The liability of atypicals and the metabolic syndrome

[goingbroke]

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We have seen the TV ads and the warnings in journals about the risks of metabolic issues with the use of atypical antipsychotics and the associated liability. The new thing is to check all those parameters, weight, waist circumference, lipid panel, etc not just for the patients but to cover ourselves from malpractice. While it sounds good in theory many low functioning schizophrenics and others using the medications are horribly noncompliant. We check these metabolic parameters and almost all of them are not considered normal. We have great treatment ideas like exercise, diet, and monitor your blood sugar. We try and document that we advised these treatments when we know they won't be done. We are lucky many take their medications and come to appointments. So my question is whether taking all these steps is really advantageous from a legal or ethical standpoint. If I find that a patient's cholesterol is too high and I know realistically that it isn't going to be corrected do I just levae myself open to liability. Another big questions is how big of a liability problem is this? I think that psychiatrists are so used to having virtually no liability outside of suicide that when any mention of potential lawsuits occur when get frightened. Does anyone have any experience or know of an individual that has had to deal with these lawsuits? And what has been the experience? Thanks.

 

[Solideliquid]

Think about it from an attorney's point of view. Say a patient comes to you and complains that his psychiatrist caused him/her to develop Diabetes after being on a atypical for years.

So you review the medical records and you see in the documentation how for years, this psychiatrist has recommended changes in diet, exercise, and has been setting appointments with family medicine doctors. You also notice this particular patient has not followed any of these recommendations.

Do you think as an attorney you would want to spend the tens of thousands of dollars to put together a case (and perhaps go to court) when most likely you'll lose given all this evidence? "So Mr X, why didn't you go to the followup appointments to get your cholesterol/sugar checked even after your psychiatrist recommended this to you X amount of times?"

Patient X: "Hmm, I don't know".

Case dismissed. Attorney has just spent a small fortune without any return.

 

[TheWowEffect]

Think about it from an attorney's point of view. Say a patient comes to you and complains that his psychiatrist caused him/her to develop Diabetes after being on a atypical for years.

So you review the medical records and you see in the documentation how for years, this psychiatrist has recommended changes in diet, exercise, and has been setting appointments with family medicine doctors. You also notice this particular patient has not followed any of these recommendations.

Do you think as an attorney you would want to spend the tens of thousands of dollars to put together a case (and perhaps go to court) when most likely you'll lose given all this evidence? "So Mr X, why didn't you go to the followup appointments to get your cholesterol/sugar checked even after your psychiatrist recommended this to you X amount of times?"

Patient X: "Hmm, I don't know".

Case dismissed. Attorney has just spent a small fortune without any return.

Good reply👍

 

[OldPsychDoc]

Bottom line(s):
Educate.
Monitor.
Document.

 

[goingbroke]

Thanks for your replies. I actually have been doing all the monitoring, advising and documenting but after awhile it becomes frustrating. You points are well taken. Does anyone know of an verdict against a psychiatrist in one of these cases? I think that it could be hard to show use of atypicals directly causing metabolic issues.