avoiding court

[alina_s]

For those of you with more legal experience or forensically-trained, any guidance on avoiding court? I work in community mental health and see a lot of kids in state custody. In my state, when kids are removed from their parents, parental rights remain intact, often for 2+ years, and parents maintain decision making around psychiatric care and major surgeries. This means that I need to have good relationships with the foster parents and bio parents, and there are often many hearings while the kid is in custody. My employer handles subpoenas and I don't even hear about them unless they can't be quashed and last week, one couldn't be. I start my notes with a disclaimer about "This evaluation was performed to guide treatment only. It is not a forensic or custody evaluation and should not be used as such," and my employer's legal department warned the lawyer that I could be a fact witness only, talk about my notes only, and they still insisted. I also spoke to the lawyer ahead of time and warned him that talking to me about mom's participation in treatment would likely hurt his case. Is there anything I could do differently in the future? I was truly irritated that he kept asking me leading questions to try to get an opinion on fitness of mom and foster mom too. Definitely didn't write about either in my notes.

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[Sushirolls]

That's what lawyers do. They push, they prod.

Go in there with robot mode.

"thank you for the interesting question, esquire"
"I cannot opine further beyond my notes, as I am not an expert witness but a treating physician for XYZ"
Please wait while I find the note.
Then read from the note.

Lawyer asks again.

"thank you for the interesting question, esquire"
"I cannot opine further beyond my notes, as I am not an expert witness but a treating physician for XYZ"
Please wait while I find the note.
Then read from the note.

Repeat until they get the clue.

*Granted I've only done commitment hearings.

 

[PsyDr]

They are trying to be bullies, because it is cheap. If you make it expensive, they will stop.

1) Make sure everyone knows that you will confine yourself to the role of a fact witness (i.e., only read the notes). Most of the time, they will leave you alone. It lets them know that their bullying is not going to work.

2) When they demand you show up, you bring your notes, you listen to each question, you SLOWLY look at your notes, and respond, "That is not in my notes.". Do this EVERY time . They are wasting your time, you can waste theirs. They will either get the point, or get annoyed.

3) When they try to bully you into offering an opinion, tell them, "Counselor, it was my understanding that I was being called as an unpaid fact witness. As I am not being paid, can you rephrase the question to the facts? I wouldn't want anyone to think you are trying to engage in theft of services on the record. " OR "I was not trained in any issues of child custody, my professional ethics say I shouldn't engage in such duals roles, and I have no opinions on the matter that would meet Daubert. ". This puts their license on the line.

 

[whopper]

Agree with the above. Often times lawyers will request things that they even believe will not be relevant but just in case do it. They don't lose any sleep if forcing you into court ruins your schedule for a day, week, even weeks or longer.

To answer you question but this likely won't help you, several institutions make arrangements with the local courts to make this as pain-free as possible. E.g. state hospitals may have a courthouse within the hospital. Local involuntary psych units sometimes have the judge physically enter the hospital (so the judge and lawyers are more inconvenienced than the doctors) and hold the session in that location.

The above really often depends on the hospital management making a good relationship with the local courts.

Where I used to be a doctor at a state hospital in Ohio the courthouse was in the hospital (although at times I had to go to a different local court), and if something held me up, the judge would just tell everyone to move to the next case until I came back. Further the court officers and I had a good working relationship. No problem.

Compare that to a different local court where I had to drive 2 hours to get there, spent 45 minutes looking for parking, spent another 30 minutes going through security, and while in court waited about 5 hours.

 

[watto]

Do you have any friends who are lawyers? Get someone to practice with you. It is amazing how quickly you can become comfortable with the suggestions above.

 

[Candidate2017]

Is there anything I could do differently in the future?

Build a time machine, go back and not do child psych?

Joking aside, they are just doing their job. If you were sued, or in a divorce or custody battle for your kids, would you want a lawyer who just shrugs and accepts whatever someone tells them? Or would you want them to be a pit bull on meth?

All in all, this is another example of boundaries in psychiatry. We should expect people to constantly push against boundaries as part of our work, as well as our obligation to maintain boundaries.

 

[Merovinge]

Build a time machine, go back and not do child psych?

Joking aside, they are just doing their job. If you were sued, or in a divorce or custody battle for your kids, would you want a lawyer who just shrugs and accepts whatever someone tells them? Or would you want them to be a pit bull on meth?

All in all, this is another example of boundaries in psychiatry. We should expect people to constantly push against boundaries as part of our work, as well as our obligation to maintain boundaries.

This has nothing to do with CAP, and everything to do about working in this specific treatment setting.

OP you are doing needed work, if no one has thanked you yet today, thank you for your service. This will continue to happen but if you follow the above advice you will get better at it. If you ever come to AACAP let me know and your first drink is on me.

 

[calvnandhobbs68]

Build a time machine, go back and not do child psych?

Joking aside, they are just doing their job. If you were sued, or in a divorce or custody battle for your kids, would you want a lawyer who just shrugs and accepts whatever someone tells them? Or would you want them to be a pit bull on meth?

All in all, this is another example of boundaries in psychiatry. We should expect people to constantly push against boundaries as part of our work, as well as our obligation to maintain boundaries.

The legal system dragging you forcibly into court and you having to figure out how to comply without acting as an expert witness isn't really an example of "boundary setting"....

 

[comp1]

If you really want to avoid it, get a job with the feds. Their lawyers tend to be much better at quashing subpoenas by simply asserting supremacy (Touhy regulations). The federal government has wide latitude as to what state matters it will allow its employees to participate in, generally very little.

 

[alina_s]

If you really want to avoid it, get a job with the feds. Their lawyers tend to be much better at quashing subpoenas by simply asserting supremacy (Touhy regulations). The federal government has wide latitude as to what state matters it will allow its employees to participate in, generally very little.

Hah! I am quasi-fed, IHS privatized through the Indian Self-Determination Act. Maybe that’s why I made it for 5 years without court?

 

[alina_s]

Thanks for the suggestions. I'm not sure how I can make it expensive for them, since I'm salaried and I think my employer charges them zilch, except to try to make it slow and tedious for them next time. Will work on robot mode, and definitely print out all of my notes and flip through them one by one. I hate being on stage.
Back when I was dealing with commitment hearings, the courts did make it pretty painless, but this is different.

 

[alina_s]

This has nothing to do with CAP, and everything to do about working in this specific treatment setting.

OP you are doing needed work, if no one has thanked you yet today, thank you for your service. This will continue to happen but if you follow the above advice you will get better at it. If you ever come to AACAP let me know and your first drink is on me.

I do often go to AACAP

 

[PsyDr]

Thanks for the suggestions. I'm not sure how I can make it expensive for them, since I'm salaried and I think my employer charges them zilch, except to try to make it slow and tedious for them next time. Will work on robot mode, and definitely print out all of my notes and flip through them one by one. I hate being on stage.
Back when I was dealing with commitment hearings, the courts did make it pretty painless, but this is different.

Expensive does not equal money. They are trying to bully you into offering an expert opinion, because it is cheaper than paying for an expert witness. They undoubtedly tell their clients, "Instead of hiring an expert, I can make him/her give us an opinion. He/she is cheaper, and knows the situation better". The client is already paying the attorney on an hourly basis This plan seems like a good idea. So long as it works.

They will try to escalate the bullying, sometimes threatening. That is why you point out that they are attempting to steal your services (i.e., get a professional service for free). I think it is fair to force them to admit that. They won't like that, because it could affect their license. That's an expensive problem for them.

If you NEVER give them an opinion, and you are ALWAYS painfully slow, the word will get out. "Don't even bother with trying to get Dr. Alina_s to give you an opinion, it's not worth it.".