Case Conference

A case conference is a cost-effective alternative to a follow-up IME or a follow-up record review that allows for a quick reassessment of a case. Case conferences are often held face-to-face in our office but, if time is important, can be done over the telephone or via secure video teleconference. A case conference approach is often particularly effective in cases with new clinical information that affects ongoing treatment. Frequently, such new information (i.e. the result of a new imaging study or the findings and recommendations of a new surgical consultant) leads to requests for surgical procedures and the need for an insurance company representative to either approve or deny and for legal professionals to advocate for or against the proposed intervention. An interim case meeting and reassessment can be an effective means of facilitating critical decision making and either approving an urgently needed, appropriate intervention or disapproving unnecessary or overly aggressive care recommendations by treatment providers. Case conferences usually work best after an initial independent assessment (IME) of a case has already been rendered and when the patient is known to Dr. Zunkeler. In some cases, particularly when there is a time limitation, Dr. Zunkeler can review all relevant records and imaging studies without interviewing the patient prior to the case conference.

 

If desired, a written report of the case conference can be provided by Dr. Zunkeler. Case conferences are particularly convenient in cases in which urgent interventions are requested by treatment providers, in cases in which patients have been hospitalized and complex management issues need to be addressed from the insurance and/or legal point of view, or in cases in which patients have suffered permanent neurological deficits and have ongoing treatment needs. A case conference can also be a convenient management tool for attorneys to help prepare for depositions or settlement conferences.

 

We can usually accommodate conference requests at very short notice, i.e. within several days rather than weeks, to meet the needs of our clients.

What should you expect from a case conference?

For a case conference to be effective, the parties participating in the conference should prepare by reading up on the case. It is usually best if the client's questions and expectations for the conference are put in writing before the conference. Typical questions that are addressed in a case conference include: 1. What is the patient's current clinical status, and what are the actual medical needs? 2. Has the patient benefited from treatment to date? 3. Other than the proposed intervention, are there other treatment options from a neurosurgical perspective, and how successful is each treatment option expected to be? 4. Has an end point of treatment been achieved, and if not, when can it be expected? 5. Going forward, what are the anticipated medical needs over the next 1, 5, or 10 years?

 

 

What are the potential shortcomings of a case conference?

While a case conference can be very enlightening and supportive for insurance and legal professionals from the standpoint of clarifying the medical needs of a patient, a case conference is primarily a communication tool between members of an administrative patient management team. A case conference cannot replace the experience of a face-to-face encounter. The information obtained by the examiner directly from the patient through a history and physical examination during an independent medical evaluation (IME) is sometimes still needed. If necessary and feasible, an IME visit can be scheduled later, i.e. after a record review and a case conference have been completed.

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