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When is it OK for a doctor to hug a patient?

Medical oncologist Dr. Kaoutar Tlemcani says “There are times patient needs hug.”

Medical oncologist Dr. Kaoutar Tlemcani says, “There are times a patient needs a hug.”

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Updated: April 2, 2012 5:42PM

You’re at a critical juncture in a health situation. Is it time for a hug?

A hug between a doctor and patient might be just what both ordered. Still, it needs to be in the proper context and between two willing huggers.

“We don’t want to deny a patient or physician a moment that can bring healing,” says Dr. Mark Kuczewski, director of the Neiswanger Institute for Bioethics and Health Policy at Loyola University Chicago, yet he stresses hugs between vulnerable patients and doctors become difficult when the nature of the affection might be misunderstood by the patient or physician.

Acknowledging the uniqueness and delicateness of the patient-physician relationship as well as the emotionally-charged situations that can happen in a clinical setting, Kuczewski (pronounced Kuh-chev-ski) maintains it’s imperative that the person who initiates the hug be the less-powerful person and that the hug — or sign of support — seem natural and unforced.

Dr. Katherine Puckett, national director of Mind-Body Medicine at Cancer Treatment Centers of America, agrees, saying, “I think hugs are OK as long as patients want them. The caregiver must always follow the lead of the patient — it’s about what the patient who is vulnerable needs, not what the caregiver needs to feel better.”

Though she doesn’t describe herself as a hugger by nature, Dr. Kaoutar Tlemcani, a medical oncologist at Cancer Treatment Centers of America Midwestern Regional Medical Center in Zion, hugs her patients every day.

“I have a very comfortable relationship with my patients. My patient is the decision maker — it’s not like I’m their boss. I feel as it my patients are my friends. If I try to do a handshake with a male patient, I get pulled into a big hug. If I go to leave a patient and don’t give a hug, I get a dirty look because I didn’t put a good ending on our time together. Sometimes it’s a hug of support, sometimes it’s a celebratory hug, sometimes it’s a hug following bad news — there’s nothing sexual about it,” explains Tlemcani (pronounced Tlem-connie) whose husband, Dr. Bruce Gershenhorn, also is a medical oncologist on the Zion staff.

Tlemcani insists there is no reason a patient — or a patient’s family or friend — can’t ask for a hug. “We’re in this together — the patient and the physician. There are times a patient needs a hug. There are times a little hug, a little smile, a little laugh can ease tenseness, seriousness, sadness.

“And though I try to read a patient through their posture, their eyes, their words, sometimes I don’t extend a hug as quickly as a patient would like or as quickly as the patient needs. That’s when they need to say, ‘I need a hug.’ I want my patients to ask for what they need from me,” adds the oncologist who gives her patients her cell phone number and makes herself available to them 24 hours a day.

“And I don’t shy from crying in front of my patients. I don’t feel I have to hide it — it isn’t a weakness. It is a compassionate reaction. I think it’s a bit arrogant to not cry. Patients come here seeking help — they are my friends, and we can share tears and then a hug,” Tlemcani says.

When a physician feels uncomfortable accepting a patient’s hug, Kuczewski recommends the physician try to inject a handshake before the patient moves in for a hug.

Kuczewski emphasizes that hug-avoiding physicians can still show support of their patients by leaning forward, facing the patient when talking, and making eye contact and/or touching a patient’s elbow or forearm, considered less invasive than a hug.

“When in doubt, substitute a handshake or other sign of support, and doubt early and often. Anytime you question a hug, don’t do it. You [the physician] can graciously and easily deflect the momentum toward a hug by extending a hand for a handshake or providing a comforting word,” Kuczewski explains.

“I’m not a hugger” is the easiest response to thwart most unwanted hugs, he says. If the care provider persists and strays beyond what the patient finds acceptable, Kuczewski recommends the patient find a new doctor. Advances deemed inappropriate by a patient should be reported to the State Medical Board.

Sandy Thorn Clark is a local free-lance writer.

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