Living through the events described below has been a learning experience for me and will likely influence the way I practice child psychiatry throughout my career. I hope that, by my sharing my experience in this essay, others will learn something, as well.

On a Wednesday afternoon, 4 months before I was scheduled to complete my child psychiatry fellowship, I was summoned to my supervisor's office. He informed me that a 9-year-old patient of mine had made an allegation that I had touched him inappropriately and had taken a picture of him inappropriately during an appointment 1 month earlier. I was told that the patient's mother "did not believe him," but "thought she should tell somebody."

The hospital elected to do an internal investigation, which included a risk-management person meeting with me later that day. During this meeting I stated that although I routinely do take the patient's blood pressure in the presence of his or her parents, I otherwise never touch any of my patients, nor do I photograph patients. I added that I was quite sure I had never met with this patient apart from his mother, since he regularly met with a therapist on an individual basis, and most of the interaction during our psychopharmacology clinic visits was between me and the patient's mother. The risk-management person asked whether I was working alone on the day in question. I told her that I could not remember whether someone such as a medical student or visiting resident was present with me that day and added that unfortunately I, like many others, did not routinely document their presence. She pointed out to me that I was finding myself in a situation that is "an occupational hazard" for anyone who works with children. I was told to continue with my clinical duties while the internal investigation was being conducted and did so dutifully the next day, with a renewed respect for defensive medicine.

On Thursday evening, it dawned on me that, a few weeks earlier, a pediatric resident had "shadowed" me in my psychopharmacology clinic. Could this have been the same day that the misconduct allegedly took place? I certainly hoped so. On Friday morning, I decided to do some investigating on my own. I made some phone calls and was able to confirm that I indeed had a resident shadowing me on the day in question. I relayed my discovery to those involved in the internal investigation and was told that "things were looking good." I breathed a sigh of relief. What had blindsided me less than 48 hours earlier appeared to be going away about as quickly as it had arrived. So I was doubly surprised when, several minutes later, the risk-manager called and said, "Oh my God, I just received a call informing me that the sheriffs are on the way to the hospital to arrest you. Do not go anywhere; I'll be right over."

Moments later, I was being discreetly escorted down the freight elevator by hospital security staff. We met an unmarked sheriff's car at the loading dock, where they proceeded to pat me down, put me in handcuffs, and take me to the station for questioning. I was placed in a secure room after having my belt and shoelaces safely removed, and I was then read my "Miranda rights." They proceeded to try to question me, but I elected to follow the advice the risk-manager had given me shortly before I was handcuffed, and refused to answer any questions until I could speak to an attorney.

After sitting in the secure room alone for about an hour (by far the worst part of the day) I was informed that the decision had been made to "book and release" me with orders to return for a "charging date" about 3½ weeks later. The charge in question: first-degree sexual assault of a child—a felony. It turns out that "book-and-release" is a process that can take between 3 and 9 hours, involving a background check, fingerprinting, and "mug shots." During this time, I was put into a "holding area." My bench-mates were people from the prison system brought down to the jail for a court date and others, like me, who had been arrested for various crimes. Perhaps the most memorable moment of my time in Booking occurred when a prisoner who noticed that I was upset proceeded to try to make me feel better, pointing out, "Man, it's going to be all right; you'll be out soon, and I'll still be doing 20."

After 9 hours in the booking area, I was finally released. All of the events recounted thus far occurred in just over 48 hours. The worst part about the next 3 weeks was that NOT a lot happened. I met with a lawyer on Sunday and told him all I knew. He was quite confident that this would all go away quickly, but I thought that maybe this was what he told all his clients.

While the hospital discussed the possibility of putting me on "administrative leave," my program instead elected to have me do a nonclinical research elective while the investigation/legal process played out. I appreciated this, as it allowed me to continue in my program without losing time. My lawyer indicated early on that he wanted to offer a meeting between me and the detectives in his presence, but this did not occur until nearly 3 weeks after the arrest. Only then was I finally able to tell the detectives my side of the story.

By this time, the detectives had located the pediatric resident who was present in my clinic on the day of the alleged misconduct, and she had verified that she had not witnessing any wrongdoing during the appointment when the abuse was alleged to have taken place. Nevertheless, the detective indicated that it would be up to the D.A. (District attorney) to decide whether or not I would officially be charged the following week. While I geared up for another set of questions on the day of my meeting with the D.A., in fact, the D.A. never even asked to speak to me. He had apparently reviewed the detective's investigation and decided not to proceed with charges. I was pleased with the positive, albeit anticlimactic, ending to my legal saga.

I was informed later that day by my employer that I should resume all my clinical duties the next day, nearly 4 weeks after I first had heard of the allegation. As an update to all of this, I was recently informed that my state licensing commission had also caught wind of the allegations/investigation, and, after reviewing the case, the screening committee had also decided not to pursue any further action. This was all good news. What can the reader learn from my experience? Three things come to mind: 1) Being falsely accused of inflicting trauma is traumatic itself. I know that I have a better understanding of what my patients must feel like when things "out of their control" happen to them; 2) Documenting the presence of a shadowing resident or other attendant (witness) may not help patient care, but, in my situation, it would have perhaps led to a shorter investigation; and 3) Being falsely accused by our patients is absolutely an occupational hazard for any physician.

Is this a necessary hazard? I would have thought the least likely time an accusation like this would occur was when I had "a shadowing resident" present, as well as the patient's mother, and therefore had not met with the child alone. There have been many times and will continue to be times when I am with children alone without their parents or "a shadow." I cannot help but wonder what would happen if a child in such a situation made an allegation against me. Some have suggested that perhaps having windows in the office doors would protect against these sorts of claims. Anything short of videotaping all encounters with all patients would still present some risk. Before this incident, if you had asked me whether videotaping all encounters was excessive, I think I would have said yes. Having gone through the events described above makes me wonder if perhaps this documentation is warranted to help protect both patients and healthcare providers. I have been told that it is common practice for teachers in many schools to make efforts to never be alone with children: why should it be different in a medical setting?

Training programs can learn from the above experience, as well. When a trainee is being accused of misconduct, it is important to remember that in our society one is innocent until proven guilty. My program and the individuals in the psychiatry department made special efforts to ensure that I was not losing time as the investigation was proceeding. Many also made special efforts to offer their support to me during this process, and it was much appreciated. It is extremely important to discuss the multiple risks that physicians face while practicing medicine and to discuss methods to reduce risk, including complete documentation.

I must stress that, no matter how much one reduces risk, significant risk will still remain. Procedures for handling crises within an institution, whether it is a needle-stick or an accusation of wrongdoing, should be discussed and defined before such crises occur and should be well known to the administrators and residents alike. It is my hope that the reader will recognize that being falsely accused is an "occupational hazard" for psychiatry trainees and others in the healthcare field. It is essential that trainees be aware of this risk. I believe that both trainees and training programs can and should change their practice in a manner that will help protect both patients and healthcare providers.

At the time of submission, the author reported no competing interests.