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Christopher R. Brigham
,
Waqas A. Buttar
,
Mark Bucksbaum
, and
James B. Talmage

approaches are useful tools in reducing physician burnout. 5 Other approaches, such as clinical decision-making, reflect higher risk. From clinical decision support to drug discovery, AI techniques such as machine learning (ML) and natural language processing (NLP) demonstrate immense potential to improve the quality of care and health outcomes. 6 Many of the participants in the medicolegal field are involved with workers' compensation systems. It appears that these systems are slower to adopt technology than other arenas. Therefore, it is useful to consider how AI could

in AMA Guides® Newsletter
Charles N. Brooks

, the body's structure, then physiology, how the body parts work, followed by pathology, what can go wrong, then history-taking and physical examination skills, and finally treatment. It concludes with a discussion of often misused medicolegal terms applicable to injury and illness. Anatomy Appropriate localization of symptoms is important when taking a history and performing a physical examination, having ramifications regarding diagnosis, treatment, and causation. A common example of anatomical imprecision pertains to the shoulder. Instead of the shoulder

in AMA Guides® Newsletter

Author: Mohammed I. Ranavaya, MD, JD, MS Published by the American Medical Association, 2019 Reviewed by Christopher R. Brigham, MD, MMS Physician's Guide to Medicolegal Practice , by Mohammed I. Ranavaya, MD, JD, MS, and published by the American Medical Association in 2019, is a splendid resource for any physician or other healthcare provider who wants to perform medicolegal work. Much of the unique knowledge and skills necessary to be successful in this arena are not taught in medical school or residency, making the information in this book

in AMA Guides® Newsletter
Charl Els
,
Barry Gelinas
,
Rose M. Carter
, and
Les Kertay

not be sufficient to constitute a comprehensive assessment. It is recommended that a disclaimer addressing the limitations of such testing should be added to the report. Ruling Out Malingering A high index of suspicion for malingering should be maintained. Malingered psychiatric conditions may be more common in medicolegal settings that commonly involve the avoidance of an unpleasant duty or requirements (eg, incarceration, military service, or when someone is seeking insurance or entitlement benefits) (6th ed [2022]). 10 The DSM-5 8 defines malingering

in AMA Guides® Newsletter
Christopher R. Brigham
,
Waqas A. Buttar
,
Mark Bucksbaum
, and
James B. Talmage

across computers that are linked in a peer-to-peer network); 8 Web3 (decentralized internet built on blockchain technology); 9 and other emerging technologies. AI is used across healthcare systems to support medicolegal operations and enhance productivity, efficiency, and the quality of service, which improves patient outcomes and decreases costs. 10 It is crucial for medical, legal, and claims professionals to identify whether they are at the forefront of adopting AI technologies or lagging. This assessment will provide a roadmap for implementing breakthrough

in AMA Guides® Newsletter
Steven Feinberg
and
Christopher R. Brigham

necessarily to facilitate the well-being of the examinee. Impartiality, objectivity, and an understanding of medicolegal issues are required. Unlike a medical consultation report, the IME report is not confidential and is likely to be read by many stakeholders in the claim; it should be easy to read and understand by nonmedical personnel. Standards for IMEs were published in the September–October 2017 issue of the Guides Newsletter. 1 Reference 1. Brigham CR , Direnfeld LK , Feinberg S , Kertay L , Talmage JB . Independent medical evaluation best

in AMA Guides® Newsletter
Robert J. Barth

Library to fall short of its mission. Specifically, the primary purpose of the Guides is to assist adjudicators and others involved in the evaluation of medicolegal claims, especially workers compensation claims (6 th ed, ages 19-20,). 4 Despite its nature, CRPS has somehow become a major issue in medicolegal claims. For example, research findings have repeatedly indicated that whenever this concept is applied to an examinee, the overwhelming probability is that the examinee will be filing a medicolegal claim. 5 , 6 CRPS claims are especially prominent in workers

in AMA Guides® Newsletter
Christopher Brigham
,
Lorne K. Direnfeld
,
Steven Feinberg
,
Les Kertay
, and
James B. Talmage

relevant to the claim and answer the referring client's questions. Impartiality, objectivity, and an understanding of both clinical and medicolegal issues are required. In many jurisdictions, the IME report may be considered part of a requesting attorney's work product, and access to the report may initially be restricted to the requesting source. However, if legal issues remain unresolved, the report is usually made available to all parties in the dispute under court rules of discovery. It is then likely to be read by many stakeholders in the claim and should be

in AMA Guides® Newsletter
Christopher R. Brigham
,
James B. Talmage
,
Charles Brooks
,
Gunnar Andersson
, and
Craig Uejo

. The Effects of Anthropometrics, Lifting Strength, and Physical Activities in Disc Degeneration . Spine 2007 ; 32 ( 13 ): 1406 - 1413 (PMID: 17545908) In summary, current scientific evidence does not support the premise that “cumulative trauma” results in or aggravates degenerative disc disease. “Repetitive strain injury” of the spine is a mythical medicolegal concept, not a clinical or pathologic reality. 15 Editorial Comment: In future articles, we will explore the relationships among work, low back pain, and degenerative disc disease. We will

in AMA Guides® Newsletter
Alan Colledge
and
Greg Krohm

Abstract

The AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides) specifies that impairment evaluation may be conducted by a treating or nontreating physician. A treating physician who is knowledgeable about the use of the AMA Guides may be the appropriate professional to evaluate impairment, but in cases that involve pain, disability, and medicolegal (forensic) issues, a truly independent medical examiner typically is most appropriate. All specialties share the same elevated risk of iatrogenesis when treating and evaluating/forensic roles are mixed because mixing compromises the quality of care and threatens the viability of the therapeutic relationship. Further, all treating specialties share the same bias toward offering treatment for most complaints—rather than engaging in the type of cautious skepticism that is required for competent impairment evaluation and other forensic duties. Finally, no treating clinician, regardless of specialty, can offer allegiance to judicial and administrative decision-makers. Treating clinicians often find themselves in a position in which they would be cutting off a source of their own income if they were to offer opinions that the clinical presentation is not valid, work related, or injury related, nor is the patient in need of further treatment. Such a financial conflict of interest can be eliminated only by referral to independent examiners and restricting treating clinicians from becoming involved in such decisions.

in AMA Guides® Newsletter