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- Nov 7, 2005
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Hey, I'm a psych resident and planning to start an outpatient child practice when I graduate. I've been doing research on every aspect of setting up a practice, especially in regards to liability. I've come across some disturbing articles, especially from Dr. Robert Simon who apparently is some big whig forensic psych:
"Standard of care requires that psychiatrists or their designees be accessible to suicidal patients and that they respond within a reasonable time. "
"In solo practice, the psychiatrist or covering clinician must be accessible 24 hours a day, 7 days a week, by cell phone, pager...Twenty-four hour coverage for patient emergencies is an established... standard of care." ("Suicidal Patients' Access To Their Psychiatrists")
This is pretty disturbing to me. I like the idea that when I'm out of the office, I'm out of the office. I'm okay with leave a message and I'll get back to you within 24 hours. Some people are saying that "Standard of care" is within an hour or less. Now, come on, It's 2:00AM in the morning and a patient calls me because they're feeling suicidal? I mean I would tell them to go to the ER or I would have to call the crisis line MYSELF to get them to the ER for evaluation. Why can't the message, "If this is an emergency, call 911, go to the nearest emergency, or call the crisis line" work? I mean if I have an asthma attack, or a heart attack, or a gunshot wound, my internal medicine doctor is definitely not going to answer the phone to tell me to go to the emergency room. This is why we have emergency rooms, for .... Emergencies.
I'd like to know if anyone really has been sued for not being available if a suicidal patient killed them self? Could I negate this "standard of care" by telling my patients (even before I establish a doctor-patient relationship) that I will not be available even for emergencies after 10:00PM and that I will get back to them within 24 hours?
Penny for your thoughts ...
"Standard of care requires that psychiatrists or their designees be accessible to suicidal patients and that they respond within a reasonable time. "
"In solo practice, the psychiatrist or covering clinician must be accessible 24 hours a day, 7 days a week, by cell phone, pager...Twenty-four hour coverage for patient emergencies is an established... standard of care." ("Suicidal Patients' Access To Their Psychiatrists")
This is pretty disturbing to me. I like the idea that when I'm out of the office, I'm out of the office. I'm okay with leave a message and I'll get back to you within 24 hours. Some people are saying that "Standard of care" is within an hour or less. Now, come on, It's 2:00AM in the morning and a patient calls me because they're feeling suicidal? I mean I would tell them to go to the ER or I would have to call the crisis line MYSELF to get them to the ER for evaluation. Why can't the message, "If this is an emergency, call 911, go to the nearest emergency, or call the crisis line" work? I mean if I have an asthma attack, or a heart attack, or a gunshot wound, my internal medicine doctor is definitely not going to answer the phone to tell me to go to the emergency room. This is why we have emergency rooms, for .... Emergencies.
I'd like to know if anyone really has been sued for not being available if a suicidal patient killed them self? Could I negate this "standard of care" by telling my patients (even before I establish a doctor-patient relationship) that I will not be available even for emergencies after 10:00PM and that I will get back to them within 24 hours?
Penny for your thoughts ...