When physicians make the decision to retire from the practice of medicine, they have to address their patients’ need for continued care. A jury in North Carolina found that a psychiatrist committed medical malpractice when he failed to make arrangements for follow-up care on behalf of one of his patients.
In the case of Williamson v. Liptzen, Wendall Williamson, claimed that his treating psychiatrist, Dr. Myron Liptzen, failed to refer him to another psychiatrist after deciding to retire from practice. As a result, Mr. Williamson claimed his psychiatric condition deteriorated to the point where he could not control his actions.
In January 1995, Williamson was a law student at the University of North Carolina when he fired a rifle on a busy street near the campus killing two men he had never met before. Williamson’s attorney claimed his client could not be found guilty of killing these individuals by reason of insanity. Williamson’s attorney argued that his client was a paranoid schizophrenic who believed he was saving the world by firing the rifle. After a criminal trial, the jury found that Williamson was legally insane. Williamson was then sentenced to live in a locked psychiatric ward until he is no longer a danger to society.
Williamson had been treating with Dr. Liptzen for his psychiatric illness until 8 months prior to the shootings. His psychological history indicated that he had experienced psychological problems since 1992 and had been previously committed to a psychiatric ward. During his six treatment sessions with Williamson, Dr. Liptzen diagnosed psychosis and delusional disorder grandiose. He prescribed anti-psychotic medication for Williamson who began to show signs of improvement. Dr. Liptzen engaged in six treatment sessions with Mr. Williamson.
As part of his medical malpractice lawsuit following the shootings, Williamson claimed that Dr. Liptzen did not properly explain to him the seriousness of his illness when treating him.
At trial, Dr. Liptzen testified that believed that Williamson understood the seriousness of his illness. He stated that Williamson knew that he should seek out a different psychiatrist if he needed to continue his treatment. However, Dr. Liptzen never gave Williamson a specific referral to another psychiatrist for at the end of their treatment sessions.
The jury found Dr. Liptzen negligent in failing to provide continuity of care and awarded Williamson with $500,000 in damages. Dr. Liptzen intends to appeal the jury’s verdict.
Physicians who plan to retire must be mindful of their patients’ need for continuity of care. Retiring physicians should not rely on their unadvised patients to find follow-up care. These physicians should thoroughly explain to their patients the severity of their medical conditions and the importance of continued medical attention. Physicians who are discontinuing their practice should provide their patients with a follow up treatment plan, which may include a referral to another physician. All this treatment advice should be documented in the patient’s medical record. In addition, the physician should send a letter to each patient reiterating the suggested plan for follow up care. If a physician is a member of a group practice, he should advise the patient of other physicians available in the practice. Further, the group should advise the patient that they will coordinate the transfer of care to a physician in their group, or to a physician of the patient’s choice.
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