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November 1, 1995

Boundaries in the Physician-Patient Relationship-Reply

Author Affiliations

The Menninger Clinic Topeka, Kan
Harvard Medical School Boston, Mass

JAMA. 1995;274(17):1346. doi:10.1001/jama.1995.03530170025025

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In Reply.  —Based on the comments of Dr Fay and Dr Lazarus, we can only conclude that they have misread our article. We do not believe that all forms of physician self-disclosure are harmful. In our article, we are quite clear that we are referring to the physician's disclosure of personal problems to the patient in a manner that burdens the patient. If Fay will review the references he cites on outcome data when therapist self-disclosure was used, he will discover that these studies did not involve the revelation of serious personal problems to the patient. While Fay accuses us of errors in fact and logic, we can assure him from our extensive clinical experience evaluating and treating physicians charged with boundary violations that the slippery slope phenomenon is pervasive in these cases. We agree that all instances of overstepping boundaries do not lead to more serious violations such as

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