ISSUES IN PRACTICE - Medical-Legal

Question 1

What is the professional standard for
psychiatrists who want to use text with
their patients? (2x)

Answer 1

Document and store all texts as part of

patient’s medical record

Question 2

Child psychiatrist is unprofessional
online. Most severe disciplinary action
by Federation of State Medical Boards?
(2x)

Answer 2

Revoke medical license

Question 3

Major barrier to establishing patient
portal access for adolescent med clinics?
(2x)

Answer 3

Establishing/Maintaining patient

confidentiality

Question 4

Next step when psychiatrist at a hospital
gets a subpoena for current patient whose
parents are divorcing and CPS is involved?

Answer 4

Call Risk management

Question 5

Psychiatrists response to parent’s request
to set up a new electronic patient portal for
their child (that best reflects AACAP’s
policy on confidentiality)?

Answer 5

“I will first need to talk to your child about

the information that it will contain”

Question 6

MD wants to educate patients about his
specialty field on social media. Appropriate
way to do this?

Answer 6

Create separate public social media page or

account to share this information

Question 7

How should a physician working in a small
town approach possibly running into
patients and their families outside of the
clinic?

Answer 7

Inform patients and their parents that there
may be potential meetings outside of clinic
and follow their suggestions

Question 8

In event that EMR is breached, per Health
Information Technology for Economic and
Clinical Health (HITECH) Act, next step is?

Answer 8

First notify affected patients

Question 9

Physician forgot to put concerning CT info
elicited during a session several days ago in
his progress note, what should he do?

Answer 9

Immediately document the concerning info

Question 10

During a job interview, interviewer asked
applicant for patient care
recommendations. Applicant Psychiatrist
found liable regarding treatment of patient
if?

Answer 10

Psychiatrist interviewed the patient

Question 11

Parent requests child’s treating psychiatrist
to write a letter to court supporting their
fitness as a parent in an ugly divorce. Next
step?

Answer 11

Recommend having them request this of a

non-treating psychiatrist

Question 12

What safety precaution should a consulting
psychiatrist take for a 15 yo who presents
to the ED after being referred by school
counselor due to self-harm, denies SI, not
currently on antidepressant? Parents refuse
psych hospitalization and want to follow up
with PCP.

Answer 12

Confirm a next-day appointment with the

outpatient provider.

Question 13

Psychiatrist wants to start 12 yo child of
divorced parents with shared custody on
SSRI. Mother is present at evaluation and
consents, but reports that father “hates
medications.” What’s your plan?

Answer 13

Attempt to reach out to father and obtain

consent before starting medication

Question 14

Likely reason psychiatrist would get a
subpoena related to current therapy patient
whose divorcing parents are fighting for
custody?

Answer 14

Psychiatrist has potential information

relevant to case

Question 15

Parents want psychiatrist to treat their
child with complementary and alternative
medicine (CAM). What’s the legal issue?

Answer 15

Recommending CAM and getting informed
consent makes provider responsible for
treatment

Question 16

Physicians can be found guilty of

malpractice if

Answer 16

Harm or damage was sustained by the

patient

Question 17

Child’s psychiatrist subpoenaed in custody

case. Parents refuse consent to disclose
information. Next step?

Answer 17

Psychiatrist should go to court hearing and

notify that there is no consent

Question 18

Parent reports during initial evaluation that
patient may have been sexually abused by
another child. What is the obligation of the
psychiatrist?

Answer 18

Report to CPS

Question 19

The testimony of a psychiatrist who treated
a child of a divorcing couple should
include?

Answer 19

Why the child was treated

Question 20

One of your adolescent therapy patients is
charged with felony assault. Parents want
you to testify as an expert witness in the
case since you are an expert on provoked
violence by bullying. Next step?

Answer 20

Decline, this would be double agentry

Question 21

Child's treating psychiatrist gets a
subpoena from one of the parent's
attorneys to appear in court with child's
medical record during a custody battle.
Next step?

Answer 21

Seek informed consent from both parents

to share information with court

Question 22

Psychiatrist seeing adolescent patient for
two years gets a subpoena testify in custody
case when parents divorce. Next step?

Answer 22

Make sure parents were notified and

provide consent for testimony

Question 23

Adolescent female with insulin-dependent
diabetes is pregnant, has poor prenatal
care, and wants to keep it a secret from
parents. What would justify telling parents?

Answer 23

Imminent danger to patient

Question 24

Staff posts picture with patient on social
media after attending their theatre
performance. Next step for psychiatrist?

Answer 24

Ask staff to remove post

Question 25

Reason for disclaimer "information does
not constitute professional advice" on
emails/electronic platforms when
providing general mental health
information?

Answer 25

Identify that no doctor-patient relationship

formed