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Unsolicited Contacts

Overview | Clinical Scenarios | References
By Susan Hatters-Friedman, MD

OVERVIEW

Definition

Unsolicited contact from non-patients may occur via email or social media. As has been noted in the Boundaries section, care should be taken regarding professionality. However, physicians should be cautious to not establish a doctor-patient relationship if they decide to respond to unsolicited contact.

  • Duty: A duty of care exists once a doctor-patient relationship has been established.

CLINICAL SCENARIOS

Unsolicited emails or social media contacts from a non-patient to a physician do not warrant an automatic response. If a psychiatrist provides medical or psychiatric advice in a reply email or message, they may establish a legal duty to the patient.

Scenario #1: A non-patient friend of a friend sends you an email asking for mental health advice. Her daughter appears to be exhibiting signs of autism and she wants your take on it.

Scenario #2: A non-patient friend of your cousin messages you on social media to ask if you think their dose of an antidepressant medication is too high.

How-To:

  • The most appropriate reply may be a generic statement reminding the person that there is no doctor-patient relationship. Further, the person should be encouraged to seek psychiatric consultation locally.
  • Giving specific advice to the person or emailing about the situation, even if you are only trying to be helpful, may be seen as establishing a doctor-patient relationship.
  • Unsolicited emails should not be considered to be reliable sources of information. Information may be misrepresented or inadequate.
  • Otherwise, the person who receives online advice might even defer obtaining actual help because they believe that the email or social message provided the answer.

REFERENCES

  1. Friedman SH, et al.  Group for the Advancement of Psychiatry. Unsolicited Emails to Forensic Psychiatrists. Journal of the American Academy of Psychiatry and the Law. 2016 44:470-478 available at http://jaapl.org/content/44/4/470
  2. Friedman SH, Martinez R. Boundaries, Professionalism, and Malpractice in Psychiatry. Focus Psychiatry 2019 17(4):365-371.
  3. Recupero PR.  E-mail and the Psychiatrist-Patient Relationship. Journal of the American Academy of Psychiatry and the Law. 2005 33:465-475 available at http://jaapl.org/content/33/4/465
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