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Stories from the front: IE excesses and how to counter them
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Stories from the front: IE excesses and how to counter them
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Stories from the front: IE excesses and how to counter them
Stories from the front: IE excesses and how to counter them
Journal Article

Stories from the front: IE excesses and how to counter them

2008
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Overview
In two prior papers, \"Properly Documenting a File and Forensic Examination of IME Doctors\" and \"Qualifications and Paradigms for the Independent Examiner,\" we first explained how field practitioners can better document case files to withstand challenges, including those made by Independent Examiners (IEs, a.k.a. IMEs, ICE, DME, QME), and addressed forensically examining the IE, as well. The second paper sought to establish reasonable standards and protocols to which IEs should be held. It is thought that, in this way, the examiner's credibility can be established, to say nothing of actuating fair and accurate examinations. Still, despite nationwide protest and outrage among practicing doctors and angry patients, the reality is that in a vast majority of jurisdictions in the U.S., any doctor can become an IE merely by making application with an insurance company or intermediary; for most states, there are simply no standards or guidelines to organize this process. We have always spoken out against this. The previous two papers represent two of the few published works on this subject. This paper will demonstrate the excesses some IEs go to in cutting claims. While we hasten to add that this is not an indictment against all Independent Examiners, these are stories that need to be told because they shed light on what is becoming alarmingly commonplace in health care: IEs who ignore patients, ignore factual medical realities, and ignore sworn testimony, downgrading real injuries under the fiction of being \"independent.\" When called to task, the IE has only to say, \"That's my opinion,\" without threat of lawsuit, discipline, or any form of sanction. We consider such scenarios a moral outrage and an injustice to patients who suffer as the result of biased \"independent\" examinations. Many IEs do \"reviews\" and \"independent examinations\" full time and do not actually treat patients anymore. Although business is booming, it's the patients who lose out. [PUBLICATION ABSTRACT]