Those third-party reports
Online posting: January 29, 1997
Published in print: Mar. 1, 1997 (CMAJ 1997;156:634)
Re: Independent medical examinations and the fuzzy politics of
disclosure, by Dorothy Grant, CMAJ
1997;156:73-5 [partial text / en bref]
I read with interest this excellent summary of the current issues
concerning who has access to the information contained in third-
party independent medical examinations (IME). Her suggestions
about what to tell patients are excellent. However, I suggest
that the word "patient" in itself is inappropriate because there
is, in fact, no physician–patient relationship. In my reports, I
generally describe the individual as the "examinee," as this is
one way to ensure that a clear distinction is made.
It is important that the physician advise the examinee that an
IME will be conducted but no treatment will be performed and no
patient–physician relationship will exist. I suggest that the
following statement be read and signed by all people undergoing
an IME.
"I understand that the purpose of the examination is
evaluation only, and no treatment is undertaken. I further
understand that the client requesting and paying for the
assessment will receive a report. I realize that no
physician–patient relationship is established during the course
of this assessment."
Since I began using this signed statement and discussing its
intent, I have had no problems concerning inappropriate requests
for copies of reports from my office. When required, a photocopy
of the examinee's signed statement may be produced.
Canadian physicians should know that formal training for
independent medical examiners is available through the American
College of Occupational and Environmental Medicine. Physicians
may then sit the American Board of Independent Medical Examiners
examination. Those who pass are generally well prepared to deal
with the special requirements of the IME.
Rick Zabrodski, MD
Certified Independent Medical Examiner
Clinical Assistant Professor
Faculty of Medicine
University of Calgary
Calgary, Alta.
rzabrods@acs.ucalgary.ca
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