This column is provided as a service to the membership by the Psychiatrists' Purchasing Group Inc. (PPG), operator of the APA-sponsored Professional Liability Insurance Program.

When a psychiatrist receives a subpoena duces tecum for a patient's records that is signed by a clerk of the court, should the records be released?

This subpoena is in reality an attorney's subpoena. Records should not be released without the written authorization of the patient. If the patient refuses to consent, the psychiatrist should write to the requesting attorney and advise that without the patient's written authorization, the records cannot be released.

Each situation is unique, however. If you are an APA-sponsored Professional Liability Insurance Program participant and unsure of an appropriate response to a subpoena for records, you can call our Risk Management Consultation Service.

I have read several articles over the last few months relating to a significant increase in malpractice claims against psychiatrists. What are some of the leading causes for these claims?

There are several reasons for the increase in malpractice claims, including the litigious climate and publicity surrounding allegedly questionable practices by some behavioral health care practitioners.

Two of the leading causes in psychiatric medical malpractice in the claims database of the APA-sponsored Professional Liability Insurance Program are the classifications of incorrect treatment and incorrect diagnosis. Incorrect treatment includes, for example, a failure to treat appropriately major depression, bipolar disorder, or alcohol and substance abuse. The classification of incorrect diagnosis includes, for example, a failure to diagnose an underlying tumor or steroid-induced psychosis.

If you have any questions or would like to find out more about the APA-sponsored Professional Liability Insurance Program, please call PRMS at (800) 245-3333, ext. 389.

APA welcomes the opportunity to hear from you about APA-sponsored benefit programs. Send your questions on the APA insurance and special benefit programs to Benefacts, Psychiatric News, APA, 1000 Wilson Boulevard, Arlington, Va. 22209-3901.

(Psychiatric News, December 20, 1996)