This week on White Coat Black Art (listen live on November 15, 2008 at 430 pm or 5 pm NT or download the podcast dated November 10, 2008), I talk to an Independent Medical Examiner (IME). IMEs are physicians hired by third party insurers and workers' compensation boards to conduct independent examinations of patients to verify claims of injury, illness and disability. They are called IMEs to distinguish them from your own physicians, who are your advocates.
The focus of the interview was the role played by IMEs in outing exagerrated and even bogus claims of injury.
Since that interview, a number of you have expressed outrage that we would put such an interview on the air. From what I gather, the gist of the objections made by some of you is that by putting the interview on the air, we were endorsing the notions that patients lie frequently about illness, injury or disability, and that we agree with everything the guest said about the process and outcome of independent medical evaluations.
Most avid listeners of our show know that none of the above is true. We put interviews on the air -- not as tacit endorsement of what they say -- but so that you know what people on my side of the gurney think and believe about the health care system.
For nine years, I cared for patients with severe forms of chronic pain. As their physician, I was their advocate. Many of them were sent to IMEs. I saw first hand the adverse impact these assessments had on my patients. I also came to realize just how it easy it is for an IME to cite lack of objective evidence for chronic pain when the pain is real.
If you've undergone an IME and feel you've been wronged in the process, I feel for you. If you want recourse, you should ask for a second IME (as many people have), or complain about the physician who conducted the IME to your provincial College of Physicians and Surgeons.
But not for one minute will I apologize for putting an IME on the air. To make your way in the health care system, you need to know the players. Same goes if you want to change the system. In my opinion, that means knowing the role played by IMEs, and hearing what they have to say.