Ok, this is understandable but
What exactly are we worried about being sued for here, for a spinal cord stimulator? I feel like we're grasping at straws to come up with zebra cases of how we'd be getting sued for a spinal surgery we didn't perform. Who is the one doing the suing? Patient suing us for "clearing" them? Family suing us because we "cleared" someone for surgery who later kills themselves and they argue they only killed themselves because the surgery went poorly and they should have never been cleared? Maybe I'm naive but these seem pretty unlikely.
Are people getting sued for a missed diagnosis of histrionic personality disorder? Is this a thing that actually happens?
The surgeon is the one getting sued, bringing in the psychiatrist is meant to spread the liability a bit, and have back up about something that a failed spinal implant patient could claim as low hanging fruit, that they had a poor result because they weren't properly ruled out or assessed as a candidate for the surgery. As said, psychiatric factors are proven to be relevant. And surgeons under no circumstances can claim expertise in that area. So the only way to close that loophole is with an eval by the relevant expert. This has value, even if we argue that expert is not even able to make that assessment. I'll explain.
The issue with some of the medmal stuff, is that while things have to appear to make sense on some surface lay person assessment, it doesn't have to make medical sense in the way it does to us.
"My client had a poor result. They did not experience significant pain relief, and they had a complication of infection. Patients with certain psychiatric factors have been shown not to have benefit from the surgery. Dr. Surgeon did not discuss this with the patient, nor did they assess for the presence of these factors in selecting my client for this procedure."
So, unfortunately the above makes sense to most people. But just sending the patient to psychiatry doesn't meaningfully address the above you argue!!!
"My client, Dr. Surgeon, discussed the risks and benefits of the procedure. The patient was referred to psychiatry and assessed, whereupon both Surgeon and Psychiatrist in consultation agreed that the patient was a candidate for surgery. However outcomes cannot be guaranteed...."
So much of it is rebutting certain arguments, and when it comes to medical opinions, there is power in numbers.
Someone might come back and try to then argue about how the psychiatrist came to their opinion, but at this point the "gotcha" of, "psychiatry is relevant and you didn't consult psych," has been eliminated. Actually getting into the weeds of whether or not what the psych did has validity, tends to be a bit beyond what most folks are going to follow.
So the psych eval isn't about helping the psychiatrist in the event of a lawsuit. The opposite, really.
"Human liability shield" or whatever Stagg said is a great formulation of this.
Given the above, that's why we're saying, this shouldn't come cheap.
Lmao. You know the saying, if an intervention has no chance of benefit, and only risk of harm, then exposing someone to it, is only exposing them to risk of harm without any benefit. That's basically what an eval like this is, IF as stated there's really no good way to do it.
If you do something that you don't think is really going to help the patient, and just opens you up to lawsuit, in the hopes it helps another professional in case of lawsuit... the only way to balance that scale is money.
