ABSTRACT
Dr Gulka knew that John and Betty were under considerable stress, keeping their small business financially viable with the arrival of large grocery chains in the area and caring for Trevor, their eight year old who had cystic fibrosis. Dr Gulka saw the concern on the parents' faces. He began to understand the importance of placing limits on the demands of his medical practice. Dr Gulka continued to have mixed feelings, including guilt, but also now some relief at his decision. Clear professional boundaries create safety for both patients and physicians by eliminating the opportunity for abuse. If physicians do not set boundaries, they run the risk of 'burnout' or marital and family breakdown, while others move to larger centers where limits are more easily set. The challenge is to set boundaries that are both firm yet flexible and to establish limits before the physician's personal and family well-being is compromised.
