What would you include in the dive medical? How much can a doctor actually diagnose during the appointment? Would you tailor the medical to the type of diving a person might perform?
Unless you have you tick a "yes" on the medical questionnaire or suffer from a major medical problem, a dive medical is unlikely to uncover much. A recreational (as opposed to HSE diving at work medical) includes:
- urine test for diabetes
- quick spirometry test and stetoscope lung check
- weight, height and waist circumference
- ear function - ottoscope check of an ear canal, ear drum and ability to equalize and a test checks for inner ear balance issues
- discussion of any previous medical exams
You might get sent for further checks if you suffered from e.g. asthma. There might even be some time to ask few questions too but that's about all you can do in 30 minutes. It's absolutely worth the money if you had a problem that might impact your diving but probably pointless otherwise.
If you make the medicals mandatory, doctors, especially in the US, would need to assume a lot of responsibility for certifying that you are medically fit. So I would assume that medicals would get into philosophical territory and essentilly kill the sport:
- Should divers get routinely checked for PFO? And if a PFO is found (what size?) with no prior decompression problems - does that mean a diving ban? A limit to your diving? 10 meters no deco no more than 2 dives per day? Or you need to dive a different GF? Fixing a PFO is pretty pricey.
- Should fat divers be allowed to dive? If so, what's the cuttoff in terms of BMI or some body fat measurement? 27 or 28? Or even 29 as that's very fat to participate in a dangeous sport? Should very obese divers be allowed to dive at all? Maybe fat divers should not dive rebreathers or participate in technical diving? Maybe they should only be allowed to dive with a 1:1 oversight of a professional guide?
- Should out of shape divers be allowed to dive? If you believe in buddy system, it's a lot of hard work to rescue someone. Getting back on a boat in swell is hard work too, especially with multiple cylinders. How would you test fitness and what's the benchmark? Maybe we could adopt a swim test for lifeguards as that's an existing standard - 400 metres in 8 minutes? That's by the way significantly stricter than e.g. GUE swim tests that worry so many divers. Obviously the fitness test would not be adjusted for age.
Looking around UK dive boats, two thirds of divers including myself would fail at least one of the 3 bullet points above...
I think it's safer to keep diving a niche, overlooked sport. Any regulation makes our life much more difficult.
Exactly what you write about bmi. Are 'fat' divers directly out of shape? Not everybody with a bmi of 30 is really obese. And some can run 10km or more, so are really in a good condition.
And what is out of shape? If a normal diver who can use arms and legs cannot carry his own gear, then you can talk about out of shape and the swimtest would not be an bad idea. But 400m in 8 minutes can be challenging if you don't have the right swimmingtechnique.
And what if people have a backproblem, so cannot carry their own gear, or are in a wheelchair? Can they be fit to dive?
Having a pfo does not mean you will ever get problems in your diving career, so why check? Sometimes it is better not to know everything.
Here you see that 'diving doctors' follow their own rules, even if there are guidelines. Some won't sign off if you have diabetes or a bmi over 25.
Others sign children off that have tubes in their ears and advice to use the masks with the earprotection.
And the most funny thing was for myself 5 years ago, I told the doctor about my passion cavediving. He looked at me, said: I have to check if you are mental ok for diving and you tell me you dive in caves? I cannot agree with that.
I had to talk to get it signed off and got my medical then. But this is an example of a doctor who really does not know where he is talking about.
Another experience was 10 years ago, I talked about dives over 100m depth. He said: if you go so deep, you cannot go up directly isn't it? He had to decide if I was fit to dive, but does not know what decompression diving means. How can such a person decide if someone is fit or not? Of course I got my medical without problems. But it felt like just paying extra money.
Also, how long is a medical valid? In my country, it is 3 years if you are under 50. Otherwise 1 year. But why do people sometimes want a medical that is just max 1 year old? Then you don't trust the doctor who signed it off in my eyes. The doctor has to make a judgement if the person will be healthy in the next 3 years, and of course it is garantee till the door, but a valid medical is a valid medical in my eyes. You can ask if things changed in the time between, but to state that it is not enough? Then you want that the diver makes extra costs as it is not cheap here. Also it is sometimes waiting for months. So stay out of the water all that time? Of course not.
So the rstc form is in my eyes enough.
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Kidding!!
