Qualified Medical Evaluator (QME)

3 Key Reasons Newly Appointed QMEs delay their QME Practice

Every year, a few hundred physicians across the state of California have the desire to leverage their clinical expertise to become a Qualified Medical Evaluator (QME).  As a matter of fact, since October 2016, a total of 524 physicians have registered for the QME competency exam in hopes of becoming a QME.  However, only 181 physicians have started their QME practice over that same time frame (excluding those who passed the October 2018 QME test, as it is too early in the process for them to be listed)!

This is clearly a problem for the Department of Workers’ Compensation (DWC) in California, where there is already tremendous demand in the system for physicians.  The first problem is that the pass rate for the QME competency exam is extremely low (around 54%).  The second problem is that for those few that actually pass the QME exam, starting a QME practice can be quite overwhelming, with several hurdles in the way.

The first hurdle in becoming a QME is to take and pass the QME Competency Exam, which is offered by the California Department of Workers’ Compensation (DWC) twice per year (April and October).  Then Physicians must complete a 12-hour QME report writing course from an approved DWC education provider. Once those two items have been completed, only then can a physician finalize his/her application for QME appointment and start the process of being listed with the California DWC.

A majority of Physicians desire to get involved in med-legal work to diversify their skill set and earn supplemental income to support their primary medical practice.  However, 25% of newly appointed QMEs have yet to start their QME practice. Based on anecdotal information through discussions with newly appointed QMEs, there are 3 key reasons for this:

  1. Uncertainty in the System:  Public concern regarding the stability of the California Work-Comp system as a whole has put doubt in the minds of physicians and caused many of them to hit pause in the pursuit of taking on QME cases, most notably, the looming med-legal fee schedule changes.
  2. System Complexity: Although physicians are accustomed to working in a regulated environment, the processes, rules and regulations that exist within the California DWC are substantially different and require a different approach.
  3. Lack of Skilled Resources:  The aforementioned highly regulated environment, not only requires physicians to develop a new skill set, but it also requires their staff to learn an entirely new set of rules and skills.  Furthermore, there are very few, if any, educational resources available for the physicians’ staff to get up to speed with handling QME cases.

Providing the right services that address these reasons will help newly appointed QMEs realize their desire and start a successful QME practice.  California Medical Evaluators has created a tailored QME practice management service, the QME starter program, that is designed specifically to help newly appointed QMEs become successful med-legal experts.

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