The Goldwater Rule guides psychiatrists to share only general advice via email, saving detailed diagnoses and personalized treatment plans for face-to-face consultations.
What is the Goldwater rule?
The Goldwater Rule is a guideline for psychiatrists. It prevents them from giving a professional opinion on someone they haven't examined personally. According to an article for Psychiatry News by Aaron Levin, “The rule applies to public figures and states: “[I]t is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement."
The American Psychiatric Association (APA) established this rule in 1973. It came after an incident involving Senator Barry Goldwater. In 1964, Goldwater ran for President of the United States. During his campaign, a magazine published opinions from over 1,000 psychiatrists. These professionals speculated about Goldwater's mental health without ever meeting him. They called him "unfit" for office based on their distant observations. This publication sparked controversy and legal action.
Goldwater sued the magazine for defamation and won. This case highlighted the ethical problems of diagnosing from a distance. The APA saw a need to prevent similar situations in the future. They created the Goldwater Rule to maintain the integrity of psychiatric practice. The rule upholds that only direct evaluation leads to a credible diagnosis.
See also: Using HIPAA compliant emails to overcome mental health stigma
The impact of the Goldwater rule on communication in the psychiatric community
The Goldwater Rule shapes how mental health professionals talk to patients. It emphasizes the need for personal evaluations. Psychiatrists can't offer opinions on someone's mental health without a direct examination. This ensures accurate and ethical diagnoses.
In face-to-face sessions, this rule means psychiatrists focus on thorough, personal assessments. They gather detailed information from patients directly. This approach builds trust and ensures treatment plans are based on accurate evaluations.
Beyond in-person sessions, the Goldwater Rule affects other forms of communication. In emails, phone calls, or online chats, psychiatrists must be cautious. They can't diagnose or offer specific advice without a personal examination. This rule helps prevent misunderstandings and ensures advice is based on complete information.
For example, if a patient emails with symptoms, a psychiatrist can't give a full diagnosis. They might suggest an in-person session instead. This ensures they gather all necessary details to provide accurate care. It also prevents misdiagnosis based on incomplete information.
The steps to take to honor the Goldwater rule in HIPAA compliant email communications
Use secure email platforms:
- Use secure HIPAA compliant email services. These platforms encrypt messages as well as provide a host of other services to protect patient information.
- Double-check email addresses before sending to avoid accidental disclosures.
Limit email content:
- Do not provide specific diagnoses or treatment plans via email. Reserve detailed clinical discussions for in-person sessions.
- Offer general advice or educational information without making specific evaluations.
Schedule in-person sessions:
- Encourage patients to discuss symptoms or concerns in scheduled sessions rather than via email.
- Offer phone or video call options if in-person meetings aren't possible.
Use disclaimers:
- Add a standard disclaimer in emails, indicating that advice is not a substitute for a personal consultation.
- Clarify that specific medical advice or diagnosis requires an in-person evaluation.
Patient communication guidelines:
- Develop clear guidelines on what information can be shared via email.
- Make patients aware of these guidelines and why they are necessary.
Monitor and audit communications:
- Perform regular audits of email communications to ensure compliance.
- Create a feedback system to continuously improve email practices.
Avoid public discussions:
- Never discuss patient information or offer diagnoses in public forums or social media.
- Always prioritize patient privacy in all communications.
See also: HIPAA Compliant Email for Mental Health Professionals
FAQs
What makes a consent form HIPAA compliant?
A HIPAA compliant consent form must include clear information about the use and disclosure of patient information, the patient's rights, and an acknowledgment of understanding and agreement.
What is patient information in the context of HIPAA?
It refers to any health-related information that can identify an individual, including medical records, treatment details, and personal data like name, address, and social security number.
What is telepsychiatry?
Telepsychiatry is the practice of providing psychiatric care and consultation through telecommunication technologies.
Kirsten Peremore
