AMA Guides® Newsletter - Issue Archive

Articles

1. Letter of Appreciation and Acknowledgment

   Pages 1–1

   DOI: 10.1001/amaguidesnewsletters.2023.NovDec01

2. Impairment and Disability: A Journey of Understanding

   Christopher R. Brigham

   Pages 2–6

   DOI: 10.1001/amaguidesnewsletters.2023.NovDec02

   Abstract

   The inaugural issue of the American Medical Association's (AMA's) Guides Newsletter in 1996 ignited a conversation about the concepts of impairment and disability. Although the AMA Guides to the Evaluation of Permanent Impairment has evolved significantly with evidence-based medicine from the third edition (1990) to the current 2023 version of the sixth edition, conflating impairment and disability ratings continues. Impairment and disability are distinct terms. The extent of an injury does not necessarily predict the effects on activities of daily living, including work, given other clinical factors, comorbidities, motivation, technology, and accommodations. Patients with disabilities are best understood by embracing a biopsychosocial-spiritual model that reflects a humanistic and holistic view because disability is a multifaceted concept that is influenced by evolving physical, psychological, and psychosocial factors. Evaluating impairment is a challenging undertaking and physicians tasked with impairment evaluations must be trained to use the AMA Guides appropriately.
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3. Stress and Cardiovascular Disorders: A Review and Suggested Impairment Rating Methodology

   Stephen L. Demeter

   Pages 7–19

   DOI: 10.1001/amaguidesnewsletters.2023.NovDec03

   Abstract

   Stress can be divided into two types: physical and mental. This review focuses only on mental and/or psychological stress and two types of cardiovascular problems—coronary artery disease and hypertension—because they are the two most commonly encountered cardiovascular diseases requiring an impairment evaluation. This information can serve as a paradigm for other cardiovascular disorders.
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4. Comprehensive Medical History Interview: Practical Guidance

   Christopher R. Brigham, Steven Feinberg, Waqas A. Buttar

   Pages 20–45

   DOI: 10.1001/amaguidesnewsletters.2023.NovDec04

   Abstract

   Independent medical evaluations (IMEs), impairment assessments, and providing clinical care mandate obtaining an appropriate history. The medical interview is a crucial component for obtaining an accurate and complete medical history for IMEs, which requires interpersonal and analytical skills. The interview is a purposeful conversation aimed at understanding the patient's experiences, with a focus on verbal and nonverbal cues, to help build a comprehensive understanding of the patient's injury and current problems within the context of their overall health. The extent of history that is documented depends on the purpose of the evaluation and the nature of the injury. The process involves documenting chief complaints, injury details, pre-existing conditions, clinical course, current symptoms, and functional and past medical history.
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5. Q&A: Impairment Ratings From Nontreating Physician

   Christopher R. Brigham

   Pages 46–47

   DOI: 10.1001/amaguidesnewsletters.2023.NovDec05