This story appears in the March 21 print edition of Transport Topics
A nearly 2-year-old requirement that physicians administering truck driver medical exams be trained and certified appears to have strengthened federal regulators’ ability to weed out drivers with potentially unsafe medical conditions, according to a top regulatory official.
“The program has raised the bar on safety for medical exams,” said Chuck Horan, who heads Federal Motor Carrier Safety Administration medical programs.
Since May 2014, FMCSA has required all driver medical examiners to receive training, pass a test and register on a national agency website — plus attend a refresher course every five years.
During that time, the agency’s 47,000 certified medical examiners have conducted more than 8.5 million exams, temporarily disqualified 212,000 drivers and permanently disqualified about 70,000, Horan said.
Interstate truck and bus drivers normally must pass an exam every two years, but some medical conditions only allow drivers to go unexamined for a year, or even less.
“Before, we didn’t really know who was giving the exams,” Horan told Transport Topics. “What we’re finding now is that many of the medical doctors or others that were doing the exams really weren’t familiar with our regulations — what our standards were — and were allowing folks that probably shouldn’t be on the road to drive.”
Perhaps the most convincing evidence of the program’s improvements is the growing number of drivers seeking exemptions for such disqualifying medical conditions as diabetes, poor vision and hearing.
“In particular, both our vision exemption program and diabetes program have grown significantly in the last two years — almost doubled,” Horan said.
He added, “We’re getting a lot of drivers calling us with complaints saying, ‘Why am I being asked about this stuff now? I’ve been driving for 20 years, and nobody ever asked me about this before.’ To me that’s a good thing.”
Brian Morris, associate corporate medical director for All One Health Resources Inc. of Woburn, Massachusetts, said he believes the quality of medical examiners and their exams have improved significantly.
“I’ve definitely noticed that we’re seeing more people that don’t meet the requirements right away, but maybe will down the road, and also more people that are just disqualified indefinitely,” Morris, also a member of FMCSA’s medical review board, told TT.
However, Morris said he has concerns that examiners have varied medical backgrounds. Those on the registry include practitioners, physicians, physicians assistants, chiropractors and physical therapists.
“So while you can instruct these individuals in the regulations and guidelines, many of them don’t have the medical training to really have a deep understanding of some of the conditions that they’re seeing,” Morris said. “Someone who is a chiropractor or physical therapist is not going to understand valvular heart disease the way a physician would.”
“But certainly, over the past few years, there’s been a marked improvement overall. There’s no doubt about that,” Morris added.
For drivers to be granted exemptions for disqualifying medical conditions, they generally must have a commercial driver license, three to five years of safe driving and submit to monitoring, according to FMCSA.
Michael Megehee, president of TeamCME, a nationwide network of certified medical examiners based in Pendleton, Oregon, said that medical examiners are doing a better job today of catching the errors made by previous examiners.
He also agrees there is substantial evidence that there have been more driver exam failures since the certification process was implemented.
But he, too, has concerns.
“To be very honest with you, there’s work to be done, because on other certain specific issues medical examiners still do not have the conformity that I believe they need to have,” Megehee said. “Like whether a driver needs more testing, needs to be treated or needs a one-year or two-year certificate. But it takes time to get more than 40,000 doctors doing the same thing.”
Sean Garney, director of safety policy for American Trucking Associations, said ATA has supported the concept of a registry, but had concerns early on.
“To their credit, FMCSA and the examiner community has coalesced and reached their goal of more than 43,000 examiners earlier than they expected,” Garney said. “For years and years, drivers were going to their family physicians who were signing off on their exams. Now they’re having to go to new, certified doctors who have a greater awareness of all the things the FMCSA is asking doctors to look at.”