It happens every year. Or, every other year, if you’re young, healthy and lucky.
What is “it”? It’s the dreaded DOT (Department of Transportation) physical examination.
What once was biannual slam dunk for most drivers has evolved into an event that strikes fear into the heart of every driver who is a few years older — and a few pounds heavier — than when their driving career started. The exam that used to be a perfunctory “check the box” event is more comprehensive than ever, relying on the physician’s opinion rather than simply meeting test criteria.
Hypertension (HTN), commonly known as high blood pressure, is a great example of how the DOT exam has changed over the years. HTN is very common among the U.S. population. Factors that can contribute to HTN include age, stress, obesity, smoking and more. Unfortunately, many drivers today are impacted by more than one of these factors.
In the past, drivers whose blood pressure exceeded DOT limits had some options. Most clinics would allow a return visit to recheck blood pressure. Some advised the driver to test early in the morning, skip the coffee or take a couple of aspirin before trying again. The driver could retest as many times as the clinic would allow.
If the driver still couldn’t pass, there was always the option of the clinic down the street, unless the driver’s employer specified a certain examiner. Drivers had favorites, sharing information about which clinics were more lenient than others or which had “problem” doctors. Drivers could even go to their private physician — or chiropractor or dentist — for a new exam. All that was needed were the proper forms.
All that changed on May 21, 2014. That’s when the Federal Motor Carrier Administration’s (FMSCA) National Registry of Certified Medical Examiners, a list of medical professionals allowed to provide DOT physicals, became effective. On Jan. 30 of the same year, a provision that required each state to revoke CDL driving privileges of drivers who did not have a valid medical examiner’s certificate (MEC) on file went into effect.
The new regulations changed something else, too. Rather than trying to get the right numbers to enter on a driver’s medical examination report, examiners were required to indicate that the problem was controlled. For many drivers, that meant a trip to their primary-care physician (if they had one) to be treated for high blood pressure or another condition identified in the exam. Sometimes the answer was as simple as a prescription for medication to treat the condition.
While the requirements of the exam were getting tougher, new medical conditions were added to the list. One of the most notable of these was sleep apnea and, more recently, chronic obstructive pulmonary disease (COPD). Physicians started measuring neck circumference and calculating body mass index (BMI). More than a few drivers were surprised by a requirement to undergo sleep apnea testing as a requirement for passing their physical.
Since many drivers taking pre-employment physicals are between jobs, insurance coverage for the testing — and any follow-up treatment isn’t available — putting the driver in a difficult situation.
Even drivers who are working can have difficulty getting regular medical treatment. Appointments are sometimes scheduled months in advance, and getting home for doctor visits can be problematic. Drivers who don’t have health insurance coverage can have difficulty paying for services. Worse, many drivers don’t even have a primary care physician, reasoning that a walk-in clinic will suffice if they become ill.
Obtaining and keeping a medical certification takes more effort than simply showing up for a physical exam once per year. Diet and exercise are important, of course, but passing that DOT physical (and keeping your driving privileges intact) begins with the right attitude about your health. It’s not about passing the physical. It’s…
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