Purpose and Scope
CDEs address a range of referral questions, including:
Diagnostic clarification when existing assessments are inconclusive or disputed
Determination of the presence, severity, and course of medical, psychiatric, or substance use disorders
Evaluation of behavior or judgment concerns in the workplace
Assessment of cognitive functioning, insight, and reliability
Recommendations regarding treatment needs, monitoring, or readiness for return to work
Each examination follows a structured, evidence-based protocol incorporating record review, clinical interview, psychological and cognitive testing, collateral input, and consultation with specialists when indicated.
Distinguishing CDEs from Traditional Clinical Evaluations
- Clinical Diagnostic Examinations -
Objective. Comprehensive. Defensible.
Clinical Diagnostic Examinations (CDEs)—sometimes referred to as Independent Diagnostic Evaluations (IDEs)—are comprehensive, evidence-based assessments designed to clarify diagnostic, behavioral, and functional questions when a healthcare professional’s health, conduct, or judgment may affect their ability to practice safely and effectively.
CDEs are distinct from ordinary clinical visits. They are forensic in nature—conducted not for the purpose of treatment or establishing a physician-patient relationship, but to provide an independent, objective analysis that supports informed decisions by the referring entity. Typical referral sources include medical boards, hospitals, employers, physician well-being committees, and legal counsel.
Most CDEs include a Fitness-for-Duty (FFD) component, integrating both diagnostic and functional findings within a single report. This ensures that the evaluation not only identifies any underlying medical or psychological conditions but also determines whether those conditions affect professional performance or safety.
Structure and Deliverable
Dr. Granovetter provides a single integrated report containing independent but coordinated diagnostic and fitness-for-duty opinions. This report is comprehensive, defensible, and aligned with professional and legal standards, including:
American Medical Association (AMA) Code of Medical Ethics, Opinion 1.2.6 (Workplace Evaluations)
American Academy of Psychiatry and the Law (AAPL) Ethics Guidelines
APA Specialty Guidelines for Forensic Psychology (2013)
Federation of State Physician Health Programs (FSPHP) Guidelines
California Public Protection & Physician Health (CPPPH) Evaluation Standards
Each evaluation is conducted with strict neutrality, integrating clinical science and forensic objectivity. The resulting analysis provides actionable, evidence-based recommendations that serve the needs of both physician and organization—ensuring fairness, transparency, and defensibility.
Balancing Purpose and Integrity
CDEs occupy the intersection between clinical medicine and the regulatory-legal environment. They require not only diagnostic acumen but also a clear understanding of professional accountability, confidentiality boundaries, and regulatory expectations.
Dr. Granovetter’s experience in physician health, addiction medicine, and evaluation ethics ensures that each examination is performed with clarity, objectivity, and confidentiality, supporting both public protection and professional restoration.