Health assessment and independent medical evaluation
Health assessment
Inquiries into the health status of licensees may vary. Health Monitoring Program relies on different types of assessments to confirm or measure a licensee’s capacity to practice safely. Every effort will be made to be as unintrusive as possible when obtaining an assessment. Licensees will have as much input into these assessments as possible.
Care providers
Licensees will have a choice on who will conduct these assessments. Wherever possible, information will be sought from a licensee’s own care providers and those who know them best.
Requirements
CPSBC must be satisfied that the care provider conducting the assessment has the requisite expertise, is capable of assessing a licensee’s fitness to practise, and can communicate their findings in an acceptable report to CPSBC. Assessments must be guided by the best scientific evidence, and in accordance with the best published clinical practice guidelines.
Examples of fitness to practise assessments
Below are examples of evaluations that represent points on a spectrum rather than distinct categories. Many evaluations lie somewhere between these points.
- One-time fitness to practise confirmation
A relevant treating physician provides a confirmation of fitness to practise. This is often a licensee’s own primary care provider or family physician. This could include specialists such as psychiatrists, neurologists, oncologists, etc. - Detailed evaluation of medical condition
A relevant care provider conducts a more detailed evaluation of the medical condition's current status. This will often be a psychiatrist, neurologist or other specialist. - Independent medical evaluation
An objective clinical expert who does not provide primary care for the licensee conducts an independent assessment. This often will be by an addictions specialist or a psychiatrist.
Note: Not every licensee will require an independent medical evaluation.
Independent medical evaluation (IME)
An IME must be performed by a clinician approved by CPSBC. The clinician performing the IME has certain expertise, qualifications, and experience, which varies according to discipline and specialty of the monitored licensee.
In addition to conducting a detailed history and physical exam and ordering relevant investigations, the approved care provider must also review collateral information.
The report must meet all of CPSBC’s requirements and answer specific questions from CPSBC pertaining to fitness to practise.
There are four situations in which an IME may be requested:
- There is ambiguity about a diagnosis, or the extent or impact of a condition on a licensee’s capacity to practice safely is unclear.
- There is disagreement about a diagnosis. This disagreement may be by the licensee, or between different clinicians evaluating the licensee.
- The licensee’s care provider refuses to provide an IME or is concerned that it will place them in a conflict of commitment with the licensee or damage the patient-physician relationship.
- The licensee’s care provider is otherwise unable to fulfill the request to do an assessment, come to a decision, or write a report about the licensee’s capacity to practice safely.
The monitored licensee pays for the cost of the independent medical evaluation.
Costs and payment must be clearly discussed and arranged with the care provider prior to the evaluation.