Are Psychiatrists Held to the same Standards as other Doctors?

“Do no harm” is something that all doctors say when they become a doctor….

If a cardiologist prescribed a medicine that his/her patient was allergic to and the patient died, would the family be able to sue for malpractice win? most likely

If an oncologist did not present their patient with an option that they knew about, but could save their life and the family found out about it later, would the family win a malpractice suit? most likely

If a psychiatrist came to their office with obvious symptoms of tardive dyskenisia, a side effect of a medication they had prescribed and the psychiatrist did nothing about it and it became a permanent problem, would the psychiatrist get into trouble? not very likely

On the other hand, if someone went to see their primary doctor who had recently prescribed a medication and the patient showed signs or symptoms of a serious side effect and it eventually lead to a serious condition that could have been avoided, would the patient be able to sue? most likely

Let’s say a psych patient went to emergency room seeking help because they were really depressed, suicidal, hearing voices or told their doctor that they were so manic that they feel they might do something harmful to themselves or possibly someone else.  Regardless of pleasto be admitted or at least evaluated better get ignored and the doctor tells them to go home.  Is this doctor held accountable if the person leaves and kills someone, robs a bank, flies across the country with money they don’t have ,  has sex with people they don’t know, has a drug overdose, does something the voices tell them to do, etc? No

If a doctor ignored signs of a stroke or a heart attack, it could be deadly and if they did the family would win a law suit.  However, if a doctor ignored symptoms of a mental illness and did not preventing that person from ending up doing something that could potentially be deadly, nothing would be done to that doctor.  Although they did not prevent the person from doing something harmful to someone else or themselves, the medical community does not view mental illnesses and how they are treated or mistreated like they do heart attacks and strokes. Both could be deadly. However, it is excusable to ignore signs of schizophrenia, bipolar disorder, depression, etc. It is not okay to ignore signs of a stroke, high blood sugar, kidney failure, or heart attack.  

If a psychiatrist saw a patient who told them they were depressed and suicidal and they dismissed it because they thought the person was making it up or not serious and they committed suicide, would the family win a malpractice suit? doubtful 

If a psychiatrist told a patient to wait until Monday when the patient stated that they thought they were getting manic and they went and got in their car without sleeping for a few days and killed someone, would the doctor be held responsible in some way? I don’t think so. However, if a endocronologist did not advise their patient to go to hospital because they showed signs of a diabetic shock, they would most likely be held responsible if that person got in their car and ended up killing someone.

You probably see where I am going with this.  I know the answers to most of these questions from personal experience and by hearing from other patients with mental illnesses.  I can tell you that most of the time, psychiatrists are not held responsible.  They are allowed to over-prescribe medications that they get kick backs from pharmaceutical companies, can  misdiagnose, dismiss what their patients say,  ignore symptoms, not be there for patients when in need with no one on call, and drop patients that won’t take medications that they recommend for various reasonable reasons.  

Over-prescribing medications is common among all doctors because of the kick-backs they get  from the pharmeucitical companies. It might be because they are uneducated about alternative ways of treating illnesses.   However, other doctors can’t dismiss what their patients say and get away with it. They can’t ignore symptoms that cause harm and suffer no consequences, they have to be available for their patients or have another doctor on call and I would have to assume most would not drop their patients because they ask for an alternative treatment. 

In the world of psychiatry, it is a whole different story.  I know from personal experience and have heard so many horror stories. I don’t know the statistics, but I guarantee there are a lot more malpractice suits filed and won against “regular” doctors vs, psychiatrists.  Psychiatrists hold their patient’s lives in their hands yet that does not seem to matter.  Psychiatrists are not held to the same standards as other doctors and this is just wrong!



11 thoughts on “Are Psychiatrists Held to the same Standards as other Doctors?

  1. I know if quite a few cases where a psychiatrist faced malpractice, but you are right – it’s pretty rare and nothing to the extent that a physician faces. Thought provoking post. Thank you

  2. The issues of the appropriateness of Psychiatry and Psychology go to the roots of our society.

    “People” end up in the situations they find themselves in through no fault of their own nor through anything that is “special” about them.

    If you commit a crime, you are taken before the courts and can be imprisoned. People are not born criminals, it is only through unfortunate dent of circumstances they end up as a criminal.

    How often do we hear that this awful criminal should be locked away forever, even as in the USA this is often little more than a child.

    If you suggest that this person is only a victim of circumstances themselves, just listen to the howls of outrage. But incredibly you NEVER hear anyone try and discuss that should be done to stop the next similar 5 criminals who are in the making now.

    So what happens if you do not commit a criminal act, but otherwise behave in a way that the majority of society do not like ? Oh, call them “mentally ill” and “treat them”… remember in DSM 3, how homosexuality was considered a “mental disorder” ? Funny how it came such that it is no longer a disorder. Could not possibly be to do with a change in social attitudes could it ? And what other “social attitudes” determine what a mental illness is.

    As for many of the other disorders attributed to people, it is too easy to “buy into” this nonsense. To be human is to encompass a whole range of behaviors. All people, including those which society determines are “mentally ill” are primarily lacking understanding and the basic needs all humans have. To have a sense of belonging, a sense of purpose and hope for the future. In this I would also include the appropriate environment where they are allowed to foster a healthy sense of self-worth (self-esteem). Oh, but we can’t have that can we ? Better just to call them “ill” and medicate them. Hey look, we have created a whole new professional and business model.

    It was R.D. Lang who back in the 60’s said Psychiatry as a system of control – nothing has changed, just the faces and the means of delivery.

    I can assure you, it is impossible to have an “informed” rational debate with any of the Psychological or Psychiatric professions because they are all desperate to hang on the to desperate deluded beliefs. And in good old Psychological terms, when someones belief is challenged where there is no rational argument against the challenge, then a person resorts to trying to find fault in the messenger.

    Psychologist and Psychiatrists are just trained parrots living in their little cages. So long as they are fed plenty of tasty seed, they will keep trotting out the statements they have been trained to, as in “parrot fashion”… but to suggest they might try a bit of “free thought”, oh no, that will have them running for their white coats and shouting “mentally ill, mentally ill, mentally ill”. It would be a joke but for the damage these clowns do.

    If any Psychologist or Psychiatrist wished to see a “personality disorder” all they need do is to look in the mirror.

  3. I tend to agree that in a lot of ways psychiatrists are often not held to the same standards as doctors in other fields. There are often patients with psychiatric diagnoses who are not treated in the same manner by doctors in other fields, which the same standard of care as other patients who do not have psych diagnoses.

    By this I would use an example of black box warnings. There are frequently black box warnings on medications for either very serious psychiatric or very serious physical side effects to be aware of and counsel patients on.

    In my particular case, I reported to my rhuematologist that I was already feeling a level of depression that was becoming difficult to cope with because of ongoing and poorly treated chronic pain. I also have a long history of bipolar disorder. My rheumatologist prescribed me Lyrica. I actually asked quite a bit about this medication because I had had some difficulties with Neurontin and I know they are somewhat related.

    My rheumatologist did not warn me of any particular side effects out of the ordinary.

    over the following week to ten days, I actually began to feel extremely depressed and eventually edging on suicidal. Eventually i was also having cognitive effects including short term memory issues as well as balance difficulties. I informed my rheumatologist and also told her I really couldn’t deal with the side effects any more. She then informed me that Lyrica can “sometimes cause some depression” and that “maybe we should think about lowering the dose”.

    I wasn’t aware of this about Lyrica. When I looked it up, I found it was a big risk for it to cause suicidality.

    I was shocked that she would prescribe it to me without offering other options. Not only that, but not inform me of the potential serious side effect- so I could make an informed decision.

    I feel like this is not a unique situation, however. Doctors do not often feel that patients who have psychiatric diagnoses should be informed or empowered.

    It’s very disturbing.

  4. Bradley – psychiatrists ARE physicians. As far as I know, they do face malpractice and one of the most prominent reasons is a patient committing suicide or homicide. However, if a patient does not show any intention of committing the act, provides no signs and denies any symptoms, it would not be fair to hold the psychiatrist reponsible – they are not fortune tellers! The best you can do is a detailed assessment based on collateral and signs and symptoms presented by patient and their family members/friends. If all that is negative, you cannot legally force a patient to stay in the hospital and commit them involuntarily if you have no evidence. You just have to use your clinical judgment and document your reasoning for everything in case of a lawsuit. Did you have a personal experience with this?

    • Here is a statement made by a Psychiatrist, Dr Jan Holmes, employed at the time she made the statement by the Northland District Heath Board.

      “a psychiatric diagnoses is an opinion of a doctor given at a time with the information available. It is not fixed and it can be changed at any time by that same doctor. It cannot be wrong because it is how the doctor sees it at the time, even if is different from another doctor at the same interview. Opinions are a result of knowledge, experience and information, psychiatry does not have blood tests or other tests that prove something”.

      Most people who become involved with any Psychiatric services don’t have any in-depth knowledge of Psychiatry if any at all.

      Certainly people do not have any idea of the past history of Psychiatry.

      Examining this past history will tell you that change is never effected significantly from within the organization, it is only from outside pressure when the atrocities are brought to the publics attention.

      So the public can be voluntarily in the hands of these Psychiatrists on the basis that this very public feels they are doing the “right thing”. The damage done by Psychiatrist is not as obvious as when a surgeon cuts someone leg because for an ingrowing toenail.

      Most often the Psychiatrists currently practicing have no idea of the history of their profession.

      I once went to a lecture by a Professor John Read (Psychiatrist). This was to a very large audience of mostly those in the Mental Health profession.

      Towards the beginning of the lecture, he explained the Rosenhan Trial. Well it would seem this is like taking a group of soldiers, who had been in service for 10 years, and then telling them about World War 2. If you want an example of how disconnected most of those in the Mental Health System are, then this is an excellent example…

      Thank goodness the aviation industry does not work to the same ethical standards as the Psychiatric industry. Planes would be crashing all the time, even though the airline knew there was a problem with pilot training, and of course they would be blaming the passengers for the crashes.

      • “Towards the beginning of the lecture, he explained the Rosenhan Trial. Well it would seem this is like taking a group of soldiers, who had been in service for 10 years, and then telling them about World War 2. If you want an example of how disconnected most of those in the Mental Health System are, then this is an excellent example…”

        That is a really excellent point, and something I notice. To the point where it is refreshing to find someone in the mental health field who is actually interested in studies/cases/experiments which help to inform the field [pretty much in any way]. I find it sort of odd that there is this lack of sincere interest in the timeline/history/development of the mental health field for most of the profession. Not all. But most.

        It seems to be a bit of an anomaly in that there isn’t a lot of knowledge of such things that you could consider “common knowledge” unless you know precisely who the present individuals in the discussion are. Which is odd. Things like “what is abnormal” or “what is pathology” are not even really standard and practitioners often feel it is their individual judgement to determine this, where there are actually practice and ethical guidelines by which to judge abnormality and function. In theory everyone is on the same page but the reality is that a lot of mental health providers are busy writing their own books.

        It’s unfortunate, because many of the basic principles of both psychiatry and clinic psychology could be very helpful for many individuals. The faulty and biased people who run the show can make it not nearly as effective.
        To be honest, at this point it’s kind of a sh*tshow.

      • I think you are being very kind to the Mental Health Profession..

        If these clowns were called in to “help” people in Concentration Camps, the inmates would be diagnosed with depression and given medication to make them better… I would suggest that the correct action is to get the out of the Concentration Camp… the analogy with the crazy World we live in is very apt.

        and then, when I make such arguments the response is “but that is an extreme example” to which the answer is “what skill or training have you to decide what is extreme and what is not extreme, and just how do you decide where that line is” – the answer is always silence…. funny that.

        You will find that when these sort of clowns are challenged, then the answer is silence… they don’t know what to say and that can only be because their position is untenable when challenged…

        They are no more than a group of people who are like the Emperor wearing invisible clothes and when someone shouts, the Emperor has no clothes, then there is shock and silence.

      • I don’t doubt you wrote what you intended to… I did as well…. and i am positive as well, positive about stimulating debate and trying to make people more informed…

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