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[Popular Books Section]
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A PRACTICAL GUIDE
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The Comprehensive IME System: Essential Resources for an Efficient and Successful IME Practice (with two diskettes) by Christopher R. Brigham, MD Hard Bound, 8.5" x 11".
Seak Inc., Legal and Medical Information Systems, P.O. Box 729, Falmouth, MA 02541. Telephone : 508-548-7023; Fax : 508-540-8304. Publication Date 1997. xx + 304 pages, ISBN 0965219763. Price $ 459.00
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If you are a physician performing independent medical evaluations (IME), try answering the following questions before going further:
If the answer to all of the above questions, and other similar questions is "yes" then you probably don't need this book. But if the answer to any of the question is "NO" then this is a book meant specially for you, and can do wonders to your practice.
The book "THE COMPEHENSIVE IME SYSTEM" has been written as a practical guide for all those physicians who perform independent medical evaluation. The book describes the various requirements for IME, how they can be fulfilled, the various forms which should be maintained etc.
 ...the author has made use of the
hypothetical case of one John D. Sample to illustrate how the report has to be made. He has given both the sample proforma and one that has been completed. This
gives an idea regarding how the report has to be written in an efficient manner...
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The author starts by describing the basics of independent medical evaluation. An orientation about IME is given. He describes the tasks of IME i.e. all the things that are required to be performed during an IME. He also tells about the skills required in IME. This is very important, as many a time the physician is unaware of the skills required in an IME. He automatically assumes that being a good clinician is the only requirement for being a good evaluator too. What he forgets is that evaluation is much more than just examining the patient. It involves many legal and ethical questions about which the person has to be well versed; else he can land himself in big trouble especially while testifying in the court.
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The author then goes on to describe the various steps of evaluation viz. pre-evaluation, evaluation and post-evaluation. The description is very informative especially because of the inclusion of a hypothetical situation. The importance of the use of various charts, questionnaires etc. has been explained adequately. How to contact the examinee, how to greet him, how to explain him about the examination etc have been explained adequately. The chart about taking consent has been described in great detail. The author then proceeds to describe how an IME can be performed by describing the hypothetical examination of one John D. Sample. The author has described this example in great detail thereby helping the reader to understand the method of examination better.
The next part of the book deals with post evaluation i.e. how the report is to be prepared after the completion of the IME. Here the author has made use of the hypothetical case of John D. Sample to illustrate how the report has to be made. He has given both the sample proforma and one that has been completed. This gives an idea regarding how the report has to be written in an efficient manner. It also tells about how much emphasis has to be given to each part of the report. This is very important, as the final report is the only document that the physician sends to his client and the one that goes to the court, if required. So, it is the final report that decides the ability of the physician and it is the document that, if prepared properly, can save the physician a lot of trouble later.
...The (accompanying) diskettes are an important part of this book. They provide all the proformas, questionnaires
etc. in an electronic format so that they can be changed according to the needs of the individual examiner. This
also gives the examiner a ready format to refer to as and when required. The inclusion of these diskettes with the
book make it that much more valuable...
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Next comes the ways of making the practice as profitable as possible. Here the author has mentioned about the methods of minimizing the risks involved, how to market oneself, how to minimize the cost etc. All these things are very important if one has to survive in today's highly competitive world. So these topics are as important as any other in the book.
Regarding the diskettes. These are an important part of this book. They provide all the proformas, questionnaires etc. in an electronic format so that they can be changed according to the needs of the individual examiner. This also gives the examiner a ready format to refer to as and when required. The inclusion of these diskettes with the book make it that much more valuable.
There are a few flip sides to the book as well. The author thinks that pain is the only complaint for which an IME is done. Otherwise he would have given more than just one example to illustrate how an IME is done. Just one example is never sufficient to illustrate one's point of view. Another shortcoming that we noticed was that the author made just a passing remark on how to differentiate between a malingerer and a genuine patient. Since, to differentiate between a malingerer and a genuine patient is the main idea of doing an IME, the inability to do the same defeats the very purpose of doing an IME. Another noticeable shortcoming is that there is mention of somatoform disorders but no details have been given. Here also the author has laid more emphasis on how these disorders are related to the patient's perception of pain instead of how these disorders per se are to be handled. Only a few of these disorders and some of their diagnostic criteria have been mentioned. This does not give any idea regarding how to proceed while dealing with such problems. A better method would have been to describe a few conditions and the ways in which the person is going to present. Then the author could have proceeded to mention the ways in which those patients could be handled.
However the positive aspects of the book more than compensate for these few shortcomings. All in all, this book does give a lot of relevant information, and is quite useful. Some readers however may find the cost just a trifle too high.
-Puneet Setia and Avneesh Gupta
Department of Forensic Medicine and Toxicology,
Maulana Azad Medical College,
New Delhi, India
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-Anil Aggrawal
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