All
individuals being examined for the first time will be asked to provide a
medical history in his or her own words.
Normally
that history is obtained by having the examinee fill out a form designed to
elicit a medical history appropriate to the complaints and to the type of
examination being performed, and to then fill out a “Symptom Diagram”, all done
while in this office at the time of the examination.
My
staff and I are available to an assist in the completion of that form should
the examinee experience any difficulty.
The examinee is always expected to personally complete the "Symptom
Diagram" on the last page of that form.
There
have been requests from attorneys representing individuals who are to be
examined for medical-legal purposes, that they be provided with the history
form in advance, so that it might either be reviewed with their client before
hand, or so that their client might bring a completed form to the examination.
I
must object to this in the strongest possible terms.
It
is my position that I should be able to carry out my examinations under exactly
the same circumstances and under no greater terms or restrictions than were
placed upon those physicians who had already treated and/or evaluated the
individual and who might be called as expert witnesses. If it is indeed the goal of the legal system
to maintain a "level playing field", no restrictions can be placed
upon my examinations that were not previously placed upon the adversary’s
experts, and certainly those physicians were permitted to obtain a history
directly.
The
examinee’s attorney has every opportunity to list as many diagnoses,
complaints, and treatments as he wishes, when he or she prepares the answers to
interrogatories, documents that I review if they are provided, as they usually
are. On frequent occasion I have found
significant discrepancies between what is in the interrogatory answers and the
answers obtained directly from the person being examined.
The
role of any doctor is to obtain a history from the person being examined in
that person’s own words, not in the words of a third party or in words that
have been rehearsed with a third party.
The attorney should merely instruct his client to be complete and
truthful, and let the examination take its proper course..
So
long as I behave in accordance with accepted medical rules, regulations, and
standards, there should be no interference with the manner in which I choose to
carry out an IME, a medical examination, by any other party.
Robert A. Goldstone M.D.
12 August 2009