COMMENTARY

Malpractice Dangers for Psychiatrists

O. Brandt Caudill, Jr, Esq

Disclosures

December 29, 2009

In This Article

Introduction

Psychiatrists face several unique malpractice risks, particularly in today's litigious environment with its multimillion-dollar verdicts. Some risks are similar to those of other physician specialties; some are dangers specific to psychiatrists.

Any of them can destroy a career, so it's vital for psychiatrists to be aware of the pitfalls and know how to avoid them.

Because patient records are kept private and insurance carriers don't release this data, it's hard to get concrete data on the nature of the lawsuits against psychiatrists. But in general, the major malpractice risks for psychiatrists involve suicide, lack of emergency accessibility, duty to warn, medication side effects, relationships with patients, and Internet therapy or prescribing.

Suicide probably comprises the single most common malpractice claim against psychiatrists. Suicide lawsuits are more likely to be successful if the psychiatrist is in a hospital setting rather than an outpatient practice, because there is more control over the patient in the hospital. While suicide malpractice cases are relatively infrequent, the economic exposure they bring is disproportionately high because of the deceased victim's earning-life projected over years.

In addition, suicide lawsuits often have from a unique emotional component. Such suits can be a vehicle to expiate the guilt of the patient's surviving family members. Some of them may have been abusive and may have been involved in unintentionally triggering the suicide.

Psychiatrists who are solely involved in medication management generally have less exposure than those who also provide psychotherapy. Paradoxically, there are fewer claims against Freudian-based psychoanalysts than for psychiatrists providing other types of psychotherapy. That may be due to the depth of the relationship between the patient and the psychoanalyst that is not present in shorter term psychotherapy.

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