What is a medical legal appointment?
Medical practitioners are not infrequently asked to see patients in an independent fashion. The reason for this interview is to allow a third party, usually an insurer or perhaps a workplace official, to determine the nature of that individual’s physical complaint and to put it into perspective. By this, I mean that patients are assessed in an objective fashion determining the seriousness or otherwise of their medical complaints and indeed whether they require treatment.
For instance, a patient may present with a painful knee. This knee may well be an osteoarthritic joint which is clearly a longstanding problem. The patient himself did not particularly recall an episode but has, in relatively short sequence, developed a very painful and swollen joint. As a consequence, they may believe that the workplace is the cause of their current problem.
A GP sees them and orders an X-ray and an MRI scan. This shows longstanding changes of osteoarthritis.
The patient, nonetheless, maintains that until the very minor twisting episode that they had in the workplace, they had no problems at all in relation to their knee.
The matter may be worsened by the fact that a third party, perhaps a surgeon that they have seen, perhaps a physiotherapist, might have told them that they have evidence of an acute injury.
The stage is set for the patient to expect that the treatment they have will be related to the workplace and will be coming to them without cost.
In this instance, it is essential for a third party, usually an independent orthopedic surgeon to provide a report to a third party, who usually represents the workplace. The idea behind this report is not only to determine the veracity or otherwise of the claimant’s complaints but also to determine whether they are longstanding problems or whether they are a recent issue. The premise behind this is to determine who is responsible for the management of this ongoing issue and also to determine whether the patient needs treatment now or whether the matter can be deferred. For instance, it is not uncommon for knee osteoarthritis, in the above episode to be treated non-operatively by way of physiotherapy for a short period of time.
In the above example, it would be important that the independent person does not act on behalf of the patient nor on behalf of the insurer. They are there to provide an absolute independent opinion.
If the patient has been told that the issue is a work related problem, the stage is set for conflict. Even though the independent person is acting as an independent practitioner and providing an objective assessment, the patient may feel that they are siding with the insurance company. This of course is not the case and opinions provided of this sort are professional, independent, and objective.
As you may understand, the patient may therefore feel aggrieved with the assessing individual such as the orthopedic surgeon in the above episode. However, the surgeon has not acted in anyone’s interest. He is there as an independent practitioner. He is not there to provide treatment suggestions and cannot be involved in the treatment of the patient directly.
Reports generated in this context are usually sent to the general practitioner who is caring for the patient. They may feel aggrieved as they may have an erroneous understanding that this is a work related problem.
The patient may choose to vent their frustration by way of the internet. This is the method by which most comments are placed on Rate My Doctor or Rate my MD. These comments are unable to be certified and clearly require an independent assessment. They are rarely an objective assessment of the matter and often present a biased viewpoint to which the assessing practitioner is unable to respond.
This is of course an unfair situation not only for the independent practitioner but also for the insurer. They are given the understanding that the independent practitioner has acted against their wishes when this is not the case at all. The independent practitioner has merely acted in an independent fashion.