Physical examination of psychiatric outpatients: medical and legal issues

The nation's courts are increasingly defining standards for the practice of psychiatry, but they have not given substantial attention to whether a psychiatrist can be found liable for failure to perform or obtain a physical examination of an outpatient. The few court decisions on this issue involve obvious infractions against good medical care and do not provide useful clinical guidelines. The authors' review of the literature indicates that although psychiatric patients are less healthy than the general population, and the majority of psychiatrists feel physical examination of outpatients is important, psychiatrists rarely conduct such examinations and only a small percentage initiate them. The authors offer recommendations concerning physical examinations that they believe are consonant with good psychiatric outpatient care.