A British association which provides legal advice and support to doctors said physicians should not respond to amorous advances from patients on social networking sites like Facebook.

The Medical Defense Union (MDU), which describes itself as the UK's leading medical defense organization said it is aware of a number of cases where patients have attempted to proposition doctors by sending them an unsolicited message on Facebook or similar sites.

The MDU said in a statement that it advises its members that responding to patients in this way may be seen as overstepping the professional boundary of the doctor/patient relationship.

The pitfalls posed to doctors using social networking sites by inadvertently breaching confidentiality or posting unprofessional content, such as photos, have been well documented, MDU medico-legal adviser Dr. Emma Cuzner said.

But she said doctors may be less prepared for patients using sites like Facebook to ask them out on a date.

Some doctors have told the MDU they feel it would be rude not to reply, if only to politely refuse, but given that this is not a professional route of communication, any correspondence of this sort would clearly stray outside the doctor/patient relationship.

The MDU cited a case in which a female general practitioner (GP) was asked out for a drink by a patient as she left her surgery. When she declined, the patient started pestering the doctor via Facebook and sent her a bunch of her favorite flowers, lilies, which he had ascertained from her freely available Facebook page.

The MDU said it helped the GP nip the patient's advances in the bud, and also suggested she considered employing some of the security and privacy settings on the site.

The MDU also said that doctors should be wary about the issues surrounding the use, or absence of chaperones, for intimate examinations.

In a five-year study, MDU clinical risk manager Karen Roberts, reviewed claims and complaints about women's health made against GPs.

During the five-year period of the study, there were 48 complaints about the use, or more usually the absence, of a chaperone for an intimate examination.

The majority of complainants alleged an inappropriate examination had taken place or that no chaperone was offered, although six patients complained about the presence of a chaperone or that the doctor would not perform the examination without one.

The MDU said it advises doctors that, as well as offering a chaperone for intimate examinations, communication is often the key to avoiding such complaints.

Doctors are advised to explain the reason for an examination and what it will involve and to ensure the patient is given privacy to undress and not to make personal comments during the examination, the MDU said.

(Reporting by Paul Casciato, editing by Patricia Reaney)