Welcome and Introduction – Phillip Resnick, MD

Trends in Psychiatric Malpractice: A Tale of Sex and Violence – Phillip Resnick, MD

• The difference between unintentional and intentional torts
• The four components of negligence
• How to understand and interpret the malpractice standard
• The bases on which the standard of care is established
• The meaning of dereliction of duty, proximate cause, and foreseeability
• The types of malpractice claims made against psychiatrists and psychologists
• The duties a clinician may have to third parties
• How sexual misconduct differs from most other malpractice claims
• The steps to take to minimize malpractice risk
• The do’s and don’ts of documentation

Risk Assessment for Suicide and Malpractice Avoidance – Phillip Resnick, MD

• The scope of the problem of suicide
• To identify static, dynamic, and acute suicide risk factors
• To use the ‘suicide ladder’ to help structure your risk assessment
• Why near lethal suicide attempts should not be ignored
• How to conduct a complete data collection as part of the assessment
• The role and limits of ‘No-Suicide’ contracts
• The usefulness of and details about ‘Safety Plans’
• The risk of inpatient suicide and how to address it
• How the clinician is often seen as an adversary to the suicidal patient
• The benefits and risks of hospitalization of at risk patients and how to weight them
• How and when to conduct and adequately document your suicide risk assessments
• The management factors that increase malpractice risk and how to avoid them

Violence Risk Assessment and Malpractice Avoidance – Phillip Resnick, MD

• The meaning of hindsight bias and its impact on malpractice trials
• The difference between making a threat and posing a threat
• How to identify a psychotic crescendo that can lead to violence
• The relationship of violence to mental illness
• The four factors through which dangerousness is judged
• The meaning of ‘risk’ and ‘substantial risk’ and relationship to commitment
• The impact of hallucinations and delusions on risk of violence
• How to conduct an assessment of dangerousness
• How to set up a violence reduction and prevention treatment plan
• How to use ‘liability prevention’ in potentially violent patients

Malpractice Issues in Confidentiality and Privilege – Phillip Resnick, MD

• The difference between confidentiality and privilege
• Your duties to report and based on what information
• The role of HIPAA in confidentiality and its exemptions
• The 11 situations in which you are exempted from privilege
• What the Jaffe vs. Redmond US Supreme Court case established
• The 3 extensions made to the Tarasoff court decisions
• How state statutes differ on duty to report and to protect
• What you should do when a patient reports a past homicide to you
• How your moral duty may exceed your legal duty

Do’s and Don’ts of Depositions – Phillip Resnick, MD

• Why you need to prepare for depositions
• How to be prepared for depositions
• What lawyers do to lull you into complacency
• The tricks lawyers play to get you to say things best left unsaid
• The four components of the demeanor you should maintain
• The four reasons not to volunteer information
• The types of questions you should refuse to answer
• Your rights as a deponent and how to take advantage of them
• What you absolutely should do after a deposition

Foreseeability and Documentation – Jack Krasuski, MD

• The importance of foreseeability and how it often remains unaddressed
• To recognize potentially negligent assessments
• Nine problems with treatment plans that increase patient risk and open clinicians to malpractice suits
• Simple ways of improving treatment plans to reduce negative outcomes
• How to document patient interactions to reduce malpractice risk
• Ways of documenting objective criteria in a patient’s readiness for discharge notes
• The difference between errors of fact and errors of judgment and which is much serious
• How to assess a patient for potential future acts of violence, self-harm, and suicide
• How established ‘patterns of risk’ can be used to assess and manage patients

Medical-legal Issues in Psychiatry Audience Q&A – Phillip Resnick, MD