Psychiatrist diagnosed Burlington optician without meeting him | CBC News (2023)

A Burlington optician is outraged after discovering a psychiatrist he'd never met wrote a criticaltwo-page psychiatricevaluation about him without ever seeing or talkingto him.

The optician, JayHakim,filed a complaint with the provincial medical regulator, which concluded the psychiatrist's conduct was appropriate.

Hakimappealed the regulator's decision; that appeal was heldin a hearing downtown Hamilton on Wednesday.

The case raises "some very serious consequences for society" if it's allowed to stand, Hakim argued.

It also parallels issues raised in the United States over whetherpsychiatrists can ethically provide opinions on the mental health of presidential candidates they've never met.

In the U.S., psychiatrists are called to observe the Goldwater rule, refraining from diagnosing a person without meeting and examining that person as a patient.

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The rule, adopted by the American Psychiatrists Association, was named for a presidential candidate many psychiatrists openly called unfit for office in the 1960s.

It's been in the news again lately at a time when psychiatrists have been tempted to label deficiencies they find in current presidential candidates, particularly Donald Trump.

Among the rationales touted in support of the Goldwater rule is that diagnosing someone from a distance can stigmatize that person and their family – and often turns out to be wrong.

Opticians feud

Six years ago,Hakimbecame embroiledina feud with fellow members on the executive council of the College of Opticians of Ontario, which regulates opticians.The outcome of that dispute isbeing hammered out in a separate legal case.

But through the legal filings in that case, Hakimlearned that Joel Sadavoy – a prestigious Toronto psychiatrist specializing in geriatric care—had at the request of theopticians' collegewritten a two-page psychiatric evaluation about Hakim without meeting him in person.

The psychiatrist's determinations werereached through reviewingsome of Hakim's emails and documents sent by the college.

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In addition to this appeal, Hakimhas servedSadavoywith anotice of action on defamation over the diagnosis.

"He has a medical file on me; I've never met the man," Hakim said Wednesday.

'Unique issues that can be difficult to navigate'

Hakim takes issue with the evaluation being done at all, without his consentor knowledge.

He complained initiallyto the governing body for psychiatrists, the College of Physicians and Surgeons of Ontario.

The college has language about third-party reports, acknowledging that they "often give rise to unique issues that can be difficult to navigate."

The College's reasons for findingSadavoy's conduct appropriatewere not made public during Wednesday'sappealhearing beforeHealth Professions Appeal and Review Board.

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But at the hearing, Sadavoy's attorney, MarcFlisfeder, said the college had foundthe psychiatrist's actions hadn't crossed anylines, that therewas no requirement for Sadavoy to obtain consent from Hakim for the evaluationbecause none of Hakim's personal medical records had been disclosed to the psychiatrist.

'Makes a mockery'

At the hearing, Hakim argued that the college's investigation didn't go far enough and its conclusion was unreasonable.

Marvin Ross, representing Hakim,argued that the practice of secretly commissioning psychiatric evaluations of third parties is "Stalinesque."

He called on the appeal review board to send the matter back to the college for further review.

"What Dr. Sadavoy wrote was defamatory and makes a mockery of psychiatric evaluations." Ross said. "It also has some very serious consequences for society if it is allowed to stand."

But Flisfederargued the college had properly investigated and reasonably concluded that the psychiatrist was within his rights to deliver the opinion as a "possible diagnosis."

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The college's investigation into the complaint, he said, "does not need to be perfect or exhaustive; it simply needs to be adequate."

Sadavoy did not appear in person at the hearing.

'…and the patient'

Near the end of Wednesday's hearing, one of the three non-medical, independent panelists noted to the parties that at the time the diagnosis was written, thepolicy ofthe College of Physicians and Surgeons of Ontario on undertakinga third-party report read:

"It is imperative that physicians discuss their role in the reports process … with the third party and the patient or examinee."

Asked by CBC News whether it has a Canadian equivalent to the Goldwater rule, the Canadian Psychiatric Association provided itsethical position statement on courtroom testimony, which states in part:

"Whenever possible, psychiatrists should testify ... as to the mental state of a particular person only if they have examined that person or made significant attempts to do so."

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The statement goes on: "They may review records and critique a diagnosis but should not make a diagnosis without an examination of the person."

The review board didn't state a timeline for releasing its decision, which will be public. | @kellyrbennett


Can a psychiatrist diagnose a person without meeting them? ›

In the U.S., psychiatrists are called to observe the Goldwater rule, refraining from diagnosing a person without meeting and examining that person as a patient.

Is it normal to get a second opinion from a psychiatrist? ›

Your diagnosis is uncertain

Misdiagnosis is not unusual in the psychiatric field, and some psychiatrists actually recommend second opinions when diagnosing certain disorders. If you still feel in the dark about what you're experiencing, talking to another psychiatrist can help you gain clarity.

What questions do they ask in a psychiatric evaluation? ›

Your doctor will ask questions about how long you've had your symptoms, your personal or family history of mental health issues, and any psychiatric treatment you've had. Personal history. Your doctor may also ask questions about your lifestyle or personal history: Are you married? What sort of work do you do?

How long does it take for a psychiatrist to diagnose someone? ›

The duration of a psychiatric evaluation varies from one person to another. The amount of information needed helps to determine the amount of time the assessment takes. Typically, a psychiatric evaluation lasts for 30 to 90 minutes.

How long does it take for a psychiatrist to diagnose you? ›

The duration of a psychiatric evaluation varies from one person to another. The amount of information needed helps to determine the amount of time the assessment takes. Depending on the situation, a mental health evaluation can last anywhere from 20 to 90 minutes long, and in some cases longer.

How often do psychiatrists misdiagnose? ›

According to a 2000 study, psychiatrists were correct when diagnosing major mental health disorders only about 70% of the time. This means that 30% of patients were misdiagnosed; while they thought they had a disorder like schizophrenia or bipolar disorder, instead they just had anxiety or depression.

What should you not say to a psychiatrist? ›

With that said, we're outlining some common phrases that therapists tend to hear from their clients and why they might hinder your progress.
  • “I feel like I'm talking too much.” ...
  • “I'm the worst. ...
  • “I'm sorry for my emotions.” ...
  • “I always just talk about myself.” ...
  • “I can't believe I told you that!” ...
  • “Therapy won't work for me.”
Aug 9, 2021

Can a psychiatrist misdiagnosed? ›

This study revealed that more than a third of patients with severe psychiatric disorders were misdiagnosed (39.16%). The commonly misdiagnosed disorder was found to be a schizoaffective disorder (75%) followed by major depressive disorder (54.72%), schizophrenia (23.71%), and bipolar disorder (17.78%).

Do psychiatrists diagnose first visit? ›

The first visit is the longest.

You'll fill out paperwork and assessments to help determine a diagnosis. After that, you'll have a conversation with the psychiatrist and an NP or PA may observe. The doctor will get to know you and come to understand why you are seeking treatment.

Can a psychiatrist diagnose after one session? ›

Psychiatrists can make a diagnosis and treatment plan quickly – often within one 60 minute session.

Do psychiatrists have to tell you your diagnosis? ›

You have specific rights when disclosing your diagnosis as a client receiving therapy. For example, it's your right to ask your therapist to tell you if they believe you have a mental health condition. If you want a diagnosis, you can ask your therapist upfront.


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