Customer Reviews

The Psychiatrist in Court: A Survival Guide

5 star:		(2)
4 star:		(1)
3 star:		(1)
2 star:		(0)
1 star:		(0)

 

 

Unfortunately, the only realistic way to practice medicine these days is defensively. With every decision you make and every note you write, you have to have an imaginary lawyer sitting on one shoulder watching (and sadly an insurance utilization reviewer peering over the other). When making a judgment call, a doctor now has to imagine the worse possible outcome and then imagine themselves defending their decision in that case. Gone are the days when doctors are put on pedestals and are free to exercise their best judgment based some part on knowledge but also intuition and gut feelings. For the most part this is a good thing, the system certainly wasn't perfect back in the day, but between the fear of lawsuits and the need to conform to standards created by insurance companies, efficient medicine, many doctors are too distracted to remember that most important part of patient care is caring for your patients. Like it or not, this is the environment in which we operate today, so at some point it makes sense to stop complaining and just try to understand it.

Doctors and lawyers train in very different ways, which results in the two disciplines thinking about cases and discussing them differently. Lawyers can take a case and manipulate individual variables, creating an infinite amount of hypothetical questions that a doctor on the stand has to answer with a `yes' or `no' or else appear to be obfuscating. But doctors are used to thinking of cases as individuals, with a complex interaction of variables on multiple levels contributing to a total picture. And as complex as this is in general medicine, it is even more complex in psychiatry, where numerous medical, social and psychological factors interact, and where the emotional baggage attached to every little piece of jargon is weighted with stigma and moral indictments.

Dr. Gutheil provides enough of a background for a psychiatrist to at least take the stand and not get flustered. The mere act of getting flustered by the questioning of a talented attorney is enough to make you look guilty and defensive, even though we all know that in reality it has nothing to do with your clinical skills. Gutheil's approach is light and humorous enough to make this topic readable, and that's saying a lot. I've so far been fortunate enough to have not had any nightmare situations, but it's just a matter chance, so I'm grateful to have this book in my arsenal.

A very good overview for those practitioners that are unfamiliar with the legal system. Quite easy to read and understand, especially if one is called upon to testify or be deposed. It seems the only problem is that the book may be too simplistic for one already slightly familiar with the process of a trial. I would recommend it highly for medical students and psyciatric residents in their early years of training.

In all modesty [ahem!] this is a very handy way to cope with the horrors of going to court as defendant or witness; it tells you how to understand and cope with depositions and trials; though aimed at the newbie, it has some value to more experienced witnesses.

This book is only 126 pages long and, like it says inside the back cover, "uses humour and cheerful informality... to show you how to deal with the legal system successfully." This book is for the treating psychiatrist who gets called to go to court. It has a very good appendix which describes the two hats ethical dilemma that occurs when you are asked to evaluate a patient you are treating.

The Psychiatrist As Expert Witness, Second Edition is another small book by the same author for the examining psychiatrist.