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DOT Physicals


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  • 2 weeks later...

I passed and my SP did not. So guess who gets all the DOTs? You have to pass it individually and get your own unique number.

Hmmm...Wouldn't this be exceeding your SP's scope of practice and thus in violation of medical board statutes?  I really want know the answer because our this is what the risk management team has informed us.  Thanks.

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Guest Paula

^^^^ Good question.  If an SP is not qualified to perform a DOT physical does it automatically disqualify the PA who is qualified by certification?  This is all the more reason for PAs to be unhinged from the MD license and to carry our own.  These are the type of rules that will continue to restrict access to care and the FED gov't probably hasn't even considered the question.

 

I was offered the opportunity to learn colposcopy through a special training program by Indian Health Service.  I would have jumped at it but hesitated because my GP SP is not trained.  He also said he had been asking to go to the training for years and wanted to do it.........but of course did not follow thru when it was finally approved.  So I was not able to go either.  Stinks to have my SOP tied to the SP.  It is something we could have used here at our clinic to provide the needed services and expand what we do.  

 

BTW...He took the DOT test and passed, I didn't take the course since only one of us got approved to do the training.  I'm actually ok with it for now as I didn't really want to get certified and have more work delegated to me, and it might have set up a SOP issue.  

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Hmmm...Wouldn't this be exceeding your SP's scope of practice and thus in violation of medical board statutes?  I really want know the answer because our this is what the risk management team has informed us.  Thanks.

Good question. As I understand it, performing physical exams are within my scope of practice because I have years and years of experience doing them. Since I took the training and and passed the certification test, performing DOT physicals are now in my scope of practice and I have the papers to prove it. My DSA stipulates that I can diagnose and treat conditions that I have proficiency in and that I feel comfortable doing. It is a grey area for sure... one among many for PAs.

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My clinical preceptor (he is a PA) is having me do these as a student, although, he is in the room supervising me (and completing the forms as I do the exam).  I just have assumed this is ok - it's (unfortunately) been about the only thing I've been allowed to do !  Should I decline doing these??!!

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  • 8 months later...

Just wondering for those of you who do DOT Physicals... For people with cardiac issues such as atrial fibrillation etc, do you require a letter from the Cardiologist stating that in their expert opinion the patient is able to safely operate a commercial vehicle?

 

My attending physician makes us send these letters out to other physicians, and the majority of time they either do not want to write the letter because it is "our responsibility to make this determination" or they are just nasty/unhappy about having to do the extra work.

 

On some of the more straight forward cases I have accepted office notes from visits to the specialists, and made the determination on my own based on notes/testing/etc.  

 

My attending physician said this is not allowed and it is MANDATORY to have these letters in such instances.

 

I was just wondering how other people handle this?  Do you give out similar letters?  If so do you get a lot of push back?

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  • Administrator

On some of the more straight forward cases I have accepted office notes from visits to the specialists, and made the determination on my own based on notes/testing/etc.  

 

My attending physician said this is not allowed and it is MANDATORY to have these letters in such instances.

 

I was just wondering how other people handle this?  Do you give out similar letters?  If so do you get a lot of push back?

I think your SP needs to read the rules again.  The Certified Medical Examiner makes the call, using consultants and additional testing as he or she deems best, especially in cases where *guidelines* are not being followed.

 

Having said that, if you send a driver to a cardiologist for a workup secondary to a DOT physical finding, it would seem to me to be professional discourtesy for the consultant to not render an opinion on fitness for commercial vehicle driving--that's part of what he or she just got paid to do.

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Guest Paula

My truck driver neighbor is spitting tacks with all these new rules.  Always had a fat neck. Had to go for this study and that study....sleep apnea and others.  Not all paid for by his employer.  I think he is going to retire early. 

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