By John McElligott, MD
By next spring, the medical examiner who does your DOT physical must be part of a National Registry. That sounds easy but it’s not that simple for members of the medical community. It’s not like just joining a club and getting a membership card. And it’s not easy for truckers either, who now must get their DOT physical from a “certified” medical examiner.
Physicians are getting a lot of questions on what this means both for medical examiners and for our professional truck driving patients. Here are a few examples of what we are hearing.
Are you certified to be a medical examiner under the new FMCSA rules? Do you have to be an MD to be certified? My doctor is a DO (Doctor of Osteopathy), and I also used a chiropractor. Can they be certified?
Yes, I am certified by the National Registry of Certified Medical Examiners (you’ll see this called the NRCME ) as a medical examiner for FMCSA/DOT. My certification is good for 10 years with a required five-year continuing medical education course. The training course that allows a provider to sit for the national certification can be done at a meeting or online.
I chose to do the online course since it was far less expensive and time-consuming. The online course took 25 hours to complete and pass the pretest. The pretest must be passed with a grade of 100 percent in order to take the national certification exam. The exam is taken at a testing facility and because this is a federally regulated testing program, it is time-consuming just to do the registration.
In addition, the provider must have a certificate showing that he has taken the education course and passed the pretest. The certification test lasts about three hours and is time sensitive. I must say that it was difficult, especially when trying to balance studying with seeing patients.
Those eligible for certification by the FMCSA include MDs, DOs, physician’s assistants, chiropractors and nurse practitioners. Presently there are 2,000 to 3,000 participants and more expected as the deadline of May 21, 2014, gets closer.
My concern has always been that rural doctors will not become certified because of the expense and added work placed on office staff. Each DOT long form will be electronically transmitted to the FMCSA by the end of each workday.
I live in Nevada and see on the FMCSA map that we have only six certified doctors here in the whole state. Four are in Las Vegas, one in Sparks and one in Elko. I live hundreds of miles from any of them. What am I supposed to do?
If you live in the state of Nevada and there are only six certified doctors who are widely dispersed, then I would certainly find a doctor now to do what I’m doing. That is getting the word out and talking to doctors in rural areas in order to make recertification and new certification easier.
Nationalregistry.fmcsa.dot.gov will walk you through finding a doctor in certain ZIP codes and even cities.
Do I need to use a certified medical examiner right now so when the compliance deadline rolls around in May 2014, I will be legal?
You do not need to use a certified medical examiner at this time. The compliance deadline is May 21, 2014, and if you require certification or recertification now or before the deadline you may use whomever you choose.
What happens if we don’t have enough certified medical examiners by next May?
If it turns out that we do not have an adequate number of certified medical examiners, the FMCSA will have to make some choices. One option could be to extend the certification deadline. Another possibility is to “grandfather in” positions for those who are occupational health certified. The latter will not help truckers who live in rural areas. We’ll have to see how many register and how FMCSA reacts.
Do Mexico-domiciled and Canada-domiciled truckers need to abide by this rule, too?
No. Although this was challenged by OOIDA, it was decided that because the U.S. has certain treaties with both Mexico and Canada, drivers from those countries who drive in the U.S. do not need to comply with the rule as far as their DOT physicals are concerned. LL
John McElligott is an MD, Fellow of the American College of Physicians, and medical director of the St. Christopher Trucker Development and Relief Fund. Jeff Heinrich, who serves as the column's medical editor, has a Doctor of Education degree and is Physician Assistant Certified.
This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher. Please remember everyone's health situation is different. If you have questions regarding medical issues, consult your personal physician.