In short
Professional boundaries are the limits that keep the doctor-patient relationship safe and focused on the patient. Good Medical Practice requires you to maintain them and never to use your position to establish a sexual, exploitative or inappropriate relationship with anyone under your care, including those close to the patient. A breach does not have to be sexual, and the responsibility to hold the boundary is always yours. Sexual misconduct is a mandatory notifiable concern, treated very seriously and sometimes criminal, so if a boundary notification is made, get advice immediately.
What are professional boundaries for doctors?
They are the limits that define the doctor-patient relationship and keep it professional, safe and focused on the patient's care.
Good Medical Practice, the code of conduct for doctors, states that professional boundaries are integral to a good doctor-patient relationship, and that good medical practice involves maintaining them and never using your professional position to establish or pursue a sexual, exploitative or other inappropriate relationship with anyone under your care. The Board also publishes separate guidelines, Sexual boundaries in the doctor-patient relationship, which apply to all doctors. Because of the inherent power imbalance and trust involved, the responsibility to maintain the boundary rests with you, not the patient. For the overall process, see our guide to what happens after a notification to the Medical Board.
Who do professional boundaries extend to?
Beyond the current patient, to those close to them, and in many cases to former patients.
The code is explicit that the prohibition on inappropriate relationships includes people close to the patient. A boundary can be breached not only with a patient, but with:
Whether a relationship with a former patient is appropriate depends on factors such as how much time has passed, the nature of the previous care, and the patient's vulnerability. It is never appropriate with a current patient.
What are the rules on examinations and consent?
A physical examination must be clinically indicated and consented to, and good communication prevents most boundary misunderstandings.
For every physical examination
- It must be clinically indicated for the person's care.
- You must obtain informed consent before you begin.
- Explain what you will do and why, in terms the person understands.
- Offer a chaperone for intimate examinations, and record it.
An examination that is not clinically indicated, or to which the patient has not consented, may constitute sexual assault or abuse. Clear communication before and during an examination is the most effective way to avoid misunderstandings, and a well documented consent process protects both the patient and you.
Does a boundary breach have to be sexual?
No. Exploitative or inappropriate relationships, and imposing your beliefs on a vulnerable patient, can also breach boundaries.
While sexual misconduct is the most serious category, the code also prohibits exploitative and other inappropriate relationships, and asks you to avoid expressing personal beliefs in ways that exploit a patient's vulnerability or are likely to cause distress. Sexual misconduct itself covers a wide range of behaviour.
- A sexual relationship with a current patient, regardless of apparent consent
- Sexual remarks, humour, innuendo or flirtatious behaviour
- Touching a patient in a sexual way
- An examination not clinically indicated or not consented to
- Asking about sexual history when not relevant and unexplained
- Exploitative financial or personal relationships
How serious is a boundary notification?
Among the most serious a doctor can face; it can place your registration at risk and, in some cases, amount to a criminal offence.
The Medical Board treats allegations of breaching professional boundaries very seriously, because they go to the trust at the heart of medicine. Sexual misconduct in connection with practice is a category of notifiable conduct, carrying mandatory notification obligations. Depending on the facts, a boundary matter can lead to conditions, suspension or cancellation, and conduct such as a non-consented examination may also be a criminal matter. This is precisely the kind of notification where you should not respond, and must not contact the notifier, without legal advice. Where there is a serious risk, the Board can also take immediate action while it investigates.
How should you respond to a boundary notification?
Get legal advice first, preserve all records and communications, and prepare a response that shows genuine insight.
Contact your medical defence organisation immediately, and do not respond or contact the notifier without advice. Preserve all records and communications exactly as they are, because altering or deleting anything is treated very seriously. With advice, prepare a reflective statement that shows you understand the power imbalance and why the boundary exists, and evidence remediation such as targeted boundaries CPD and concrete changes to your practice.
Illustrative example
The concern: A patient felt an intimate examination was not adequately explained and that consent was unclear.
Reflection: The doctor recognises how a rushed consent process and no offer of a chaperone left the patient feeling unsafe, whatever was clinically intended.
Insight: They reflect honestly on the power imbalance and the patient's experience, without minimising.
Remediation: They complete CPD on professional boundaries, and adopt a clear routine for explaining examinations, confirming consent, and offering and recording a chaperone.
How can you avoid boundary problems in the first place?
Set clear boundaries early, communicate well, and be especially careful with examinations, self-disclosure and online contact.
Most boundary problems build gradually rather than starting dramatically, so prevention is largely about good habits. Establish clear professional boundaries from the outset and reset them promptly if they are challenged. Keep examinations clinically focused, explained and consented, with a chaperone offered and recorded for intimate examinations. Limit personal self-disclosure, keep contact within professional channels, and do not connect with patients on personal social media. Be alert when you notice yourself treating one patient differently, communicating outside work, or keeping aspects of a relationship private from colleagues, as these are early signs to act on. Where you feel a situation is becoming difficult, seek advice from a senior colleague or your medical defence organisation early, which is a strength rather than a weakness.
How can CPD help with a boundary concern?
Targeted CPD on professional boundaries gives dated evidence that you understand the standard and have changed how you practise.
Boundary concerns are often about judgement, communication and habits, so evidence of structured learning is particularly relevant. CPD on professional boundaries, aligned with your CPD registration standard, helps you show you understand where the line sits and have embedded safe practices such as consent and chaperone routines. Paired with a reflective statement that shows genuine insight into the power imbalance, it directly addresses what a Board looks for. Browse the range of CPD for doctors.
Matched to boundary concerns
Courses for a professional boundaries notification
Structured CPD chosen for boundary and conduct concerns, to help you evidence insight and remediation. Independent CPD you can use as evidence of remediation.
Professional Boundaries for Clinicians
- Directly targets the boundary concern
- Understand and hold professional limits
- Evidence your understanding for the Board
Ethical Boundaries with Patients and Colleagues
- Ground boundaries in medical ethics
- Recognise the power imbalance in practice
- Show the reasoning a Board looks for
Professionalism and Boundaries in the Use of Social Media
- Address online and messaging boundaries
- Understand how contact crosses the line
- Evidence safer digital conduct
How to Deal With a Notification or Investigation
- Understand each stage of the Board's process
- Know what to do, and what to avoid, early
- Respond calmly and well prepared
Official sources
Frequently asked questions
Can I have a relationship with a former patient?
It depends and caution is essential. It is never appropriate with a current patient. With a former patient, factors such as the time elapsed, the nature of the previous care, and the patient's vulnerability all matter, so seek guidance first.
Does a boundary breach have to be sexual?
No. Exploitative or other inappropriate relationships, and imposing personal beliefs on a vulnerable patient, can also breach boundaries. Sexual misconduct is the most serious category, but the duty is broader than sexual conduct alone.
What are the rules on physical examinations?
An examination must be clinically indicated and consented to. Explain what you will do and why, obtain informed consent, and offer and record a chaperone for intimate examinations. An unwarranted or non-consented examination may be sexual assault.
Do I need a chaperone?
Offering a chaperone for intimate examinations is strongly advised and should be recorded. It protects the patient and provides an independent account, reducing the risk of misunderstanding and supporting your position if a concern is later raised.
How serious is a sexual boundary notification?
Very serious. It is a category of notifiable conduct, can place your registration at risk through conditions, suspension or cancellation, and some conduct may also be criminal. Do not respond or contact the notifier without legal advice.
Can I keep working during a boundary investigation?
Sometimes, but boundary and sexual-conduct matters are more likely than most to attract immediate action if there is a serious risk. Whether your registration is restricted depends on the Board's assessment after a show cause process.
What should I do if a boundary notification is made?
Contact your medical defence organisation immediately and take advice before responding. Preserve all records and communications exactly as they are, do not contact the notifier, and prepare a response showing genuine insight and remediation.
Does CPD help with a boundary notification?
Yes. Targeted CPD on professional boundaries gives dated evidence that you understand the standard and have changed your practice, such as consent and chaperone routines. It never guarantees an outcome, but it directly addresses a boundary concern.
Dr Richard
Course Facilitator
A practising clinician with over 21 years of experience and postgraduate training in healthcare law and ethics, so every course reflects both clinical reality and Australian regulatory standards.
Written and reviewed by Dr Richard. Last reviewed . Read full profile
AHPRA Courses is an independent training provider. Our courses are structured CPD that practitioners can use as evidence of remediation. We are not affiliated with, endorsed by, or acting on behalf of Ahpra, the Medical Board of Australia, or any other regulator. Courses provide evidence of remediation and do not determine the outcome of any matter. This article is general information, not legal advice. If you have received a notification, seek advice from your medical defence organisation or a health law solicitor.