Understanding forensic psychiatry in healthcare practices and collaboration between legal nurse consultants and physicians

In 2000, the Institute of Medicine stunned many professionals with their published report that noted the vast number of deaths that occur each year in hospitals across the United States which reach as many as 98,000. Therefore, it comes as no surprise that the healthcare arena faces litigious issues regularly, with some specialties budgets being significantly impacted by the cost of maintaining liability insurance. Legal Nurse Consultants and forensic physicians working in tandem but who work independently from treating clinicians can carry out forensic independent medical examinations (IME). This can help to assess the validity of malpractice claims, including issues of causation and degree of injuries claimed due to the incident(s) and recommend treatment strategies where appropriate. Reviews can cover a wide range of issues such as a person's past or current testamentary capacity, a prisoner or an accused person's mental health and/or mental impairment where necessary sending them for more assessment or treatment outside prison. This article argues that independent medical reviews are a useful tool that can assist the civil and criminal courts processes.

Cardiopulmonary Exercise Stress Testing – an Update

This article updates one published in The Guides Newsletter in January/February 1998 and reflects changing legislation in the workers’ compensation area and also in motor accident compensation. In the various Australian state and federal jurisdictions, impairment rating has become an important component of independent medical examinations, and in many areas, impairment guides have been adopted as a mandatory tool for assessing permanent impairment. For example, in the mid-1990s the state of Victoria established use of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, as the sole tool for evaluating impairment and continues to use this edition to the present time. Despite the publication of the AMA Guides, Fifth Edition, in 2000, the Motor Accidents Authority in New South Wales (NSW) continues to use the fourth edition, supplemented with the NSW Motor Accidents Authority Guidelines. In November 2001, Tasmania adopted the same guidelines that were being used by the NSW Motor Accidents Authority. Despite publication of the AMA Guides, Sixth Edition, in 2007, there has remained a general reticence in Australia to progress to use of this latest edition either as stand-alone impairment rating tools or an underpinning of the purpose-developed impairment guidelines already in place. A large number of Australian medical assessors have become used to the model based on the NSW WorkCover Guides for the Evaluation of Permanent Impairment, which interprets the AMA Guides, Fifth Edition.