Assessing Adverse Outcomes and Learning Needs in Canadian Psychiatric Independent Medical Examinations.
Journal: The journal of the American Academy of Psychiatry and the Law
Volume: 52
Issue: 1
Year of Publication: 2024
Affiliated Institutions:
Dr. Booth is an Associate Professor, Division of Forensic Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Ottawa and Forensic Psychiatrist, Integrated Forensic Program, Royal Ottawa Health Care Group Ottawa, ON. Dr. Waldman is an Assistant Professor, Department of Psychiatry, Faculty of Medicine, University of Manitoba and Medical director, Roblin Medical Forensic Group, Winnipeg, MB. Ms. Fortier is a Medical Analyst Researcher for Safe Medical Care Research, Canadian Medical Protective Association Ottawa, ON. Dr. Garber is a Professor in the Department of Medicine and the School of Public Health and Epidemiology, University of Ottawa, Ottawa, ON, a Professor in the Department of Medicine, University of Toronto, Toronto, ON, and Director of Safe Medical Care Research, Canadian Medical Protective Association. Ms. Hardy is Chief Executive Officer, Canadian Psychiatric Association. Dr. Lemay is a Medical Analyst Researcher, Safe Medical Care Research, Canadian Medical Protective Association. Mr. Liu is a Statistical Data Analyst, Safe Medical Care Research, Canadian Medical Protective Association. Dr. Tomita is a Clinical Associate Professor, University of British Columbia, Vancouver, BC. Dr. Ramshaw is an Assistant Professor, Division of Forensic Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Toronto and a Forensic Psychiatrist, Forensic Service, Centre for Addiction and Mental Health (CAMH), Toronto, ON. brad.booth@theroyal.ca.
Dr. Booth is an Associate Professor, Division of Forensic Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Ottawa and Forensic Psychiatrist, Integrated Forensic Program, Royal Ottawa Health Care Group Ottawa, ON. Dr. Waldman is an Assistant Professor, Department of Psychiatry, Faculty of Medicine, University of Manitoba and Medical director, Roblin Medical Forensic Group, Winnipeg, MB. Ms. Fortier is a Medical Analyst Researcher for Safe Medical Care Research, Canadian Medical Protective Association Ottawa, ON. Dr. Garber is a Professor in the Department of Medicine and the School of Public Health and Epidemiology, University of Ottawa, Ottawa, ON, a Professor in the Department of Medicine, University of Toronto, Toronto, ON, and Director of Safe Medical Care Research, Canadian Medical Protective Association. Ms. Hardy is Chief Executive Officer, Canadian Psychiatric Association. Dr. Lemay is a Medical Analyst Researcher, Safe Medical Care Research, Canadian Medical Protective Association. Mr. Liu is a Statistical Data Analyst, Safe Medical Care Research, Canadian Medical Protective Association. Dr. Tomita is a Clinical Associate Professor, University of British Columbia, Vancouver, BC. Dr. Ramshaw is an Assistant Professor, Division of Forensic Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Toronto and a Forensic Psychiatrist, Forensic Service, Centre for Addiction and Mental Health (CAMH), Toronto, ON.
Abstract summary
Despite the importance of independent medical examinations (IMEs), there is virtually no literature on the risks to the IME assessor nor the learning needs of psychiatrists in this area. To address this deficit, a retrospective chart review of nearly 38,000 cases from the Canadian Medical Protective Association (CMPA) identified 108 files involving complaints or legal actions against psychiatrists performing IMEs. Most complaints identified by the CMPA were to regulatory bodies, including biased opinion, inadequate assessment, inappropriately relying on a requester's information without independent evaluation, nonadherence to regulatory body policies, cursory documentation lacking relevant details, and communication breakdowns. A survey by the Canadian Academy of Psychiatry and the Law (CAPL) and the Canadian Psychiatric Association (CPA) had 306 Canadian psychiatrist respondents. About 37 percent of psychiatrists completing IMEs reported medico-legal consequences, including complaints to regulatory authorities. Only 40 percent of those doing IMEs and 20 percent of all psychiatrists had formal training in doing IMEs. The studies confirm that despite a low but important risk of medico-legal consequences, many psychiatrists performing IMEs do not have formalized training. Using the new CAPL is a step to reduce the risk of such evaluations.
Authors & Co-authors:
Booth
Waldman
Fortier
Garber
Hardy
Lemay
Liu
Tomita
Ramshaw
Study Outcome
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