In my opinion, play is about helping your patient to enjoy the examination in whatever style she/he wants.
Long ago, in my medical and sensation play, I drew the line in the sand; I, personally, am not about casual sex.
That said, I will support my plày partner's need for sexual gratification without oral sex, or penetration.
Play can be very sensual. As a play.docologist, it's my preference to help a patient enjoy themselves to the fullest extent, without crossing boundaries
And, yes, there are those that believe for play to be real in its purest sense, it should not involve sex or sensuality. My play is tailored to bring pleasure to my partner, however she/he desires to receive it.
For me, it is all about the patient.
Just my 2 cents...
Dr Marcus Welby