Medical Approval Issues

[oly5050user]

What does that refer to?

---------- Post added August 18th, 2015 at 05:32 PM ----------tater than



So three doctors refuse to sign off that the OP is medically clear to dive... but a I'm supposed to accept the higher risk associated with taking their word that they are?

Actually, you're not even giving me that option. You're suggesting that I don't even need to know that three doctors refuse to sign off on the OP.

Sorry... no.

The three doctors know better than a scuba instructor. If the doctors say NO then it is No..no instructor in their right mind will accept the liability on this one.

 

[RJP]

But you also gave me a way out of that mulberry bush and allowed me to take responsibility for my unimportant medical conditions. For that, I am thankful.

Which way out is that?

 

[raftingtigger]

So I went to my doc and gave him the relevant forms and information required for review by PADI and after 10 minutes of reading through it and considering he shrugged and simply stated, "I don't feel comfortable signing-off on this because I know nothing about diving and the risks and this documentation is not thorough enough. In addition I'm not willing to take on the liability due to my ignorance." So he sent me to an asthma specialist for further investigation, where I was given spirometry tests and blood oxygen tests before and after strenuous exercise and I passed them both without any issue - but again they claimed no knowledge of diving so didn't feel comfortable signing-off on my forms either.

This is from the first post. I only see reference to 2 doctors, both of which said (according to the OP) paraphrased - 'I don't know enough about the subject to give an expert opinion'. Neither said 'You are not fit to dive'.

The three doctors know better than a scuba instructor. If the doctors say NO then it is No..no instructor in their right mind will accept the liability on this one.

2 doctors apparently said "I don't have the training to know", they did not say "no diving".

Everyone is in such a tizzy over medical disclosure, much of which is overly broad and catches too many 'false positives', and yet the classes I have been party to (student, observer, etc) or have otherwise heard of, gloss over the real medical risks of diving. These risks (barotrauma, dcs, panic, thermal stresses, etc.) while mentioned aren't generally made "real" for the student until the Tech level.

I'm a proponent of a form that explains the medical risks of different conditions to prospective students and then explains how important it is for the student to discuss their medical condition and consequences of diving with their doctor before beginning.

Lastly, if you think there is any chance in the world of all divers truthfully answering every question on the current form you are living in a fantasy world. I have seen too many DOT medical certificate (commercial drivers) that fail to disclose conditions that DO have an impact on driving safety to feel otherwise. Even with a new national database on completed DOT exams there is currently no way to see if the applicant answered yes to one of the screening questions before and not now - unless the same provider is doing all the exams and has that info in their office files.

 

[rmssetc]

This is part of why I really don't even want to see the medical form; let the student look at it, and if there are any YES answers, then don't even show me the form.....just give me the doctor's signature. The only purpose of the form is for me (the instructor or diveboat captain) to advise you (the student or diver) if you need a doctor's signature. The purpose of the form is NOT to have me evaluate your medical fitness. So give me back a medical form that is all NOs, or give me a doctor's OK for you to dive.

There's been lots of talk about liability, and how the medical release 'protects' the dive op.

It's extremely easy to see this all being flipped around...

Imagine, if you would, a large dive op in a popular area (think Florida Keys). They've got 50~100 customers/weekend, or 2500+ individuals/year.

Now, imagine that their office is burglarized, or someone leaves a filebox on the ground next to their car when they're bringing everything back from the boat, or a hurricane takes the roof off the office, scattering papers everywhere, or someone cleans out the 'old' files from a 'couple of years ago' and takes them to the local dump for recycling. Medical release papers. With names, and addresses, and details of medical conditions. Fluttering in the wind. Lining some birdcage. Scanned and on the internet. All those checkboxes saying "Yes" to recreational drug use making their way into prosecutor's offices, winding up in child custody disputes, etc.

Next, imagine the schools of hungry lawyers circling the wounded dive op, filing class action suits about invasion of privacy, etc.

In this world, the dive ops would be shredding those medical forms as fast as they could, and would refuse to ask for another one ever again!

As someone who works in healthcare, who deals with data covered under HIPAA regulations (American healthcare legislation dealing with protection of personal health data, many other countries have similar--or more stringent--privacy regulations), I'm amazed and uncomfortable about the information requested on the medical release and the care (or lack thereof) with which that information is handled.

I'd be fine with the dive op explaining each question on the form with me in advance, discussing with me about how each question is related to specific risks about diving, then simply asking if I would say "yes" to any of them -- that protects them and helps educate divers.

I'd be fine with signing a statement to the effect that I am either unaware of any conditions that require a medical release, or I have gotten the medical release.

 

[RJP]

His YES response dictates follow-up and I would not expect you to be sufficiently qualified or authorized to declare him fit in light of those follow-up results. But, he should now know enough about his asthma condition to realize his asthma is not a reason to limit his diving. So, rather than waste the time, effort, and money finding a Dr that will sign off on his waiver, I suggest changing the YES to NO. I guess He could either explain to his provider why he is doing that, or find another provider.

That's a leap that the OP can make for themselves. They have no right to make that leap for ME.

I believe I have a right to a high degree of certainty that a student I accept is medically clear to dive. If a potential student doesn't believe I have that right, that's OK with me.

 

[Hawkwood]

This is from the first post. I only see reference to 2 doctors, both of which said (according to the OP) paraphrased - 'I don't know enough about the subject to give an expert opinion'. Neither said 'You are not fit to dive'.

Not only that, the six (?) pages that accompany the form are directed towards physicians with explanations as to the concerns with each item. My family doctor, oncologist, and endocrinologist have not had an issue with signing the "certificate".

Just in case there is any confusion, I have posted a copy of the Medical Statement. There are no "details" of medical conditions required. Confidentially? The form asks if you take prescription medication. It does not ask what those are. Nor would I care. If the answer is yes, and the certificate was signed off, then presumably the risks (or lack thereof) are understood.

For example...I would answer yes to that question. I take blood pressure meds...fortunately the type that would not be a contradiction to diving.

 

[RJP]

This is from the first post. I only see reference to 2 doctors, both of which said (according to the OP) paraphrased - 'I don't know enough about the subject to give an expert opinion'. Neither said 'You are not fit to dive'.

I didn't say they declared the op unfit to dive. I said they refused to declare them fit to dive. I don't care WHY they refused to do so. If their doctor doesn't know enough about the subject to declare them fit to dive... why would I accept that the OP does?

---------- Post added August 18th, 2015 at 06:58 PM ----------

I'd be fine with signing a statement to the effect that I am either unaware of any conditions that require a medical release, or I have gotten the medical release.

So you'll provide a statement saying you have received medical clearance, but you won't provide the actual signed medical clearance?

 

[Russoft]

Hi guys, new to the boards here but thought it would be a good place to ask about a problem I'm currently running into.

...

The trouble is they require a pretty strict medical form and I have very mild, well-managed asthma and was honest and put a "Yes" on the medical questionnaire, so I was told I need a physician's approval. ...

Unless it's serious enough to warrant meds, I don't mention asthma to anyone. I went through a slew of exams for asthma when applying for the Navy. They couldn't definitely figure out if I actually had asthma so they shrugged and said it was fine. Wasted months of my time. If it's not a big deal in your opinion, don't divulge it. that's my experience.

Sent from my SM-G900W8 using Tapatalk

 

[RJP]

There's been lots of talk about liability, and how the medical release 'protects' the dive op.

It's extremely easy to see this all being flipped around...

Imagine, if you would, a large dive op in a popular area (think Florida Keys). They've got 50~100 customers/weekend, or 2500+ individuals/year.

Now, imagine that their office is burglarized, or someone leaves a filebox on the ground next to their car when they're bringing everything back from the boat, or a hurricane takes the roof off the office, scattering papers everywhere, or someone cleans out the 'old' files from a 'couple of years ago' and takes them to the local dump for recycling. Medical release papers. With names, and addresses, and details of medical conditions. Fluttering in the wind. Lining some birdcage. Scanned and on the internet. All those checkboxes saying "Yes" to recreational drug use making their way into prosecutor's offices, winding up in child custody disputes, etc.

Next, imagine the schools of hungry lawyers circling the wounded dive op, filing class action suits about invasion of privacy, etc.

In this world, the dive ops would be shredding those medical forms as fast as they could, and would refuse to ask for another one ever again!

As someone who works in healthcare, who deals with data covered under HIPAA regulations (American healthcare legislation dealing with protection of personal health data, many other countries have similar--or more stringent--privacy regulations), I'm amazed and uncomfortable about the information requested on the medical release and the care (or lack thereof) with which that information is handled.

As with everything in this day and age, I think you're right that the approach to date privacy and data protection need to evolve. However, the simple fact currently is that there is NO "invasion of privacy" and no "HIPPA violation" in cases where information is given voluntarily.

As to the idea that there will be scores of lawyers lining up for a class action lawsuit against some commercial endeavor that is two bad months away from going bankrupt... well that's just silly. Class action lawyers - and therefor class-action lawsuits - require two things

1.) A defendant with deep pockets
3.) Tens of thousands of plaintiffs with damages

"Cap'n Jack's Scuba Hut" losing a folder of medical forms would hardly get the attention of even the most desperate plaintiff's attorney.

---------- Post added August 18th, 2015 at 07:13 PM ----------

If it's not a big deal in your opinion, don't divulge it. that's my experience.

What about the guy who who thinks being three months post-MI "is no big deal in his opinion"?

Again, I'm not saying the guy can't go diving if he wants to. I'm simply saying he doesn't have the right to deprive me of information that I need in order for me to make an informed decision about whether to take him on as a student.

 

[raftingtigger]

I didn't say they declared the op unfit to dive. I said they refused to declare them fit to dive. I don't care WHY they refused to do so. If their doctor doesn't know enough about the subject to declare them fit to dive... why would I accept that the OP does?

I certainly didn't say you did. I didn't quote you until now.