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Empirical findings on legal difficulties among practicing psychiatrists

James H. Reich, MD

Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA

Jose Maldonado, MD

Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA

BACKGROUND: This article reviews the published literature on areas of legal difficulty among practicing psychiatrists.

METHODS: A literature search using PubMed identified studies of malpractice lawsuits or medical board discipline of psychiatrists between 1990 and 2009. Eight studies of physician discipline in the United States and one from the United Kingdom were identified. Information from 3 insurance companies and 3 sets of aggregated insurance company data also were available. One follow-up study of hospitalized psychiatric patients also was reviewed.

RESULTS: Studies of medical board discipline indicate that, compared with other specialties, psychiatrists are at an increased risk of disciplinary action. Psychiatrists who were female, board certified, and in practice for a short period of time had a lower chance of medical board discipline. Psychiatry claims accounted for a very small proportion of overall malpractice claims and settlements. The amount of patient disability secondary to alleged malpractice was the most important variable predicting insurance payout.

CONCLUSIONS: Psychiatrists appear to be disciplined by medical boards at an above-average frequency compared with other medical specialties. However, few malpractice suits reach the courts, and psychiatry represents a very small proportion of overall physician malpractice claims and dollars of settlement.

KEYWORDS: malpractice, medical board discipline, psychiatrists


CORRESPONDENCE: James H. Reich, MD, Department of Psychiatry, University of California, San Francisco, 2406 Clay Street, San Francisco, CA 94115 USA, E-MAIL:
Annals of Clinical Psychiatry ©2011 Quadrant HealthCom Inc.

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