What do you do when it's the patient who violates a DC's professional and personal boundaries?
Posted in Case Studies on Thursday, August 24, 2023
Jill Waterman was referred to Jon Gillet, DC, by her primary care doctor after a minor vehicle accident in early 2016. At the time, she was critical of the care rendered by her previous chiropractors.
Jill’s condition significantly improved after a couple of months of treatment with Dr. Gillet. On July 15, 2016, he dismissed her from care for the injuries she suffered from the car accident, with instructions to return for maintenance care as needed.
Three days later, Jill emailed Dr. Gillet to ask if his email was private, and he replied that it was. She then asked him to be her personal chiropractor for weekly maintenance care, as no other chiropractor could get it right. Dr. Gillet was flattered and responded that he would.
Jill attended her first maintenance appointment, consisting primarily of stretching and flexibility exercises, on July 27, 2016. Dr. Gillet documented that she tolerated the session well.
Later that day, Jill emailed Dr. Gillet 12 provocative photographs with the comment, “I hope you like these. Let me know if they’re any good! Have fun!” Dr. Gillet replied, “OMG!!!” and “Amazing!!!”
Early the next morning, Dr. Gillet emailed Jill that he couldn’t get over her sexy photos, but they “couldn’t do this.” Dr. Gillet promised he’d never share the pictures, and he would look forward to their continued visits—even more so now.
Jill and Dr. Gillet exchanged several emails that morning, including one in which Dr. Gillet stated, “I just keep envisioning what other photos may have been taken!! Ahhhh!!! But alas……” Twenty-three minutes later, Jill replied, “Which panties do you prefer—grey or purple?” Attached to the email were eight photos of Jill wearing nothing but panties.
Between August and October 2016, Jill and Dr. Gillet exchanged many more emails, several of which included photos and were flirtatious in nature. On Oct. 25, 2016, Jill emailed, “I’ve never been so attracted to a man in my entire life. I find everything about you fascinating.”
After Jill’s Nov. 1, 2016, appointment, she emailed Dr. Gillet that she wished she knew how he felt about her. Dr. Gillet responded that although she was a beautiful woman, he was her doctor and a happily married man, and he wanted to keep it that way. He added that he would see her the following week. Jill continued to attend her weekly appointments with Dr. Gillet—and sent him similar emails periodically.
Dr. Gillet Addresses Impropriety More Forthrightly
Dr. Gillet discontinued responding to Jills emails after his November 1 reply. However, on Dec. 6, 2016, he emailed, “The reason I have not responded to your emails is I don’t believe it is appropriate. Our conversations need to be kept within the office. If you respect my wishes, we can continue our doctor/patient relationship. If not, I can recommend some other chiropractors. If you are okay with my request, we can continue within the confines of the parameters I stated earlier.”
Despite this message, Jill continued to send Dr. Gillet flirtatious, nontreatment-related emails every week or so through Jan. 27, 2017. At that point, he responded with essentially the same message as before. Jill replied, “Wow! I’m embarrassed,” but she continued to attend her weekly appointments.
In early February 2017, Jill emailed Dr. Gillet, asking him to conduct their next appointment at a hotel. Dr. Gillet replied: “I have been clear on multiple occasions, both in email and verbally, that this situation is completely inappropriate and wrong. I am a happily married man. Respect that. I am your doctor. Please respect that. I will keep this between us and be your doctor but only if you conduct yourself within the parameters I set forth.” Jill continued going to her weekly appointments.
On Feb. 25, 2017, Jill emailed Dr. Gillet, saying it was critical that he call her because her husband, Mick, found out about the prior emails. That day Dr. Gillet sent Jill both an email and a certified letter dismissing her as a patient. She responded to his email acknowledging the dismissal. She said she explained to Mick her interest in Dr. Gillet was unrequited, and she told her husband to stay away from him.
Later that day, Dr. Gillet left his office and was met by Mick who said he had hacked into his wife’s email and discovered that Dr. Gillet had been corresponding with her. Dr. Gillet told Mick that if he read the emails, he would know there was nothing going on between them and that Jill’s overtures had been rejected.
The next day Dr. Gillet emailed Mick a copy of the prior dismissal letter sent to his wife and a comment that Jill had harassed him. He also attached multiple emails exchanged between him and Jill.
On Feb. 28, 2017, Jill emailed Dr. Gillet to tell him she found his emails to Mick, adding that she had no idea her presence was so abhorrent to him. Fearing the allegations would surface or he would be served with a lawsuit, Dr. Gillet revealed the flirtatious emails and photos to his mother, who worked in the clinic, and to his wife.
A Lawsuit Ensues
About a month later, Dr. Gillet received two emails from attorney Sally Lee:
- The first email stated that Jill had retained Ms. Lee to address concerns about Dr. Gillet’s clinical treatment and his breach of patient confidentiality. Ms. Lee asked Dr. Gillet for his malpractice insurance information.
- The second email indicated that Jill wanted to contact Dr. Gillet confidentially and resolve the matter privately.
When Dr. Gillet received this correspondence, he contacted NCMIC, his malpractice insurance carrier. A NCMIC representative contacted Ms. Lee on March 20, 2017, requesting a detailed narrative of Jill’s allegations and the documentation to support those allegations.
No further communication occurred until Nov. 21, 2017, when Dr. Gillet received a letter from Ms. Lee. The letter contended Jill suffered physically and emotionally from the chiropractic treatment, and Dr. Gillet’s disclosure of confidential patient information caused her substantial harm as it led to physical abuse by her husband. The letter stated Ms. Lee would send a detailed demand letter within the next week.
Nonetheless, it wasn’t until Feb. 21, 2018, that Ms. Lee faxed a complaint to NCMIC captioned “Jill Waterman v. Jon Gillet, DC,” which indicated her intent to file the action on the following day. However, the complaint said that Ms. Lee was open to discussion to resolve the matter.
At that point, NCMIC retained Floyd Andrews as defense counsel who asked Dr. Gillet how he would like to resolve the matter. Recognizing his standing in the community could be adversely affected by the allegations, Dr. Gillet said he would like to have it handled as quickly as possible.
Mr. Andrews proposed mediation, and Ms. Lee initially agreed but later declined as her client did not want to contribute toward mediation costs. Mr. Andrews advised against paying the entire mediation costs as the defense would appear too eager to resolve the claim. Consequently, no mediation was held.
In December 2018, Jill finally provided her written discovery responses. Because she claimed damages of more than $400,000, an early resolution seemed unlikely. Therefore, the defense team saw no downside with deposing her. However, repeated requests to set the deposition date went unheeded. On April 28, 2019, plaintiff attorney Lee finally contacted defense counsel—not to schedule the deposition but to advise she was withdrawing as Jill’s attorney. Mr. Andrews never received notice of a new plaintiff counsel, so he proceeded to communicate with Ms. Lee in the meantime.
On June 12, 2019, Ms. Lee inquired if there was any interest in resolving the matter. Defense counsel responded that he was willing to listen, but he didn’t believe the plaintiff had a good case in terms of liability, causation or damages.
After much back and forth, the case ultimately settled for $3,500 after Dr. Gillet provided his written consent. NCMIC’s legal costs to defend the claim were just under $25,000.
What Can We Learn?
In this case, the doctor was aware that Jill Waterman’s actions were improper, but he chose to ignore the signs of a risky situation. Patients necessitating caution include:
- The previous doctor basher who talks poorly about other doctors. Check your ego or you soon may join the list.
- The flatterer who initially shows you unabashed enthusiasm. These patients know you are the one—until you aren’t.
- The scholar who researches every nuance and wants to direct all decisions. Encourage patient participation, but not dominance, over decisions.
- The sexually aggressive. See Failure to Act below.
Failure to Act
Although the doctor in this case did not engage in an actual sexual encounter with the patient, his long and inappropriate virtual relationship could have easily ruined his practice and reputation, not to mention caused marital and legal woes. At the first sign of sexually aggressive behavior, in person or otherwise, stop the behavior. Further, consider immediate referral of the patient, depending on how egregious the behavior is. If you decide to continue seeing the patient, a chaperone is recommended for all further visits. It is the patient’s word against yours.
Think about the “cost” to your practice if publicity is generated by an inappropriate encounter. Restoring your reputation is almost impossible because the negative seed of unprofessional conduct has been planted. Even patients who have been longtime patients may wonder if the rumors were true.
While this case was not a traditional malpractice case where harm was alleged, the patient did allege emotional distress. Imagine a jury learning that the doctor did not stop the inappropriate behavior but allowed it to continue for many months. The doctor’s behavior was so unacceptable that his board of examiners likely would have initiated disciplinary proceedings.
Without an authorization to do so, providing the patient’s dismissal letter to her husband would be a breach of HIPAA requirements.