Transcript High Risk Clients

Identifying and Assisting Clients and
Colleagues with Major Medical Issues
Prepared by JoAnne M. Zboyan, Esq.
Of
High Risk Clients
 Physical Disability
 Substance Issues (Drug, Alcohol)
 Emotional/Mental Health Issues/Acute Psychological Issues
 Aging
 Loss of Independence/Inability to Care for Self
 Medical Board/Licensure/Privileging Issues
 Civil Litigation
 Practice Break Up/Exclusion
High Risk Clients
(Continued)
 Criminal Issues (Alcohol, Theft, Fraud, Sex Assaults, Sexual
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Boundary Issues)
Domestic/Divorce/Loss of Children
Rehabilitation (Required)
Financial Issues/Business Continuation Expenses
Bankruptcy
Loss of Status/Friendships/Focus/Purpose/Identity/Loss of
Hope
Anniversary of Significant Events
Isolation
Disability-Individual (STD/LTD); SSDI
Warning Signs
 Excuses for refusing treatment
 Avoiding CPHP/Attorney Regulation
 Missed Medical Appointments
 Missed Urine Drops
 Failure/Unwillingness to Proceed with
Treatment/Proceedings
 Inability/Unwillingness to Assist Counsel
 “Bending the Facts,”/Evasive Behavior
Physician Suicides
 As many as 400 MD’s each year (equivalent of 1 entire med
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school class) (Louise Andrew study updated 3/8/12)
Physicians mortality risk from cancer/heart disease
(sufficient care and early diagnosis)
Med school students (Accidents No. 1; Suicides No 2)
General Population Depression estimated 12% males; 18%
females
Stigma of mental health issues ANDREW STUDY
Physician Suicides
(Continued)
 Medical Students/Residents 15-30% screen positive for
depression/mental health issues ANDREW STUDY
 Medical Personnel
 Increased knowledge of suicide; increased knowledge of lethal
means
• Failure to report/undereporting of suicides
• Highest suicide rates – affective disorders (depression, bipolar
disease, alcoholism, substance abuse)
 chance of death by suicide for physicians as much as 70%
higher for male M.D.s than men in the general population
ANDREW STUDY
Physician Suicides
(Continued)
 As much as 250-400%  risk for female M.D.s than other
women in the population ANDREW STUDY
 Physicians who attempt suicide have a much higher success
rate
Barriers – Access to Psychiatric Care
Case Study B
 Long Time Client
 Anesthesiologist-Access to Drugs
 Extended Addiction Issues/Treatments (alcohol, drugs)
 Multiple Rehabilitation Attempts
 Resistance to Treatment
 Isolation/Loss of Friendships
 Financial Issues
Legal Issues
PENDING/PROSPECTIVE LEGAL ACTIONS
Medical Board/Attorney Regulation
Civil Litigation
Practice/Firm Dissolution
Criminal Matters
Domestic Matters
Bankruptcy
Coordination of Counsel
 Criminal
 Domestic (Restraining Orders)
 Board
 Disability (Individual/SSDI)
 Civil
 Bankruptcy
 Partnership
 Hospital
 Personal Counsel
 Estate/Probate
Resources
 Hotline-Nat’l Suicide Prevention1-800 273-TALK
 CPHP/COLAP
 AA
 Caduceus
 Insurance
 COPIC/Liability coverage (Board/Attorney Reg/Claims)
 Disability
 Survivor Benefits
 Health –Mental Health coverage (therapy, psychiatrist)
 Internist