scholarly journals Independent medical evaluation for sick-listed patients: a focus group study of GPs´ expectations and experiences

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Aase Aamland ◽  
Elisabeth Husabo ◽  
Silje Maeland
2017 ◽  
Vol 47 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Aase Aamland ◽  
Irene Øyeflaten ◽  
Silje Maeland

Background: Norwegian politicians have proposed the use of an independent medical evaluation (IME) as a possible solution for reducing long-term sick leave. The use of an IME implies that a new doctor interferes in the relationship between sick-listed workers and their general practitioner (GP). The aim of the current study was to explore experiences of IME doctors from an ongoing randomized controlled trial (the NIME trial evaluating the effect of IME in Norway). Methods: Two focus group interviews were conducted with eight of the nine IME doctors employed in the NIME trial. The discussions were audio-taped and transcribed. Systematic text condensation was used for analysis. Results: The participants reported that the IME provides important second opinions, which they felt empowered the sick-listed workers and provided new insights into their condition. Beneficial IME working conditions and enhanced insight into different sick leave measures were crucial to this perceived usefulness. Some of the participants expressed disappointment with GPs acting as passive conductors and struggled to provide feedback politely. Some adjustments were proposed as necessary for the IME to be implemented nationwide. Conclusions: The participants seemed to have gained a different stakeholder identity by sometimes seeing GPs, their peers, as obstacles to return to work and welcomed the use of IME on a regular basis.


2000 ◽  
Vol 5 (5) ◽  
pp. 4-5
Author(s):  
James B. Talmage ◽  
Leon H. Ensalada

Abstract Evaluators must understand the complex overall process that makes up an independent medical evaluation (IME), whether the purpose of the evaluation is to assess impairment or other care issues. Part 1 of this article provides an overview of the process, and Part 2 [in this issue] reviews the pre-evaluation process in detail. The IME process comprises three phases: pre-evaluation, evaluation, and postevaluation. Pre-evaluation begins when a client requests an IME and provides the physician with medical records and other information. The following steps occur at the time of an evaluation: 1) patient is greeted; arrival time is noted; 2) identity of the examinee is verified; 3) the evaluation process is explained and written informed consent is obtained; 4) questions or inventories are completed; 5) physician reviews radiographs or diagnostic studies; 6) physician records start time and interviews examinee; 7) physician may dictate the history in the presence of the examinee; 8) physician examines examinee with staff member in attendance, documenting negative, physical, and nonphysiologic findings; 9) physician concludes evaluation, records end time, and provides a satisfaction survey to examinee; 10) examinee returns satisfaction survey before departure. Postevaluation work includes preparing the IME report, which is best done immediately after the evaluation. To perfect the IME process, examiners can assess their current approach to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality.


2008 ◽  
Author(s):  
Ellen H. McWhirter ◽  
Marina Valdez ◽  
Alisia R. Caban ◽  
Christina L. Aranda

2019 ◽  
Vol 40 (1) ◽  
pp. 5-17
Author(s):  
I Castroviejo Fernández ◽  
S Jourdain ◽  
N Kacenelenbogen ◽  
PR Smeesters

2019 ◽  
Vol 28 (4) ◽  
pp. 328-334 ◽  
Author(s):  
Crawford Moodie ◽  
Rachel O’Donnell ◽  
Joy Fleming ◽  
Richard Purves ◽  
Jennifer McKell ◽  
...  

Author(s):  
Allyn M Bove ◽  
Erin R Dong ◽  
Leslie R M Hausmann ◽  
Sara R Piva ◽  
Jennifer S Brach ◽  
...  

Abstract Background The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA). Methods We conducted a series of qualitative focus group discussions with groups of Non-Hispanic White and Non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of post-operative physical therapy received, and overall satisfaction with the post-operative rehabilitation process. Results Thirty-six individuals participated in focus groups. Three major themes emerged: (1) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in “prehabilitation”, and often mentioned specific interventions they felt were most helpful in their recovery. (2) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (3) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers. Conclusions Individuals undergoing TKA can largely expect positive rehabilitation experiences post-operatively. However, some barriers to post-operative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.


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