A 35-Year-Old Woman Comes to the Office for Evaluation

A 35-year-old woman comes to the office for evaluation.  Her medical problems include migraine headaches, chronic back pain, asthma, and depression.  The patient has had extensive diagnostic workup of her back pain, including several imaging studies, that was unrevealing.  At today's visit, she is seen by another physician in the same group, as her primary physician is currently on personal leave.  The patient is mildly depressed and reports continued headaches and back pain.  During the course of the appointment, the patient discloses that her primary physician asks her to undress at every visit so he can examine her breasts.  She also mentions that they were in a consensual sexual relationship that she stopped because the physician was not willing to divorce his wife to be with her.  The treating physician contacts the patient's primary physician to discuss concerns about the patient's report.  The primary physician admits to a brief sexual relationship over a year ago when he first began treating her as a patient.  However, he denies there has ever been any inappropriate behavior in the office, stating, "She is a psych patient and is always upset; you can't trust what she is saying."  Which of the following is the best next course of action?

A) Advise the primary physician to stop performing breast examinations as his intent may be misinterpreted
B) Advise the primary physician to terminate the physician-patient relationship
C) Do not act on this patient's statements as they are unreliable
D) Notify the state medical board of the physician's alleged behavior
E) Recommend that the patient report the physician's behavior to the state medical board