56 Forensic dentistry
The clerical section of the medical examiner’s office is responsible for
providing a critical interface of the office with the public (reception), tran-
scription of physician’s dictated reports, preparation of death certificates,
coordination of court appearances, and maintenance of documents, records,
and data. This section will also respond to subpoenas, public information
queries, and the myriad other requests for information that are submitted to
the medical examiner’s office each day.
In a medical examiner system, office administration must be under the
auspices of the chief medical examiner. It is imperative that this individual
have full authority over operational, budgetary, and personnel matters,
though he or she may employ administrative, fiscal, and other assistants,
and delegate duties to them as needed. It is the chief medical examiner who
will determine the procedures and policies of the office, and final author-
ity over the office must reside with him or her, as well as responsibility for
the performance of all aspects of the office. This includes responsibility for
all investigations and examinations, and for maintaining the quality of the
office’s work products. Adequate civil service protection is optimal for all
medical examiners, to help ensure that these physicians are not intimidated
or punished for their honest professional opinions, which form the true work
product of the organization.
Coroner systems will have many organizational facets in common with
medical examiners’ offices, with the exception that final authority of the
medical investigative agency does not reside with a trained physician (with
the exception of rare cases in which the coroner is also a board-certified
forensic pathologist). It is imperative, then, that the coroner’s chief forensic
pathologist has adequate authority over all operational matters to ensure
that good forensic pathology procedures are followed in all areas. This will
require adequate input into budgetary and personnel matters, as well as
medical matters.
4.7 Quality Assurance
The single most important quality control or assurance (QC/QA) mechanism
in the ME’s office is the appointment of qualified and certified forensic pathol-
ogists, particularly in the position of chief medical examiner. In modern
medical practice, board certification of physicians is expected and usually
required for the full exercise of the practice privileges in a medical specialty.^34
Similarly, such certification is necessary in the field of forensic pathology to
indicate that a practitioner has met the minimum standards of training and
knowledge in the field. In the United States, the only path to certification in
forensic pathology accepted by NAME34,35 is through the American Board of
Pathology (a member board of the American Board of Medical Specialties).