According to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, an independent medical evaluation (IME) is “an evaluation performed by an independent medical examiner, who evaluates—but does not provide care for—the individual.” In April 2002, the Work Fitness and Disability Evaluation Section of the American College of Occupational and Environmental Medicine (ACOEM) prepared a motion defining the rationale why there is no a priori establishment of a patient–physician relationship during an IME. A figure in the article includes the text of the resolution, which was proposed and debated at the House of Delegates but has not yet been adopted by ACOEM. A table prepared by the College of Physicians and Surgeons of Ontario (CPSO) enumerates differences between the usual doctor–patient relationship and IMEs in terms of duty to provide care, maintaining records, access to records, and fees. CPSO also clarifies that physicians who agree to conduct third-party examinations of individuals whom they are not currently treating have been hired by a third party to perform a particular task, typically to provide an opinion or answer specific questions about the individual. Clear and effective communication with the individual are particularly important because the individual's livelihood or compensation for injury, as well as the person's continuing health, are at stake.