The quest for excellence in forensic psychiatry

Excellence in forensic psychiatry requires adopting an appropriate professional role; developing an uncommon depth of knowledge and experience; full disclosure of credentials, biases, and weaknesses to potential clients; wise choices about which assignments to accept; and scrupulous fairness in the presentation of findings and opinions. An elusive goal in the best of circumstances, the quest for excellence can appear even more quixotic as resources diminish. As forensic psychiatry faces cost controls from insurance companies, increased competition from psychiatrists who have lost clinical opportunities, and the prospect of tort reform, the pressure to employ more efficient methods and to do more superficial work increases, threatening the quality of forensic work. The many influences, distractions, temptations, and hazards in the path toward excellence can be largely overcome by men and women of integrity, but there are inflexible barriers in the path of those who take assignments for which they are unsuited, for which the data will not be made accessible, or for which too little time is available to prepare properly. Often the most consequential decision one makes in a case is the decision to accept the case.