Expert witness

[Yellow mellow]

I have a psychiatrist friend who has asked me to testify as an expertwitness for him. I met with his lawyer today to get the details and although I was initially sure that I would absolutely help, after reading the facts of the case, I feel reluctant. The complaints against him from two prior cases was about his overprescribing of psych. meds. He was forced to take courses and had to agree on a three year probation among other criteria to continue his practice. This latest complaint railed against him is similar in that there was overprescribing again along with a complaint of his prescribing of drugs that psychiatrists would not normally prescribe. And even though these meds. antibiotics or lipids drugs and ophthalmic drops were not considered dangerous drugs, they are indeed not the norm for psychiatrist to prescribe.

There are two psych docs who have written letters against this psychiatrist saying that his medical conduct was an extreme departure from his medical scope. One of them happens to be my former PD. After reading their written testimony, I dont disagree. However, I have known this psychiatrist for a long time and I respect his intelligence and his bedside manner. I'm struggling to what I should do. Where I have a problem is how can I defend him as an expert witness. His lawyer says that with regards to his prescribing of non psych. meds, these were not serious medical conditions and that it's a matter of two school of thoughts. And in the matter of his overprescribing of four different stimulants to this patient and entrusting that patient is aware of its proper usage because he had describe in detail the effects of each drug but wanted to give patient the autonomy to decide which would be best for him.

I don't see how I can be useful if I agree with the two docs who believe that this friend of mine indeed had overprescribed. Besides, I don't know if it's wise for me to say that it's really a matter of two school of thought in the medical community where one believes that psychiatrist should only prescribe psych. meds while the other feels that as long as the drugs prescribe are not considered "dangerous" then that should considered within the standard of care. I myself practice pretty conservatively so I don't know if I m comfortable with expressing the two school of thought argument.

My biggest concern is by defending my friend, I could be essentially questioned about my own medical jusgement. I've only been out of residency for two years so it's not my goal to have the board familiar with my name defending what I believe to be wrong. With that being said, it's a dilemma for me because the patient was not injured in this or other past cases. This man has been in practice for decades ,very intelligent with excellent bedside manner. He has no other supporting witnesses and I feel terrible if I don't at least try to help somehow. The lawyer has been clear that he wants my testimony to refute the claim that his clients/ my friend's action is not an extreme departure from standard medical practice. They don't want or need my personal opinion about him as a physician.

I have given the lawyer my CV but at this point feel really unsure. Don't want to back out and disappoint my friend. Am I just being paranoid or justified in my concern ?

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[Therapist4Chnge]

1. Don't get involved in cases where you have a personal connection.

2. If the other side sniffs out any hesitancy...you can damage your credibility and possibly career.

3. You need to be able to defend anything you say on the stand, so there is no room for hurt feelings or misunderstood loyalties.

*not legal advice*

edited to clarify.

 

[SomeDoc]

I have a psychiatrist friend who has asked me to testify as an expert witness for him.

This is a red flag, which may be exposed on cross examination. Expert witnesses in such cases should be contacted by the defendant's attorney.

although I was initially sure that I would absolutely help, after reading the facts of the case, I feel reluctant.

Avoid providing assurance of assistance before reviewing the facts of the case

There are two psych docs who have written letters against this psychiatrist saying that his medical conduct was an extreme departure from his medical scope. One of them happens to be my former PD. After reading their written testimony, I dont disagree. However, I have known this psychiatrist for a long time and I respect his intelligence and his bedside manner. I'm struggling to what I should do.

Your struggle is problematic in that it represents a conflict of interest. You are trying to separate conflicting personal interest-support of your friend, from objective opinion.

Where I have a problem is how can I defend him as an expert witness. His lawyer says that with regards to his prescribing of non psych. meds, these were not serious medical conditions and that it's a matter of two school of thoughts.

Attorneys will frequently present a case to a potential expert witness in such a manner as to provide a specific spin to the case. What the attorney is doing is not unethical, as they are bound by their duty to do what is in the best interest of their client and thus will selectively present facts that are in favor of their client's case (whether prosecution/plaintiff, or defense). The expert witness should be vigilant about guarding against the formation of potential implicit biases. What the lawyer thinks is irrelevant. You will be providing an independent opinion on the case, if you choose to take on the case, which I would recommend against, given what information you have provided.

I've only been out of residency for two years so it's not my goal to have the board familiar with my name defending what I believe to be wrong.

If after reviewing the facts, you believe this to be the case, inform the attorney about your opinion.

With that being said, it's a dilemma for me because the patient was not injured in this or other past cases.

Proof of harm is not required if you are testifying to the standard of care.

This man has been in practice for decades ,very intelligent with excellent bedside manner.

Intelligence and bedside manner have no bearing on prescribing practices. This will be visited by the opposing attorney in cross examination.

He has no other supporting witnesses and I feel terrible if I don't at least try to help somehow.

You are not obligated to help as an expert witness. You are being paid for your time to render an objective opinion. That opinion may or may not support the case of the retaining attorney.

The lawyer has been clear that he wants my testimony to refute the claim that his clients/ my friend's action is not an extreme departure from standard medical practice.

The lawyer can be as clear as day as to what is needed. You need to be equally clear that you will need to review the facts of the case, charge for the time involved, and render an opinion based on the facts. If the facts are clear enough that an entire review is not necessary, inform the attorney that your impression may not be supportive of his/her case.

 

[hamstergang]

I have a psychiatrist friend who has asked me to testify as an expertwitness for him.

You didn't do a forensics fellowship, and you have a conflict of interest? Easiest 'no' ever. You wouldn't even end up helping your friend's case if you tried.

 

[erg923]

I have a psychiatrist friend who has asked me to testify as an expertwitness for him. I met with his lawyer today to get the details and although I was initially sure that I would absolutely help, after reading the facts of the case, I feel reluctant. The complaints against him from two prior cases was about his overprescribing of psych. meds. He was forced to take courses and had to agree on a three year probation among other criteria to continue his practice. This latest complaint railed against him is similar in that there was overprescribing again along with a complaint of his prescribing of drugs that psychiatrists would not normally prescribe. And even though these meds. antibiotics or lipids drugs and ophthalmic drops were not considered dangerous drugs, they are indeed not the norm for psychiatrist to prescribe.

There are two psych docs who have written letters against this psychiatrist saying that his medical conduct was an extreme departure from his medical scope. One of them happens to be my former PD. After reading their written testimony, I dont disagree. However, I have known this psychiatrist for a long time and I respect his intelligence and his bedside manner. I'm struggling to what I should do. Where I have a problem is how can I defend him as an expert witness. His lawyer says that with regards to his prescribing of non psych. meds, these were not serious medical conditions and that it's a matter of two school of thoughts. And in the matter of his overprescribing of four different stimulants to this patient and entrusting that patient is aware of its proper usage because he had describe in detail the effects of each drug but wanted to give patient the autonomy to decide which would be best for him.

I don't see how I can be useful if I agree with the two docs who believe that this friend of mine indeed had overprescribed. Besides, I don't know if it's wise for me to say that it's really a matter of two school of thought in the medical community where one believes that psychiatrist should only prescribe psych. meds while the other feels that as long as the drugs prescribe are not considered "dangerous" then that should considered within the standard of care. I myself practice pretty conservatively so I don't know if I m comfortable with expressing the two school of thought argument.

My biggest concern is by defending my friend, I could be essentially questioned about my own medical jusgement. I've only been out of residency for two years so it's not my goal to have the board familiar with my name defending what I believe to be wrong. With that being said, it's a dilemma for me because the patient was not injured in this or other past cases. This man has been in practice for decades ,very intelligent with excellent bedside manner. He has no other supporting witnesses and I feel terrible if I don't at least try to help somehow. The lawyer has been clear that he wants my testimony to refute the claim that his clients/ my friend's action is not an extreme departure from standard medical practice. They don't want or need my personal opinion about him as a physician.

I have given the lawyer my CV but at this point feel really unsure. Don't want to back out and disappoint my friend. Am I just being paranoid or justified in my concern ?

I agree with all others. You have already wasted much time here.

This all starts with knowing the basics about how the witnesses are categorized by the courts. Expert, character, material, etc.

 

[Bartelby]

If your expert opinion is that your friend did not meet standard of care and you end up on the stand then you will need to either:

1 - Offer testimony that your friend failed to meet standard of care, or
2 - Commit perjury.

Your friend has placed you in a very difficult position. You should inform the lawyer that your opinion would not be helpful to the defense in this case, even though this may mean the loss of a friendship. Under no circumstances should you suggest that you will offer a favorable opinion and then surprise your friend's defense team by saying unexpected and harmful things during the cross-examination (unless you told the defense lawyer you would do so and for some reason he still wanted you to testify!).

 

[lymphocyte]

You're making this way too complicated.

"I'm so sorry you're in this position. I wanted to be helpful but I realized I don't have the experience, qualifications, or equipoise to testify. Let me buy you a beer so we can vent."

Done.

 

[Merovinge]

First, absolutely do not testify.

That said, it's frustrating that anyone would have a problem with us prescribing statins after we induced hyperlipidemia. Also, depending on the ophthalmic drops, I use ophthalmic atropine sub lingually for clozapine patients (sialorrhea) fairly frequently and to good effect. ABx I will admit I cannot come up with a reason to be Rxing as a psychiatrist.

 

[MLT2MT2DO]

Not going to comment on the rest of it but the fact lipid drugs are "a deviation of a psychiatrists scope of practice" makes me sad. Especially when half the time it may be our drugs elevating their LDLs/Trigs.

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[MLT2MT2DO]

First, absolutely do not testify.

That said, it's frustrating that anyone would have a problem with us prescribing statins after we induced hyperlipidemia. Also, depending on the ophthalmic drops, I use ophthalmic atropine sub lingually for clozapine patients (sialorrhea) fairly frequently and to good effect. ABx I will admit I cannot come up with a reason to be Rxing as a psychiatrist.

Beat me to it..

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[notdeadyet]

I have a psychiatrist friend who has asked me to testify as an expertwitness for him.

Everything after this was unnecessary.

Don't.

 

[sunlioness]

The only clear indication for a statin that is unequivocally supported by the data is in men of a certain age who've already had an event.

I wouldn't prescribe them. And I refused one when prescribed to me just because I was bordering on insulin resistance before I lost a bunch of weight.

Now metformin? I prescribe that.

But yeah. Don't testify.


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[Salpingo]

Proof of harm is not required if you are testifying to the standard of care.

I assumed "direct harm" was one of the 4 D's for malpractice -- are you saying its the plaintiff's side that's responsible for arguing there was harm (and not the OP's job to testify against that)? I'm more curious how this case was brought and what type of harm the patient experienced. I assume if you do your due diligence (ask how they're tolerating the drug, maybe check labs to rule out rhabdo, although even that might be going beyond the standard of care), there's not much that could go wrong. Could the patient argue that you didn't refer them to a PMD, and as a direct result, they didn't have appropriate care for a subsequent CVA/MI?

 

[splik]

malpractice is different to standard of care. you are correct that harm must result from a dereliction of duty in malpractice proceedings, but it appears the complaint here is about score of practice. For example a state medical board may discipline someone who is practising outside of his or her scope of practice even if harm did not result. so there are several instances in which one may find themselves in trouble for deviating from a standard of care though there is no malpractice.

 

[Salpingo]

malpractice is different to standard of care. you are correct that harm must result from a dereliction of duty in malpractice proceedings, but it appears the complaint here is about score of practice. For example a state medical board may discipline someone who is practising outside of his or her scope of practice even if harm did not result. so there are several instances in which one may find themselves in trouble for deviating from a standard of care though there is no malpractice.

That was my initial thought reading this post, but would a licensing board hearing bring in expert witnesses?

 

[SomeDoc]

That was my initial thought reading this post, but would a licensing board hearing bring in expert witnesses?

A licensing board may request the opinion of an expert witness in cases where the specialty scope of the disciplinary panel is insufficient to render an informed decision on the practice of the specialist under scrutiny. Licensing boards also have to deal with costly lawsuits arising from the alleged improper suspension of practice privileges, so there is incentive on part of the board to protect the integrity of their decisions.

 

[lymphocyte]

The complaints against him from two prior cases was about his overprescribing of psych. meds. He was forced to take courses and had to agree on a three year probation among other criteria to continue his practice. This latest complaint railed against him is similar in that there was overprescribing again along with a complaint of his prescribing of drugs that psychiatrists would not normally prescribe. And even though these meds. antibiotics or lipids drugs and ophthalmic drops were not considered dangerous drugs, they are indeed not the norm for psychiatrist to prescribe.

And in the matter of his overprescribing of four different stimulants to this patient and entrusting that patient is aware of its proper usage because he had describe in detail the effects of each drug but wanted to give patient the autonomy to decide which would be best for him.

I've only been out of residency for two years so it's not my goal to have the board familiar with my name defending what I believe to be wrong

This man has been in practice for decades ,very intelligent with excellent bedside manner. He has no other supporting witnesses and I feel terrible if I don't at least try to help somehow. The lawyer has been clear that he wants my testimony to refute the claim that his clients/ my friend's action is not an extreme departure from standard medical practice. They don't want or need my personal opinion about him as a physician.

Sorry I'm beating a dead horse, but the more carefully I read your post... Duuuuuddddddddeee.... (I'm only using this emoticon because I can't find the face-slapping one).

This is bad news bear. This is very, very bad news bear. You feel bad for the guy. I get it. He's a nice bloke. That's great. Have a beer with him. But frankly he sounds dangerous and arrogant. This isn't a one-off issue. This is a pattern of behaviour that has already twice resulted in sanctions. You like him and and even you don't agree with his actions. How do you think a neutral or worse medical board is going to feel? Just stay away.

No psychiatrist should read this thread and come away thinking we shouldn't be prescribing non-psychiatric drugs. We absolutely should be in the appropriate setting. But this isn't a psych calculating CV risk in a patient on olanzapine, prescribing statins in accordance with the best available evidence-based guidelines, and then monitoring longitudinally. This isn't a psych treating a mild UTI-associated delirium with antibiotics in the inpatient setting. This isn't a psych using some atropine eye drops for clozapine-induced sialorrhea. All of those are well within the scope of psychiatry because they do not depart from any acceptable medical standards. Negligence or misconduct do not simply mean a bad outcome. They both are both fairly stringent legal standards and they mean different things in different venues (legal versus administrative). Here's a great article that might be useful.

Meyer DJ. Psychiatry malpractice and administrative inquiries of alleged physician misconduct. Psychiatr Clin North Am. 2006;29(3):615-28. http://www.ncbi.nlm.nih.gov/pubmed/16904502

Psychiatry malpractice and administrative inquiries of alleged physician misconduct.

Abstract
Practicing psychiatrists face a range of professional liability from malpractice litigation and from inquiries and hearings conducted by health care agencies. The causes of an action and the standards by which physician conduct is measured vary widely between these two processes. Many psychiatrists do not appreciate sufficiently the gravity of the risks they may face from an administrative sanction. Understanding the legal and administrative expectations of practicing psychiatrists serves practitioners' professional risk management. Those psychiatrists who choose to participate as expert witnesses for courts or administrative agencies need to familiarize themselves with the applicable legal standards and the respective roles of experts in these two different settings. The courts and administrative agencies have different social missions and correspondingly differing expectations of the expert opinions admitted.An expert's function as educator about the application of psychiatric knowledge and treatments to legal contexts is optimized when that expert clearly understands the function of the opinion that is sought. As educators about special knowledge to the adjudicating body, experts are advocates for their objectively generated and scientifically grounded opinion. Psychiatry is increasingly under the purview of regulations from multiple sources private and public. This article has reviewed medicolegal concepts and terms of psychiatrists' exposure to liability from a comparative point of view. Familiarity assists psychiatrists in navigating the complex legal arena in which they practice and provides a foundation for psychiatrists to work to change the multitude of laws and regulations when doing so is in the best interests of their patients and of their discipline of medicine.

 

[WingedOx]

And in the matter of his overprescribing of four different stimulants to this patient and entrusting that patient is aware of its proper usage because he had describe in detail the effects of each drug but wanted to give patient the autonomy to decide which would be best for him.

ho. ley. sh-t.

 

[PistolPete]

ho. ley. sh-t.

My exact thought. 4 stimulants given to the patient at the same time?

 

[lymphocyte]

My exact thought. 4 stimulants given to the patient at the same time?

But... autonomy!

 

[Yellow mellow]

Apparently, my instincts were right from the unanimous responses. Thank you all for your inputs. I was about to call the lawyer and my friend to express my withdraw from this case when I received an email from the lawyer stating that the medical board has agreed to proposals offered by the lawyer to resolve the pending accusation. Whew . Now I don't have to be the bearer of bad news. But of course I would never ever consider this again. Lesson learned.

 

[PikminOC]

Remember there's a reason he asked a green psychiatrist like you for this.

 

[Therapist4Chnge]

Remember there's a reason he asked a green psychiatrist like you for this.

Yeah…not sure that person would be on my, "friend" list….considering the implications if things went sideways for you.

 

[waldenwoods]

For the OP, I do not have any novel feedback, but I would just say that I would not want to be in a position to lie in court. I suppose most people would have the same opinion.

ABx I will admit I cannot come up with a reason to be Rxing as a psychiatrist.

So in an inpatient setting, let's say a homeless patient with long-standing schizophrenia who developed cellulitis prior to admission to the psychiatric unit, medicine consultant recommended X antibiotic for a total duration of 7 days (or 10 days, or 14 days, whatever), you would not prescribe the requisite number of pills to complete the total course on discharge if the patient has not completed the full course by the discharge date? Would you direct the patient to the local medical clinic and say you need to be a walk-in and establish care and have a family physician/internist to prescribe the remaining days' worth? Or send them to the ER to get the remaining supply? Just wondering.

 

[Shikima]

For the OP, I do not have any novel feedback, but I would just say that I would not want to be in a position to lie in court. I suppose most people would have the same opinion.



So in an inpatient setting, let's say a homeless patient with long-standing schizophrenia who developed cellulitis prior to admission to the psychiatric unit, medicine consultant recommended X antibiotic for a total duration of 7 days (or 10 days, or 14 days, whatever), you would not prescribe the requisite number of pills to complete the total course on discharge if the patient has not completed the full course by the discharge date? Would you direct the patient to the local medical clinic and say you need to be a walk-in and establish care and have a family physician/internist to prescribe the remaining days' worth? Or send them to the ER to get the remaining supply? Just wondering.

Personally, I'd just prescribe the ABX and what they need to get filled with the caveat documented that they must make all follow-up appointments and direct them to contact the clinic if the condition is worsening.

 

[Merovinge]

For the OP, I do not have any novel feedback, but I would just say that I would not want to be in a position to lie in court. I suppose most people would have the same opinion.

So in an inpatient setting, let's say a homeless patient with long-standing schizophrenia who developed cellulitis prior to admission to the psychiatric unit, medicine consultant recommended X antibiotic for a total duration of 7 days (or 10 days, or 14 days, whatever), you would not prescribe the requisite number of pills to complete the total course on discharge if the patient has not completed the full course by the discharge date? Would you direct the patient to the local medical clinic and say you need to be a walk-in and establish care and have a family physician/internist to prescribe the remaining days' worth? Or send them to the ER to get the remaining supply? Just wondering.

I assumed he was talking about an outpatient practice. I have completed ABx scripts before for patients being discharged (started by ID/IM) and would absolutely do so again, good example!

 

[Bartelby]

I assumed he was talking about an outpatient practice. I have completed ABx scripts before for patients being discharged (started by ID/IM) and would absolutely do so again, good example!

Based on context (multiple instances of inappropriate prescribing as confirmed by two independent reviewers) you were probably correct that this guy is independently starting antibiotics in the outpatient setting. I think it is widely if not universally accepted that psychiatrists prescribe all inpatient meds, including those medications which consultants advise on discharge.

That said, waldenwoods has a good point. There are plenty of instances where prescribing non-psychiatric drugs is appropriate for a psychiatrist.

 

[Yellow mellow]

For the OP, I do not have any novel feedback, but I would just say that I would not want to be in a position to lie in court. I suppose most people would have the same opinion.

 

[Yellow mellow]

I never considered lying for anyone.

 

[Yellow mellow]

I understand the overwhelming sentiment on this matter and I really appreciate the constructive suggestions. However, without getting into the details of why I do consider this person a good friend, I knew he was terribly desperate so I agreed to meet with his lawyer. I may be a green psychiatrist but my instincts was that I would have declined. All the helpful comments have given me assurance that I was right to question it.

Now, this may make some of you wonder why I would ask the following question but I am curious. Like I had mentioned, this psychiatrist has now been ordered to take some courses and be put under supervision or be monitored if you will for three years. I don't know how they arrived at this final decision, maybe age ? He is very old. I don't know. But he has asked me to be his monitor person. Having never been one before, I will need to ask if I would even qualify, what is it exactly that I would have to do and if he makes similar or God forbid new mistakes, am I liable in any way. Thoughts ?

 

[lymphocyte]

I understand the overwhelming sentiment on this matter and I really appreciate the constructive suggestions. However, without getting into the details of why I do consider this person a good friend, I knew he was terribly desperate so I agreed to meet with his lawyer. I may be a green psychiatrist but my instincts was that I would have declined. All the helpful comments have given me assurance that I was right to question it.

Now, this may make some of you wonder why I would ask the following question but I am curious. Like I had mentioned, this psychiatrist has now been ordered to take some courses and be put under supervision or be monitored if you will for three years. I don't know how they arrived at this final decision, maybe age ? He is very old. I don't know. But he has asked me to be his monitor person. Having never been one before, I will need to ask if I would even qualify, what is it exactly that I would have to do and if he makes similar or God forbid new mistakes, am I liable in any way. Thoughts ?

Oh dear lord.

 

[hamstergang]

I understand the overwhelming sentiment on this matter

The rest of this post suggests otherwise.

 

[Bartelby]

But he has asked me to be his monitor person. Having never been one before, I will need to ask if I would even qualify, what is it exactly that I would have to do and if he makes similar or God forbid new mistakes, am I liable in any way. Thoughts ?

Yikes. Let him know you can't because of what you perceive to be a conflict of interest. I'm confident you will really regret taking on this role if you do so. Rip off the band aid instead of creating a festering wound that will follow you for years!

 

[TexasPhysician]

For the OP, I do not have any novel feedback, but I would just say that I would not want to be in a position to lie in court. I suppose most people would have the same opinion.



So in an inpatient setting, let's say a homeless patient with long-standing schizophrenia who developed cellulitis prior to admission to the psychiatric unit, medicine consultant recommended X antibiotic for a total duration of 7 days (or 10 days, or 14 days, whatever), you would not prescribe the requisite number of pills to complete the total course on discharge if the patient has not completed the full course by the discharge date? Would you direct the patient to the local medical clinic and say you need to be a walk-in and establish care and have a family physician/internist to prescribe the remaining days' worth? Or send them to the ER to get the remaining supply? Just wondering.

If the medical board was upset about a psychiatrist prescribing abx, the state needs a new board. I doubt this was the issue being addressed though.

Psychiatrists are physicians first and should be able to treat a range of conditions just like any other specialty. In certain instances, diagnosing and treating cellulitis, strep throat, acne, etc. is appropriate in my opinion. My no means must anyone do this, but to say we can't because we are psychiatrists is crazy talk.

Diagnosing cancer and initiating treatment is a totally different story.

 

[Shikima]

If the medical board was upset about a psychiatrist prescribing abx, the state needs a new board. I doubt this was the issue being addressed though.

Psychiatrists are physicians first and should be able to treat a range of conditions just like any other specialty. In certain instances, diagnosing and treating cellulitis, strep throat, acne, etc. is appropriate in my opinion. My no means must anyone do this, but to say we can't because we are psychiatrists is crazy talk.

Diagnosing cancer and initiating treatment is a totally different story.

http://www.cnn.com/2015/07/10/us/michigan-cancer-doctor-sentenced/

 

[TexasPhysician]

http://www.cnn.com/2015/07/10/us/michigan-cancer-doctor-sentenced/

Exactly. Medical school and residency should train everyone to handle common outpatient issues in a variety of fields. It does not make you an oncologist.

 

[thoffen]

I understand the overwhelming sentiment on this matter and I really appreciate the constructive suggestions. However, without getting into the details of why I do consider this person a good friend, I knew he was terribly desperate so I agreed to meet with his lawyer. I may be a green psychiatrist but my instincts was that I would have declined. All the helpful comments have given me assurance that I was right to question it.

Now, this may make some of you wonder why I would ask the following question but I am curious. Like I had mentioned, this psychiatrist has now been ordered to take some courses and be put under supervision or be monitored if you will for three years. I don't know how they arrived at this final decision, maybe age ? He is very old. I don't know. But he has asked me to be his monitor person. Having never been one before, I will need to ask if I would even qualify, what is it exactly that I would have to do and if he makes similar or God forbid new mistakes, am I liable in any way. Thoughts ?

You are asking us for advice because you have a conflict of interest.

The answer is you cannot do this, because you have a conflict of interest.

There is no amount of professing your friendship to this physician or defense of his practices that will sway the correct answer otherwise. You are a physician. Your duty is to patients. You cannot fulfill this role objectively. You cannot put yourself in a position to harm patients because of it.

 

[notdeadyet]

Walk away. You are violating many kinds of professional ethics having any kind of involvement. This will likely not end well for you or for him.


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[MacDonaldTriad]

This would be a good time for that Bob Newhart "Stop it" video.

 

[Shikima]

Exactly. Medical school and residency should train everyone to handle common outpatient issues in a variety of fields. It does not make you an oncologist.

It does. That's why there are 3 steps to the USMLE. Day 2 of Step 3 has us doing all kinds of clinical encounters, not just which specialty track you're in.

 

[thoffen]

There are 2 separate concerns here:
1. Whether the stated physician's behavior leading to discipline was in part or (seemingly very unlikely whole) appropriate
2. Whether the OP should have anything to do with the legal responsibilities of this physician

I want to be crystal clear that, regardless of what we might decide as to concern 1, the answer to concern 2 is independently and conclusively no.

With that said, as to regards of the issue of psychiatrist prescribing drugs e.g. antibiotics, this is a gray area. We have a duty to practice within the scope of our competence. Passing step 3 or med school and having a license to practice medicine does not make us automatically competent to practice all of medicine. Prescribing antibiotics as a psychiatrist has variance in degree of competence to practice, and has variance in degree of liability. If I am to do something I am not wholly comfortable is in my scope of practice, I hope to hell I have the wherewithal to think about and document why doing so is in the best interest of the patient.