Malpractice and Boundary Violations

Common Pitfalls in Giving Medical-Legal Advice to Trainees and Supervisees

“…In the end, however, under HIPAA, patients nationwide have broad rights of access to their medical records and protected health information with few, narrow exceptions. 2,3 The supervisor was accurate in suggesting that Dr. C could refuse to respond to the subpoena or even a court order, but failed to appreciate the potential consequences of following that advice. Although state court subpoenas and court orders are valid only in the state in which they are issued, * an attorney may nevertheless move to compel compliance with a subpoena, and a court may hold an individual in contempt for failure to comply with a court order.…”

“…The key exceptions to the privilege are when the patient has made his or her mental status an issue in the litigation or where he or she has waived the privilege, such as by signing a release-of-information form. 3,4 The better advice from the supervisor would have been for Dr. C to contact Mr. Jones to inform him what information she would be disclosing to the attorney and to confirm that he still wanted her to do so. With confirmation of Mr. Jones's consent to so communicate with the attorney and to her possible testimony as a witness, the concerns about malpractice liability would vanish.…”

Legal Concerns in Psychosomatic Medicine

“…As professionals, psychiatrists owe a duty of care to their patients, both ethically and legally. Malpractice law is the area of tort law that deals with personal injuries caused by the treatment activities of medical professionals [1,69]. To establish a malpractice claim, four elements must be met.…”

“…Third, it must be shown that the breach, or dereliction, of the duty directly caused the patient's harm. Fourth, it must be shown that the patient suffered damage as a result of the physician's actions or inactions [1,39,52,69]. The elements of a malpractice action are often termed the four ''D''s: duty, dereliction of duty, direct causation, and damages.…”