ATRI survey: Drivers report increased cost in DOT physicals

By Mark Schremmer, Land Line staff writer | Tuesday, April 18, 2017

The majority of truck drivers say the cost of exams has increased while the quality of care has remained stagnant since the implementation of the National Registry of Certified Medical Examiners, according to a survey by the American Transportation Research Institute and the Mayo Clinic.

ATRI and the Mayo Clinic surveyed more than 900 commercial drivers, 300 motor carriers and 1,200 certified medical examiners to understand the impact of the registry that was started by the Federal Motor Carrier Safety Administration in 2014.

The intent of the registry was to improve the DOT physical exam process and to ensure that medical examiners understand FMCSA regulations for issuing medical certificates. Of the drivers who were surveyed, 25.6 percent were owner-operators or independent contractors leased to a motor carrier, and 11.6 percent were owner-operators with their own authority.

According to survey results, 63.3 percent of truck drivers reported paying more for exams. Meanwhile, only 6.2 percent of truckers reported improvements in the exam quality. Almost 35 percent say the quality has decreased. Nearly 12 percent of drivers rated their examination and certification experience as a “0” on a scale of 0-10 from “very dissatisfied” to “very satisfied.”

“The data show a polarity in quality of medical examiners,” Dr. Clayton T. Cowl, of the Mayo Clinic, said in a news release. “Those examiners who are performing only minimal examinations may have received substandard training or are not taking their role seriously. The key seems to strike a balance between meeting the regulatory intent of the examinations and communicating with drivers ahead of time to minimize confusion regarding the need to document clinical stability. This is particularly true for drivers with multiple or complex medical conditions from whom medical examiners do need more documentation in order to make a certification decision.”

Cited as one of the reasons for the increase in costs is that drivers often have to prove they don’t have a medical condition. Many drivers with a high body mass index, for instance, are asked to have a sleep study.

A 2016 ATRI study found that drivers spent an average of $1,220 in out-of-pocket costs for a sleep study, and 47 percent of drivers missed work to complete the sleep study. According to the study, sleep apnea-related concerns were common as drivers noted the burden of providing proof of treatment and about receiving referrals for sleep apnea testing whether or not he or she experienced daytime fatigue.

Many drivers said their exams were over fast. Almost 27 percent of drivers reported spending 20 minutes or less with their certified medical examiner, while 6.5 percent said they spent 10 minutes or less with their CME.

Truckers aren’t the only ones dissatisfied with the process. Less than 1 percent of all carriers reported no major concerns with the medical certification process.

Meanwhile, 15.3 percent of CMEs reported that they have quit or plan to quit performing DOT physicals. A decrease in medical examiners could make it more difficult for drivers to find a CME where they live.

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