Hostile psychiatric examinations short power pointPresentation Transcript
Hostile Psychiatric Examinations Janet Louise Parker B.S., M.S., D.V.M.
Administrative• Initial Complaint – Anonymous• Peer Review - identified behaviors• Monitoring & Surveillance• Lack of Notice• Lack of Due Process• Disregard for Civil Rights
Criteria for Administrative Hearing• Fraud or Felony• Professional misconduct or moral turpitude• Incompetence or unprofessional conduct
Disruptive Physician• “Reporting Impaired, Incompetent, or Unethical Colleagues,” provides a broad frame for “INTERVENTION”• Mechanisms “to assess the potential impact” of such behavior and “to facilitate remedial action.”
Work-Related Medical Examinations• Objectivity• Confidentiality• Disclosure of Potential or Perceived Conflicts of Interest• Altered Responsibilities and obligations
“Industry Employed Physician” (IEP)• Physicians- employed by businesses or insurance companies for the purpose of conducting medical examinations.• Employment, pre-employment, and work- related examinations, monitoring employees health.
“Independent Medical Examiners” (IMEs)• Not employees - independent contractors• Provide medical examinations for employees or others within the realm of their specialty• Contractual obligations to the business or insurer and depend on these parties for payment.
Conflict of Interest• Contractual arrangements• Receive payment from 3rd parties – the state, insurer or employer
Physicians Health Program• The Health Care Quality Improvement Act 42 U.S.C. § 11133(a)(1)(C)• “Impaired” physicians status• The state medical association• A sanction reportable to the National Practitioner Data Bank (NPDB)
Patient-Physician Relationship• To care for patients and to alleviate suffering• To place patients’ welfare above the physician’s own self-interest and above obligations to other groups• To advocate for the patients’ welfare.
Hippocratic Oath:“What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.”
Privacy1) Physical - individuals and their personal spaces2) Informational - specific personal data3) Decisional - personal choices4) Associational - family or other intimate relations
Corruption in the Process1) Dishonest testimony is often regularly (and unthinkingly) accepted;2) Statutory and case law standards are frequently subverted;3) Insurmountable barriers are raised to insure that the allegedly “ correct" social end is met4) Original Complaint Sealed to Prevent Discovery