PubMed · 8744888
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S Fink, T K Chaudhuri. 1996. Physician malpractice: does the past predict the future?. https://doi.org/10.1007/bf02642488
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There has been virtually no empirical study of the way in which evaluating clinicians communicate their conclusions about the risk of violence toward others. Risk communication has become particularly important in recent years, serving as the link between empirical data from recent studies and the understanding and use of such data by evaluators and decision makers. The present study considered how psychologists and psychiatrists, identified as experts in violence risk assessment, responded to eight vignettes that systematically measured preferences for risk communication. The vignettes involved the presentation of the following factors in a 2 x 2 x 2 within-subjects design, counterbalanced for order: (1) risk model (prediction vs. management), (2) risk level (high vs. low risk of the individual being assessed), and (3) risk factors (the predominance of static vs. dynamic risk factors). A total of 71 individuals (41 psychologists, 2 sociologists, and 28 psychiatrists) responded to a survey mailed to 100 individuals, for a response rate of 71%. Participants were asked to rate the value of six forms of risk communication for each of the eight vignettes. There were few significant differences between the ratings assigned by psychologists and those assigned by psychiatrists. The most highly valued form of risk communication involved identifying risk factors applicable to the individual and specifying interventions to reduce risk. A repeated-measures multivariate analysis of variance yielded a main effect for risk level and an interaction between risk level and risk factors. The implications of these findings for research and practice are discussed.
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Rheumatologists are frequently asked to see whiplash patients for an independent medical examination. There are many diagnostic and other assessment issues which arise in the setting of an independent assessment, and which do not usually arise in the usual physician-patient relationship. This article thus reviews aspects of the history, physical examination, radiological evaluation, and causation by way of the accident that are of importance to the rheumatologist as independent examiner. We address questions such as Was a physical injury likely to have occurred in the accident? What are the pertinent psychosocial aspects in the history? What are useful diagnostic signs on examination? and What is the significance of radiological findings? These are important and sometimes troublesome questions to answer in the setting of the independent medical examination, but rheumatologists can look to recent literature and research findings to assist in answering these questions.