Should healthcare providers hug their patients?

Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is looking forward to the next appointment with you. At the end of the visit, she walks up to you and opens her arms to give you a hug. What do you do?


Many may feel that they do not want to offend the patient and so they go on and give the hug even though they may not feel comfortable. In my opinion, this is the wrong choice. For starters, hugs, unlike handshakes, are sometimes intimate gestures. You hug your spouse during intimate moments but you do not shake your spouse’s hand. A hug is much more informal compared to the handshake, which results in a slippery slope.

As health care providers who need to be objective, it is important to maintain some boundaries that maintain the doctor-patient relationship (add any healthcare provider you want to in place of doctor). Hugging patients blurs those boundaries. For example, it will be more difficult to tell patients news they may not want to hear (but need to hear for their sake) if they begin to see you more like a friend or family member than a professional.

Another problem is that in this day and age, concerns about lawsuits and patient complaints are more prevalent than ever. The concern in this case is that the meaning of a hug can be misconstrued by a patient as meaning something more intimate than was intended. In addition or alternatively, some accidental touching to sensitive body area can occur during a hug that is misinterpreted by either person. This can raise concerns of sexual harassment as the person can claim that the touch was unwelcome. This is more likely to occur if the health care provider initiates the hug. It is more likely to occur when the hugger is a male health care provider and the recipient is a woman or a child. Female to female and female to child sexual harassment claims are much less common. This means that female health care providers do not need to worry as much about a sexual harassment claim based on hugging patients but the crossing of professional boundary lines issue remains.

When a patient tries to initiate a hug, my response is to simply say in a nice and respectful way that I am not allowed to hug patients because it crosses a boundary line. Then I offer my hand for a handshake. This can admittedly result in some slight embarrassment on both sides, but it is better to be safe than sorry. This solution is better than one that a supervisor once told me he used, which was to say “I think you need to get your hugs from somebody else,” which sounded too rejecting to me. If the patient insists on hugging you and lunges on you, it is best to document this clearly in your clinical note and explain that this cannot occur again.

The advice I provided above also applies when interacting with patient family members. That being said, there may always be a rare exception depending on the case and circumstances.

Dominic A. Carone is a neuropsychologist who blogs at MedFriendly.com.

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  • http://twitter.com/AfternoonNapper Afternoon Napper

  • Anonymous

    Just depends on the patient.  I hug lots of my elderly women patients.  Some of the men I’ll just pat on the back.  I do love them, and that is a good thing.  Creepy patients, no way.  Younger, closer to my age men, no way.

  • http://www.facebook.com/paul.c.weiss Paul Weiss

    My only response is to shake my head and feel sorry for the author and those who agree with him. As a health care professional, I have often been able to help people in deep and meaningful ways. I welcome hugs in return.

  • Michal Haran

    When I finished my fellowship in hematology, I was offered a position in a prestigious hospital. It was a hard decision-should I stay in this smaller urban hospital which I liked so much or embark on a more promising academic career. That day I was doing rounds with the head of my department. We entered the room of a patient he has been taking care of for nearly 10 years, who was now dying. The patient’s eyes were full of fear, he could not hide,  as he tried to attain a dignified position in his bed. “please” he pleaded as he held his physician’s hand, “do something, help me”. The head of my department talked in a calm and soft voice, as the patient gradually relaxed and then said- “I am scared, please hug me”. The head of my department, without thinking twice, leaned down and hugged him with all the warmth that one human being could give to another. I could see the fear disappear from the patient’s eyes and a smile of comfort appear on his face. At that moment I knew what my decision is and in which kind of environment I want to work  for the rest of my professional life. 

  • Anonymous

    A male doctor would have to be nuts to hug a female patient.  Yes, the majority of the time it will turn out OK, but the one time it doesn’t, your life will forever change.

  • dohkoo

    The idea that the patient-doctor relationship needs to be cold and follow rigid rules baffles me. An individual doctors decision to not hug as this author condones is his/her problem (and loss). For the rest of us who want meaningful relationships with our patients, give them a hug. They won’t misinterpret it if you’ve done your job well and appropriately. More on why hugs are important : http://www.ncbi.nlm.nih.gov/m/pubmed/8695945/

  • http://twitter.com/NurseBarbDehn Nurse Barb

     I had to pause when I read this, because there might be some differences between how a hug is perceived by a patient if it comes from a male provider or a female provider. Because I work as a women’s health care provider in an office setting and am a woman, my situation might be a bit different than a male radiologist looking over scans would be.  I find myself checking in with some patients, especially teens, who I’m trying to model behavior that communicates that they are in charge of their bodies.  “Could you use a hug?” and then let them decide.  My patients know that I’m open to hugging, but am respectful if they’re uncomfortable with the idea. It’s a fine line. You have to be very perceptive of the cues that patients are sending. Some are literally dying to be touched in a non-sexual way that communicates compassion and caring. 
    On the other hand, in my work with dying patients and those in long term care, hugging is one of the most therapeutic things I can offer to people, who open their arms and invite hugs. 

    • Anonymous

      Nurse Barb, this is so great. Best response yet! A week after reading this article, the midwife who delivered my son (after a very long and difficult labor) greeted me with a hug. It was the best, most appropriate way to reconnect after what we’d been through together.

  • Anonymous

    I think there are occasions when nothing else will do except a hug. It doesn’t happen often, but being an effective physician means that sometimes you have to drop your guard and connect in this kind of human way. Not sure how keen patients are on hugging their rheumatologist though…

  • Anonymous

    I think the writer is being too quick to impose his own thoughts on hugs on the patients. Clearly, there are some patients in some situations that would welcome and value a hug (see the story above by Michael Haran as a great example). I think about the only thing right about this article is to err on the side of not imposing hugs on people if you’re not sure whether they’ll appreciate the physical contact, but if the patient opens their arms requesting a hug, it seems to me that it’s the provider’s own hang-ups that are in the way, not any sort of risk of offending the patient / future litigation.

  • Anonymous

    As a 3rd year medical student, I rotated with a male surgeon in his mid-30′s who would not be described as “touchy-feely” by any stretch of the imagination.  One clinic day, we were seeing a mid-30′s female patient who had been diagnosed with stage 4 colon cancer.  She was probably going to die.  He encouraged her to eat, checked her incision, and discussed her notes from her oncologist.  And before she left, he gave her a very benign hug.  

    I won’t pretend to understand how difficult it is to practice medicine with the threat of a sexual harassment lawsuit over your head.  But I think sometimes the emotions of medicine are so overwhelming that there is no more beautiful and sincere way to express your feelings than a hug.  And I think to take it off the table because of a desire to maintain professional boundaries is to limit your ability to heal.

  • http://www.facebook.com/people/Steven-Reznick/100000549195050 Steven Reznick

    It depends on the situation, your relationship with the patient and the setting. If it is witnessed, done without fondling it is a gesture of support and caring for an individual. Medicine is as much an art as a science. You have to know where the boundaries are and how to stay within them. What does the same author do when a long standing patient reaches over to give you a kiss on the cheek in an innocent manner? 

  • Ben Kifle

    Interesting topic. I wonder how the author would feel about hugging the patient’s loved ones say, after a potentially risky procedure went well?

  • Neil Bossenger

    I LOL’d when reading this and possibly even snorted a tiny bit of morning coffee. Shame man, I think Dr Kevin needs a hug. But there you have it: Western medical care in a nutshell.

  • VH Pharmacy

    It’s a human emotion. What else are you going to do? Deny them of that? I would gladly give them a hug seeing as it comforts them in the time of need.

  • http://twitter.com/pamressler Pam Ressler

    Human connection is essential to the practice compassionate health care — that may or may not take the form of a hug.  That being said the ritual of medicine and nursing has always involved touch in some way and this has been lost through our increased use of technology–even the stethoscope, which required placing the hand on another person is no longer a valued tool in the physical exam. When we are dealing with suffering and pain, sometimes giving and receiving a hug is the best and most healing medicine available.  I am fortuante and honored to have been both the giver and receiver of hugs in the darkest and joyous moments in my patients’ lives. 

  • http://twitter.com/science4care Children’s Hospital

    As a social media coordinator at Children’s Hospital Boston I’ve seen many doctor-patient interactions that invlove hugs and I think the difference is the age. Kids need to be comforted when they’re undergoing procedures they might not understand and so I greatly appreciate Carone’s last line that it depends on the case and the circumstances. 

    Lindsey
    Vectorblog.org (the hospital blog I write for)

  • Peter Zafirides

    As a psychiatrist, we have long been indoctrinated to not hug our patients. Over my 15 years of practice, I have found that the more I – appropriately – let my patients know I am human (talking about my family, my life, my experiences, hugging when appropriate), it has only enriched the therapeutic experience. Plus, I genuinely care for the people I treat. I want them to know they are getting better. I want to console them when they are at their most vulnerable. To engage them in this way doesn’t TAKE AWAY from the relationship, not at all. I believe to take that extra moment, to hug another individual – whatever – let’s them know right there, at that moment, THEY MATTER. They exist. Someone cares for them. They are valid. To me, that moment may be the source of most healing for the patient. They have an ally and they know that ally is with them in this fight. It is human. And where we get sued is when we DON’T act human, and see our patients as obstacles. I deeply respect the author of this article and the valid points made. Mine is simply an alternative viewpoint given in the spirit of discussion.

  • Danielle Rosenman

    As physicians, we rely on our ability to use all our senses in evaluating our patients.  The “6th sense”, developed by training and experience, could be described as “knowing.” We apply this sense to everything, from that first moment of walking into the exam room to decide if the patient is basically sick or basically well,  to understanding whether it is appropriate to offer a hug.  I think that therapeutic touch is part of what we do, at its most basic level, as part of healing, and that I can trust my sense of what kind of touch is most appropriate, whether a handshake, or a hug, or rarely, no touch at all.  In a long career, I have always found that there are patients for whom a hug is the best healing modality, and there are many times when it provides the best healing for both of us.  That having been said, patients also have a “6th sense” of their own, and if a physician is not comfortable with a hug, it should not be forced. 

  • Anonymous

    In this day of contagious disease, hugs are safer.  In all seriousness, human touch is one of the best ways to connect with our patients.  Western medicine has had hang ups for various reasons regarding human touch and embraces.  I don’t volunteer hugs, but if a patient wants one, or needs one, I will extend to them this human kindness.  To reject the personal contact (hug) is to reject them as persons.  Of course they must be clothed at the time of the hug. 

  • Doug Capra

    Although I don’t disagree with some of the social analysis here — this article has more to say about 
    our troubled culture than it does about doctor-patient relationships, and human relationships in general.
    It seems to be more about CYA, than about what’s best for the patient. I’m not dismissing the potential consequences and how that could affect a career. I’m just sad that showing real empathy and caring seems to have been separated from “professionalism” in some areas of medical culture. I would have more respect for a provider who stood up for what he or she believed in. If the patient needs a hug, then the patient gets a hug. Give the patient a hug and be willing to defend that action based upon best practice, the power of empathy, what real professionalism means, and just plain human kindness.

  • Sheri Escalante

    Hugs are fine, in the right circumstances. I find it oddly telling that this article was written by a neuropsychologist.  
    In his case, hugs may indeed be inappropriate. 
    He is, after all, evaluating more than just the physical realm of his patients. There is a huge over riding necessity to avoid a connection emotionally.
    I don’t feel this is true with many other specialties. My PCP, my oncologist, my Ob Gyn, my surgeon….my gastroeneteroligist if I have IBD, my physiatrists if I suffer from RA, or lupus. My neurologist for my MS, seizure d/o etc.

    Hugs are fine, really. 

  • http://pulse.yahoo.com/_LVIZ46NTJPOSVG7ISBFEQJ73OA just my opinion

    A neuropsychologist’s opinion is simply not relevant to a pjhysician-patient relationship. They are not licensed to touch other people. One of the core components of the medical beside mannor is the, “therapeutic touch.” As physicians, we are frequently in the position of delivering unfortunate news, we may see our patients in crisis, and quite frequently we may not have particularly palatable therapeutic options for our patients. I have many long term patients where the only place they can expect a hug in their life is within my office. For patients that are clearly distressed, both male and female, it is rather simple to ask, “do you need a hug?” It is perverse to consider hugging as a sign of sexual predation…only in America that continues to be plagued by archaic puritan morality. Hugging is a moment of time when two human beings are sharing space, demonstrating trust and concern, and feeding the biological drive and social of need of skin hunger and which is seen in the grooming behaviors of non-human primates.

    In over two decades of practicing medicine I have only been turned down once when I asked a distressed patient if they needed a hug. When I was in academic medicine it would sadden me to see students and residents ascultate patients at arms length. This sends the subliminal message that there is something wrong with the patient and that the examiner is afraid or unwilling  to share that physical space. I always taught that an important aspect of cardiac ascultaion is to place your free hand onto the patients back, draw them close to you, and to briefly eliminate that social boundry which divides us. Again this another aspect of establishing the therapeutic touch and creating trust between two people. If your patients do not trust you they are unlikely to give much credence to any advice that you offer them.

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