Medical Evaluations

People don't plan well for medical evaluations.  They don't ask questions.  They don't understand what's required.  They therefore come away from the evaluation less than satisfied with what was communicated and often less understanding of what they went through and why.

I perform several types of evaluations in conjunction with a couple of multispecialty groups.  I've also gone through a number of medical evaluations personally. 

It's important to understand what you are wanting to get out of the evaluation.  Are you expecting a diagnosis, a treatment plan, a test result, a letter documenting a specific finding, a condition, a cure, reassurance, money in a legal settlement, a rating for a benefit?  Why are you going through the evaluation procedure?  Did you request the evaluation or did someone else require it?  Those things matter.  Regardless of whether you were required to go, it's still important to know what you want from the evaluation. 

I'm called on to do anywhere between 1 and 9 evaluations in a day.  On the days where I do a single evaluation there is an extensive history process.  The person completes lots of paperwork.  They perform tests that I administer, that are done on computer and complete questionnaires that are taken home and brought back later.  They are told to bring food, wear comfortable clothing, bring something to drink.  Depending on the nature of the evaluation, I may be attempting to exhaust them so I can document performance with fatigue.  I may repeat tests in different conditions.  I may have fluorescent lights on, distracting sounds, frequent interruptions, to see how people cope with visual and auditory distractions in the environment.  In other cases I may have a virtually soundless office with incandescent lighting, done in a very comfortable setting. I may see the same person in both settings.

On days where I perform up to 9 evaluations in a day the questions I am answering are simple.  Usually what is this test result?  The test is specified.  What is this person's full scale IQ score?  Easy.  Give me anywhere between 30 and 90 minutes and I can answer that within a range.  Some agency will ask that.  People might ask that but they really want to know more.  What am I good at?  How do I compare with other people?  How come I'm good in this area but perform poorly in this area?  What can I do to be better at this?  Why can't I pass tests even if I'm smart and know the material?  Those are more complicated questions requiring more time in an evaluation.

If I want to know if someone suffered a traumatic brain injury I can ask them about incidents of concussion, loss of consciousness, or findings on a CT or MRI scan of the brain.  If I want to know what happened to their thinking as a result of a traumatic brain injury I have to evaluate them using a battery of tests, measurements and questionnaires as part of a neuropsychological evaluation that will take several hours.  The more complicated the question the more complicated the evaluation.

It's important to know what question is going to be answered by a medical evaluation or a psychological evaluation to understand and plan for the evaluation adequately.