difficult to manage Kim with her mother working in the practice. Mr Jones was a practice …