White collar crimes are characterized by “deceit, con-cealment, or violation of trust and are not... more White collar crimes are characterized by “deceit, con-cealment, or violation of trust and are not dependent upon the application or threat of physical force or violence. Such acts are committed by individuals and organizations to obtain personal or business advan-tage ” (Ref. 1, p 3). Health care fraud is a form of white collar crime that may be committed by health care providers, consumers, companies providing medical supplies or services, and health care organi-zations. There is a trend toward increased participa-tion by organized crime groups in complex health care fraud schemes.2 There are many different types of illegal and unethical schemes that constitute health care fraud. The common types of fraud com-mitted by physicians include billing for services that
Capacity to practice ones’ profession safely and effectively may become an issue as physicians or... more Capacity to practice ones’ profession safely and effectively may become an issue as physicians or other professionals age. While this chapter will focus primarily on the psychiatric assessment of the aging physician, impairment due to illness in persons employed in other healthcare positions, the military, aviation, the judicial system, and law enforcement present similar public safety concerns. The assessment of a physician is used as a model for the evaluation of these other professionals. The role of the state physician’s health committees and physician competency committees in arranging for assessment, support, and monitoring of the impaired aging physician is discussed. Also discussed are mandatory screening and reporting regarding fitness for duty.
The journal of the American Academy of Psychiatry and the Law, 2012
Although physicians tend to be more concerned about malpractice actions, adjudication of complain... more Although physicians tend to be more concerned about malpractice actions, adjudication of complaints of alleged physician misconduct by peer review organizations and state licensing authorities can have equally serious consequences. Unlike medical malpractice, no patient injury is necessary to support the claim of alleged misconduct. Unlike malpractice, in which a plaintiff must be the injured party, in administrative peer review, colleagues, family members, and patients may all qualify as potential complainants. Unlike malpractice, where the standard of care is what the average prudent practitioner would be expected to do in similar circumstances, in peer review, the standard of care is the code that the organization has endorsed and to which the individual practitioner has agreed by choosing to join the organization. Forensic psychiatrists who may serve either as experts for a peer review or state board investigation or as peer review committee members must understand the legal fou...
The journal of the American Academy of Psychiatry and the Law, 2012
Although physicians tend to be more concerned about malpractice actions, adjudication of complain... more Although physicians tend to be more concerned about malpractice actions, adjudication of complaints of alleged physician misconduct by peer review organizations and state licensing authorities can have equally serious consequences. Unlike medical malpractice, no patient injury is necessary to support the claim of alleged misconduct. Unlike malpractice, in which a plaintiff must be the injured party, in administrative peer review, colleagues, family members, and patients may all qualify as potential complainants. Unlike malpractice, where the standard of care is what the average prudent practitioner would be expected to do in similar circumstances, in peer review, the standard of care is the code that the organization has endorsed and to which the individual practitioner has agreed by choosing to join the organization. Forensic psychiatrists who may serve either as experts for a peer review or state board investigation or as peer review committee members must understand the legal fou...
The journal of the American Academy of Psychiatry and the Law, 2011
Changing federal regulations, civil rights and malpractice cases, and new treatment methods have ... more Changing federal regulations, civil rights and malpractice cases, and new treatment methods have influenced the use of restraint and seclusion (R&S) in inpatient psychiatric treatment settings, such that restraint and seclusion today are among the most highly regulated practices in psychiatry. Despite increased pressure from regulatory bodies and litigation, the use of R&S remains controversial and risky. These procedures can compromise safety if performed incorrectly or monitored inadequately, but intervention by restraint or seclusion may be necessary to maintain safety on the treatment unit, especially during emergencies. Case law and medical research have demonstrated the importance of a patient-focused, treatment-oriented approach toward risk management. Analysis of specific clinical scenarios can help to develop risk mitigation strategies that are therapeutically conceptualized rather than driven by regulation. Insights drawn from clinical cases that have resulted in litigatio...
The journal of the American Academy of Psychiatry and the Law, 2015
Allegations of undue influence constitute a common basis for contests of wills. Legal research fr... more Allegations of undue influence constitute a common basis for contests of wills. Legal research from the 1990s suggests that gender bias factors significantly into judicial decision-making regarding alleged undue influence and testamentary intent. In this study, we sought to assess whether this bias is present today and to identify any factors that may be associated with it. Probate judges from several jurisdictions in the United States were asked to consider two hypothetical case vignettes drawn from actual published decisions. In our study, the gender of the testator played only a minor role in how judges weighed factors in the decision-making process and, overall, did not significantly influence opinions regarding the presence of undue influence. The specifics of the case and the gender of the judge emerged as the most consistent and robust potential influences on decision-making. Our results suggest that probate rulings involving undue influence are likely to represent a complex ...
In the past 25 years, the number of female forensic psychiatrists has increased dramatically. To ... more In the past 25 years, the number of female forensic psychiatrists has increased dramatically. To assess whether there are gender differences in the practice patterns of forensic psychiatry experts, members of the American Academy of Psychiatry and the Law were surveyed during an annual business meeting. Women in the sample were shown to perform fewer categories of evaluation than men. Women were less likely than men to do criminal work, civil commitment/involuntary medication evaluations, and testamentary capacity evaluations, but there was no significant difference in the percentage of those performing some personal injury/disability/fitness for duty, custody, sexual harassment, or malpractice evaluations. Gender was not a significant factor in determining hourly rate. When subjects were asked to comment on whether they thought that gender was a factor in the selection of a forensic expert, 80 percent of the women, but only 41 percent of the men, believed that gender was a consider...
The journal of the American Academy of Psychiatry and the Law, 2005
Vermette et al. [1][1] offer significant observations about the training of police officers worki... more Vermette et al. [1][1] offer significant observations about the training of police officers working with individuals who have a mental illness. The need to have effective training that meets the expectations of line officers as well as supervisors and police chiefs is readily apparent. Law
Forensic psychiatrists may be requested by a wide range of agencies and committees to assess phys... more Forensic psychiatrists may be requested by a wide range of agencies and committees to assess physicians alleged to be behaviorally disruptive. Many of the adjudicatory procedures and questions of these agencies differ substantially from the familiar ones in civil litigation. Proximate cause and patient harm are not essential elements of the forensic questions raised by these health care agencies. In addition to assessing past professional conduct, the examiner is asked to opine about the examinee's present and future professional health and fitness for duty and what treatment or professional supervision, if any, may be needed to ensure the continuance of those professional capacities.
The journal of the American Academy of Psychiatry and the Law, 2008
The National Instant Criminal Background Check Improvement Act has serious implications for perso... more The National Instant Criminal Background Check Improvement Act has serious implications for persons with mental illness with regard to the ability to purchase firearms. Federally prohibited persons include those who have been adjudicated as mentally defective, or have been committed to a mental institution, or are unlawful users of or are addicted to a controlled substance. The legislation was intended to expand the reporting practices of states by providing significant financial incentives and disincentives for releasing all relevant records, including those contained within mental health databases, to the National Instant Criminal Background Check System (NICS). As of April 2007, only 22 states were voluntarily submitting records from mental health databases to the NICS. The legislation was introduced following the Virginia Tech tragedy, when public opinion favored tightening control over access to firearms of persons with mental illness.
The American Psychiatric Publishing textbook of …, 2004
Page 419. CHAPTER 18 Forensic Psychiatry and Law Enforcement DebraA. Finals, MD Marilyn Price, MD... more Page 419. CHAPTER 18 Forensic Psychiatry and Law Enforcement DebraA. Finals, MD Marilyn Price, MD Introduction Recent interest has grown in the relationship of forensic psychiatry and law enforcement. This relationship ...
Mental health professionals frequently participate in the disability application process. Standar... more Mental health professionals frequently participate in the disability application process. Standards and requirements for a finding of disability may vary considerably from one context to another. A disability carrier may request that a mental health professional perform an independent medical examination. This chapter discusses the concepts of work capacity, functional impairment, and disability as they apply to disability evaluations performed for the most common types of disability insurers (Social Security, workers’ compensation, and private insurers), as well as work-related evaluations involving the Americans with Disabilities Act, fitness for duty and return to work, and disability in the context of litigation. Ethical issues in performing disability evaluations are addressed, including differences in the roles of the treating clinician and the independent forensic evaluator and management of situations where the evaluator’s opinion differs from that of the claimant and the cl...
White collar crimes are characterized by “deceit, con-cealment, or violation of trust and are not... more White collar crimes are characterized by “deceit, con-cealment, or violation of trust and are not dependent upon the application or threat of physical force or violence. Such acts are committed by individuals and organizations to obtain personal or business advan-tage ” (Ref. 1, p 3). Health care fraud is a form of white collar crime that may be committed by health care providers, consumers, companies providing medical supplies or services, and health care organi-zations. There is a trend toward increased participa-tion by organized crime groups in complex health care fraud schemes.2 There are many different types of illegal and unethical schemes that constitute health care fraud. The common types of fraud com-mitted by physicians include billing for services that
Capacity to practice ones’ profession safely and effectively may become an issue as physicians or... more Capacity to practice ones’ profession safely and effectively may become an issue as physicians or other professionals age. While this chapter will focus primarily on the psychiatric assessment of the aging physician, impairment due to illness in persons employed in other healthcare positions, the military, aviation, the judicial system, and law enforcement present similar public safety concerns. The assessment of a physician is used as a model for the evaluation of these other professionals. The role of the state physician’s health committees and physician competency committees in arranging for assessment, support, and monitoring of the impaired aging physician is discussed. Also discussed are mandatory screening and reporting regarding fitness for duty.
The journal of the American Academy of Psychiatry and the Law, 2012
Although physicians tend to be more concerned about malpractice actions, adjudication of complain... more Although physicians tend to be more concerned about malpractice actions, adjudication of complaints of alleged physician misconduct by peer review organizations and state licensing authorities can have equally serious consequences. Unlike medical malpractice, no patient injury is necessary to support the claim of alleged misconduct. Unlike malpractice, in which a plaintiff must be the injured party, in administrative peer review, colleagues, family members, and patients may all qualify as potential complainants. Unlike malpractice, where the standard of care is what the average prudent practitioner would be expected to do in similar circumstances, in peer review, the standard of care is the code that the organization has endorsed and to which the individual practitioner has agreed by choosing to join the organization. Forensic psychiatrists who may serve either as experts for a peer review or state board investigation or as peer review committee members must understand the legal fou...
The journal of the American Academy of Psychiatry and the Law, 2012
Although physicians tend to be more concerned about malpractice actions, adjudication of complain... more Although physicians tend to be more concerned about malpractice actions, adjudication of complaints of alleged physician misconduct by peer review organizations and state licensing authorities can have equally serious consequences. Unlike medical malpractice, no patient injury is necessary to support the claim of alleged misconduct. Unlike malpractice, in which a plaintiff must be the injured party, in administrative peer review, colleagues, family members, and patients may all qualify as potential complainants. Unlike malpractice, where the standard of care is what the average prudent practitioner would be expected to do in similar circumstances, in peer review, the standard of care is the code that the organization has endorsed and to which the individual practitioner has agreed by choosing to join the organization. Forensic psychiatrists who may serve either as experts for a peer review or state board investigation or as peer review committee members must understand the legal fou...
The journal of the American Academy of Psychiatry and the Law, 2011
Changing federal regulations, civil rights and malpractice cases, and new treatment methods have ... more Changing federal regulations, civil rights and malpractice cases, and new treatment methods have influenced the use of restraint and seclusion (R&S) in inpatient psychiatric treatment settings, such that restraint and seclusion today are among the most highly regulated practices in psychiatry. Despite increased pressure from regulatory bodies and litigation, the use of R&S remains controversial and risky. These procedures can compromise safety if performed incorrectly or monitored inadequately, but intervention by restraint or seclusion may be necessary to maintain safety on the treatment unit, especially during emergencies. Case law and medical research have demonstrated the importance of a patient-focused, treatment-oriented approach toward risk management. Analysis of specific clinical scenarios can help to develop risk mitigation strategies that are therapeutically conceptualized rather than driven by regulation. Insights drawn from clinical cases that have resulted in litigatio...
The journal of the American Academy of Psychiatry and the Law, 2015
Allegations of undue influence constitute a common basis for contests of wills. Legal research fr... more Allegations of undue influence constitute a common basis for contests of wills. Legal research from the 1990s suggests that gender bias factors significantly into judicial decision-making regarding alleged undue influence and testamentary intent. In this study, we sought to assess whether this bias is present today and to identify any factors that may be associated with it. Probate judges from several jurisdictions in the United States were asked to consider two hypothetical case vignettes drawn from actual published decisions. In our study, the gender of the testator played only a minor role in how judges weighed factors in the decision-making process and, overall, did not significantly influence opinions regarding the presence of undue influence. The specifics of the case and the gender of the judge emerged as the most consistent and robust potential influences on decision-making. Our results suggest that probate rulings involving undue influence are likely to represent a complex ...
In the past 25 years, the number of female forensic psychiatrists has increased dramatically. To ... more In the past 25 years, the number of female forensic psychiatrists has increased dramatically. To assess whether there are gender differences in the practice patterns of forensic psychiatry experts, members of the American Academy of Psychiatry and the Law were surveyed during an annual business meeting. Women in the sample were shown to perform fewer categories of evaluation than men. Women were less likely than men to do criminal work, civil commitment/involuntary medication evaluations, and testamentary capacity evaluations, but there was no significant difference in the percentage of those performing some personal injury/disability/fitness for duty, custody, sexual harassment, or malpractice evaluations. Gender was not a significant factor in determining hourly rate. When subjects were asked to comment on whether they thought that gender was a factor in the selection of a forensic expert, 80 percent of the women, but only 41 percent of the men, believed that gender was a consider...
The journal of the American Academy of Psychiatry and the Law, 2005
Vermette et al. [1][1] offer significant observations about the training of police officers worki... more Vermette et al. [1][1] offer significant observations about the training of police officers working with individuals who have a mental illness. The need to have effective training that meets the expectations of line officers as well as supervisors and police chiefs is readily apparent. Law
Forensic psychiatrists may be requested by a wide range of agencies and committees to assess phys... more Forensic psychiatrists may be requested by a wide range of agencies and committees to assess physicians alleged to be behaviorally disruptive. Many of the adjudicatory procedures and questions of these agencies differ substantially from the familiar ones in civil litigation. Proximate cause and patient harm are not essential elements of the forensic questions raised by these health care agencies. In addition to assessing past professional conduct, the examiner is asked to opine about the examinee's present and future professional health and fitness for duty and what treatment or professional supervision, if any, may be needed to ensure the continuance of those professional capacities.
The journal of the American Academy of Psychiatry and the Law, 2008
The National Instant Criminal Background Check Improvement Act has serious implications for perso... more The National Instant Criminal Background Check Improvement Act has serious implications for persons with mental illness with regard to the ability to purchase firearms. Federally prohibited persons include those who have been adjudicated as mentally defective, or have been committed to a mental institution, or are unlawful users of or are addicted to a controlled substance. The legislation was intended to expand the reporting practices of states by providing significant financial incentives and disincentives for releasing all relevant records, including those contained within mental health databases, to the National Instant Criminal Background Check System (NICS). As of April 2007, only 22 states were voluntarily submitting records from mental health databases to the NICS. The legislation was introduced following the Virginia Tech tragedy, when public opinion favored tightening control over access to firearms of persons with mental illness.
The American Psychiatric Publishing textbook of …, 2004
Page 419. CHAPTER 18 Forensic Psychiatry and Law Enforcement DebraA. Finals, MD Marilyn Price, MD... more Page 419. CHAPTER 18 Forensic Psychiatry and Law Enforcement DebraA. Finals, MD Marilyn Price, MD Introduction Recent interest has grown in the relationship of forensic psychiatry and law enforcement. This relationship ...
Mental health professionals frequently participate in the disability application process. Standar... more Mental health professionals frequently participate in the disability application process. Standards and requirements for a finding of disability may vary considerably from one context to another. A disability carrier may request that a mental health professional perform an independent medical examination. This chapter discusses the concepts of work capacity, functional impairment, and disability as they apply to disability evaluations performed for the most common types of disability insurers (Social Security, workers’ compensation, and private insurers), as well as work-related evaluations involving the Americans with Disabilities Act, fitness for duty and return to work, and disability in the context of litigation. Ethical issues in performing disability evaluations are addressed, including differences in the roles of the treating clinician and the independent forensic evaluator and management of situations where the evaluator’s opinion differs from that of the claimant and the cl...
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