That pesky Medical Statement

[scubadada]

The physician statement is really quite simple:

 

[Dizzi Lizzi]

I don't mean ro be rude but if you guys have to go to the doctor to get your meds, why not get a note saying you're good to dive at the same time?

A cautious MD (not dive medicine specialty) will hesitate at doing that, if not flat out refuse. I asked my MD for one, he said since 2 years ago I had bronchitis/asthma after a cold (was given rescue inhaler and advair), and in the way way past (childhood) I had asthma that I need to have a spirometry test. At my cost, I didn't even ask what the cost was as I know that in my hospital there has to be a team assembled during this test in case of respiratory arrest. I had a stress test 2 years ago, no problems but he wants a spirometry test. So the question of "ever had a lung disease" in the padi form is vexing to me.

My Md closely read the guidelines to physicians...

PULMONARY Any process or lesion that impedes airflow from the lungs places the diver at risk for pulmonary overinflation with alveolar rupture and the possibility of cerebral air embolization. Many interstitial diseases predispose to spontaneous pneumothorax: Asthma (reactive airway disease), Chronic Obstructive Pulmonary Disease (COPD), cystic or cavitating lung diseases may all cause air trapping. The 1996 Undersea and Hyperbaric Medical Society (UHMS) consensus on diving and asthma indicates that for the risk of pulmonary barotrauma and decompression illness to be acceptably low, the asthmatic diver should be asymptomatic and have normal spirometry before and after an exercise test. Inhalation challenge tests (e.g.: using histamine, hypertonic saline or methacholine) are not sufficiently standardized to be interpreted in the context of scuba diving. A pneumothorax that occurs or reoccurs while diving may be catastrophic. As the diver ascends, air trapped in the cavity expands and could produce a tension pneumothorax. In addition to the risk of pulmonary barotrauma, respiratory disease due to either structural disorders of the lung or chest wall or neuromuscular disease may impair exercise performance. Structural disorders of the chest or abdominal wall (e.g.: prune belly), or neuromuscular disorders, may impair cough, which could be life threatening if water is aspirated. Respiratory limitation due to disease is compounded by the combined effects of immersion (causing a restrictive deficit) and the increase in gas density, which increases in proportion to the ambient pressure (causing increased airway resistance). Formal exercise testing may be helpful. Relative Risk Conditions • History of Asthma or Reactive Airway Disease (RAD)* • History of Exercise Induced Bronchospasm (EIB)* • History of solid, cystic or cavitating lesion* • Pneumothorax secondary to: -Thoracic Surgery -Trauma or Pleural Penetration* -Previous Overinflation Injury*

 

[redacted]

I don't mean ro be rude but if you guys have to go to the doctor to get your meds, why not get a note saying you're good to dive at the same time?

The physician statement is really quite simple:
View attachment 398159

The statement is short short but not simplistic. That statement covers any and all medical conditions that might impact fitness to dive. That puts quite a burden on the doctor who the training agency/op would like to draw into their circle of liability.

I do see my Dr at least annually and we always discuss my fitness to continue diving. As long as he and I are in agreement, I feel my medical information is a private matter to be disclosed at my discretion

 

[flyboy08]

When was the last time you heard your doctor say....your healthy as an ox, go diving between now and next Tuesday, but come Wednesday at 3:24 am, you'll have a heart attack!

I get two physicals a year and am given no guarantees

 

[drrich2]

How many Physicians are comfortably familiar with diving and/or invest the time and effort to master what the spirit of the form seeks?

How many will just 'rubber stamp' the letter if the patient claims he's fine to dive? How many docs sign back to work letters based on patient say so without much familiarity with said job?

How many docs won't sign because of liability concerns and unfamiliarity with diving?

If we took a stack of 100 medical clearance to dive letters collected by a dive op., I wonder what % would reflect the assessment intended?

How many dive ops are happy with customer checking 'no' on minor things, so the op. has full deniability in the highly unlikely event of a bad outcome (e.g. Blood pressure 130/90)?

Putting it altogether, I wonder what these forms/clearance letters mean most of the time in real world use, vs what they're 'supposed' to mean.

 

[Wookie]

Back in the day, we had a question on our web form that asked "Do you have any medical contraindications to diving". If you answered yes, it directed you to get a specifically worded doctor's note. That's what folks did, as they could not go further in the sign up process until they did so. That way, no one showed up with the wrong thing. We did not want to know your particular contraindication, that's between you and your doctor, and that stupid medical form isn't allowed under HIPAA anyway. All we cared about was "do you have a contraindication", and "Does anyone else know about it"?

 

[JamesBon92007]

How many dive ops are happy with customer checking 'no' on minor things, so the op. has full deniability in the highly unlikely event of a bad outcome (e.g. Blood pressure 130/90)?

So, if someone checks "yes" on the form and the dive op lets them go diving anyway and something bad happens, wouldn't the dive op have some kind of liability?

Aside from all that, I'm 64 and my doctor thinks it's great that I go scuba diving, ride my bicycle, swim laps, go for long walks, etc. and probably wishes more of his patients would do the same. He also said I'm going to die someday, but probably not anytime soon

 

[mmerriman]

when I get my annual physical, I have the doc sign off the medical statement so I always have an up to date one. - and that way it doesn't cost me any additional money

 

[mmerriman]

Dive operators are not entitled to know your private medical issues; they are only entitled to know if you are good to dive....and that is your doctor's decision, not theirs.

agreed. I'm not a doctor. I have no business asking details. BUT if I observe something that makes me uncomfortable I reserve the right not to dive with that person/student.

 

[2airishuman]

Some of the conditions listed are so common and so unrelated to diving that there is little reason for them to be there. A quarter of all adults have hypertension, for example, and I've seen no evidence to suggest that is a risk factor for diving. There are other examples.