July's Tips: Independent Medical Exams – Who Tells Who What?

Independent Medical examinations have become increasingly more common over the past decade.  Ranging from insurance claims to determining disability, they can be a source of confusion and anger for patients, especially when the information in them leads to a loss or reduction in benefits.

Access to the information in these reports is governed by both Federal and Provincial legislation.  In Nova Scotia, physicians who conduct third-party examinations have been advised to inform patients:

• Whoever pays for a third-party examination owns it and controls its release. It is not the same as an examination done under a provincial health insurance plan and patients will only see the results if the third party that paid for the report releases them.
• In some cases physicians pass along information resulting from a third-party examination to the patient's doctor, but rules are fuzzy and vary according to the physicians and third parties involved. In most cases patients will not be allowed to see these reports¹.

The College of Physicians and Surgeons of Ontario has published a report in 2009 entitled, "Access to Reports", which states:

Physicians should be aware that after the report has been submitted to the third party, patients or examinees may contact physicians directly to request a copy of the report or a copy of documents relied upon when preparing the report.

Physicians must comply with any statutory obligations they may have to provide access to reports, documents or notes. This includes but is not limited to applicable obligations under Ontario and Canadian privacy legislation.

Should physicians be uncertain how to respond to a request for access, or what obligations they may have, the College advises them to seek the guidance of the Canadian Medical Protective Association (CMPA), or their legal counsel².

¹ Excepted from Can Med Assoc J 1997;156(1):73-5 by Dorothy Grant, coordinator of patient-physician relations with the Medical Society of Nova Scotia.

² Third Party Reports: Reports by Treating Physicians and Independent Medical Examiners, Dialogue, Issue 1, 2010, College of Physicians and Surgeons of Ontario.

June's Tips: Dictation Commands

When you dictate a text, your instructions need to be as clear as possible for maximum accuracy. There are times when you want to highlight, bold or underline particular words. As well, you may want to use parentheses and quotation marks. To clearly indicate these commands to the transcriptionist, try using this method. Say "STOP" before any command to indicate that you are going to give a specific command.

For instance, to bold specific test, say 'STOP', then say, 'in bold type ......', followed by "STOP BOLD". And continue dictating.

For parentheses, say "STOP, open parentheses ...... close parentheses".

You can also use this technique to indicate specific instructions, such as to add your credentials into a letter, to add a chart, or to indicate that you will dictate a portion of the letter or report at a later time (such as waiting on laboratory results or diagnostic imaging reports). To continue the dictation after the instructions, use 'Resume dictation' to let the transcriptionist know that you are back to dictating.

For example:

Dictating numbers:

May's Tips: The Pros and Cons of Outsourcing Your Medical Transcription