Lawyer Monthly - October 2022

the third party or the police about the threat. A psychiatrist who complies with the statute does not violate Michigan’s physician-patient privilege. However, a psychiatrist who otherwise discloses privileged communications or information without the patient’s authorisation can be sued for malpractice for breaching his or her duty of confidentiality. Where there is no clear statutory authorisation for breaching patient confidentiality, investigation into a potential violation of the Michigan Public Health Code, or a potential ground for disciplinary action by the state Board of Medicine. In Michigan, anyone can submit an allegation that a licensed health professional has violated the Public Health Code. Common allegations include poor quality of care, treatment outside of the professional’s scope of practice and billing for services not rendered. Investigations can also be triggered by reported malpractice settlements, awards or judgments (three or more in a five-year period or any number totaling more than $200,000 in a five-year period), failure to meet continuing medical education requirements, failure to timely renew a professional license, failure to report a criminal conviction, or other technical violations of the Code. An investigation begins when the Bureau a psychiatrist opens himself or herself up to liability by disclosing confidential information, even if it is done to protect the patient, protect the public, or comply with a request from a court or governmental entity. Another common allegation of malpractice against psychiatrists is that the psychiatrist engaged in an inappropriate relationship or conduct with the patient. Where liability is contested, the case often devolves into a credibility contest between the psychiatrist and the patient. Where liability is admitted or proven, the issue becomes whether additional recovery is available from the psychiatrist’s employer based on a failure to supervise or act on knowledge that an inappropriate relationship was occurring. The availability of insurance coverage for any damages can also be an issue, as many policies contain exclusions for sexual misconduct. Litigating a psychiatric malpractice case involves a discovery process different from other types of medical malpractice. Unlike a medical diagnosis that is based on symptoms, pathology or imaging, the diagnosis of a psychiatric illness is more nuanced and, arguably, more subjective. Although the DSM attempts to set standards and parameters for diagnosis and treatment of various psychiatric conditions, not all of its criteria are evidence-based and categories of diagnosis are disputed among the medical community. All of this uncertainty and subjectivity means that the depositions of the parties and their experts are frequently much longer than in other kinds of medical malpractice cases. In addition to malpractice claims, psychiatrists can also be forced to defend licensing complaints and investigations by state medical boards. Licensing actions involve a process, burden of proof and penalties that are different from a malpractice action. It is important to make sure a defence attorney has experience defending a licensing action in addition to malpractice actions. Licensing actions involve a state MY LEGAL LIFE 21 Unlike a medical diagnosis that is based on symptoms, pathology or imaging, the diagnosis of a psychiatric illness is more nuanced and, arguably, more subjective.

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