Medical Approval Issues

[archer1960]

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.

So the shop just shreds the forms when the class is done...

 

[panzerbjorne]

Silly question, when you think about it in practicality.

Assuming you're talking about the same diver... I would have no idea what my risk was if I had been given a falsely completed form with "NO" indicated on every line. With a doctor's clearance I would know there is no condition he/she considered incompatible with diving.

Unless... the new diver's doc is a personal friend, a family member, or an ignoramus who doesn't know anything about diving but reads the first page of a diving promo which points out that SCUBA is fun, easy, simple, relaxing and therapeutic - anyone can do it!

A smart doctor who is concerned with their malpractice insurance rate won't sign-off on the form, period.

 

[tursiops]

A smart doctor who is concerned with their malpractice insurance rate won't sign-off on the form, period.

More hyperbole. You might try being a little calmer and careful if you want to persuade anyone to your position.

 

[RJP]

A smart doctor who is concerned with their malpractice insurance rate won't sign-off on the form, period.

Nonsense, pure and simple. By extension a "smart doctor" would never do anything.

 

[panzerbjorne]

What makes you think I don't understand that?

But it is also true that any completed medical form (truthful or not), with one or more YES answers, may keep you from diving even when there is no medical condition that should prevent you from diving. In my case, I have already taken care to establish, with my Dr and pharmacist, that I have no medical condition that should prevent me from diving. Why would I want to provide anything but NO responses? I'm trying to see the benefit to either me or you and I'm missing it.

What I do understand is that an overbooked dive op is liable to do anything they can to solve their overbooking problem. And, since the proponent of that form was thoughtful enough to give me an option that avoids such risk to me (and does not add to anyone's risk) I choose to take that option. Is that really so hard for you to understand?

Lets take the example of the op. He went with YES on asthma, has seen a couple doctors and past the test that RSTC says needed to be done to insure the asthma should not limit his diving. And he is still being screwed over. Granted, when he first filled out his form he may not have known that he was OK to dive; but he knows now. Time to change the answer to NO and go dive.

Tempting as it is to do exactly that, I am actually waiting to speak to a DAN dive doc to get a signature and note just to be absolutely covered because there are a lot of ignorant docs and docs who don't want to risk their malpractice rates for me to be involved in what they ignorantly consider a risky sport. In the meantime, because I want to get started, I'm taking a refresher Watermanship course (funny, that one doesn't require a medical form even though people are putting their faces underwater and breathing...) I figure if nothing else I can get my water legs back about me and get used to being in the water again until such time as I determine if I have to put "all No's" on a form or not. Granted, I'll likely put "all No's" on the form either way and simply have the doctor's note for backup.

 

[rmssetc]

Originally Posted by rmssetcI'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?

Actually, I'd be fine with providing the signed medical clearance as well...if it didn't specify the condition that required clearance, for example, if it was not included with the form listing conditions requiring clearance.



Hypotheticals aside, I do fill out the release form honestly, and do present a medical release (which my GP didn't hesitate to provide).

Oh, the last 2 times I attempted to fill out the form as requested by a dive op and presented my current signed medical clearance, the op instructed me to check "No" on all the boxes. In one case my instructor & the owner discussed the medical condition with me and understood (or seemed to--they never said they were trained medical professionals) that it had no impact on diving. They seemed to be saying that (1) I wasn't at risk and (2) checking "Yes" would have prevented them from allowing me to dive, regardless of the release.

---------- Post added August 18th, 2015 at 07:59 PM ----------

So the shop just shreds the forms when the class is done...

I hope so, but doubt it. I'd feel better if the form had a section that must be signed by the recipient, requiring them to destroy the form. I'm sure that would be followed with the same accuracy that divers use when completing the form itself.

---------- Post added August 18th, 2015 at 08:05 PM ----------

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.

I never said it was a HIPPA violation.

Given the ambiguous state of 'privacy' in the US, exposure of medical information could well be seen as an 'invasion of privacy', or not.

In addition, I'm trying to remember that this is an international forum, and some members live in places with laws that provide stronger personal privacy protection than is found in the US (of course, some folks have less protection as well).

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.

IANAL, but I don't for a moment imagine any lawyer being interested in Cap'n Jack's assets. However, lots of lawyers would be after Cap'n Jack's insurance company's assets. They've got the deep pockets.

 

[RJP]

Originally Posted by rmssetcI'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.



Actually, I'd be fine with providing the signed medical clearance as well...if it didn't specify the condition that required clearance, for example, if it was not included with the form listing conditions requiring clearance.

The physician medical clearance is included in the same PDF, but it is a seperate form. Here's the level of detail that the physician must provide...

 

[panzerbjorne]

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

Let's put it this way: I'm an ex-Army Warrant Officer who's been a coach, captain and center for a B-ranked hockey team in the USHL for over 15 years now, I have hour-long cardio sessions 3 times a week in addition to weight-training on off days and I frequently run in 10k races for charity and community organizations. I haven't had an asthma attack in over 10 years and I present with ZERO symptoms of asthma and ZERO side-effects from the medication I take to manage it. My FEV1/FVC came back at 98% before strenuous exercise and 99% after 20 minutes running hard on a treadmill WITHOUT having used my management medication for 24 hours prior. I'm not a doctor, but my pulmonary doc said I'm fit as a fiddle and they just don't know anything about hyperbaric medicine and therefore are not qualified to make a decision about fitness to dive. I love how a scrawny dive instructor whose neck I could snap before he can say "Diver down!" wants to tell me I'm not fit to dive. I understand the docs not wanting to put themselves in the liability loop and if I were a doc I'd likely feel the same. But telling me I'm unfit to dive? Tell me to my face, it would take a lot of balls my friend.

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

Nonsense, pure and simple. By extension a "smart doctor" would never do anything.

If you were a "smart instructor" you wouldn't be putting yourself in the liability loop either. Guess we know what kind of instructor you are now. :cool2:

---------- Post added August 18th, 2015 at 05:19 PM ----------

More hyperbole. You might try being a little calmer and careful if you want to persuade anyone to your position.

Who said anything about persuading people and positions? I thought this was a flameboard.

 

[tursiops]

I love how a scrawny dive instructor whose neck I could snap before he can say "Diver down!" wants to tell me I'm not fit to dive. I understand the docs not wanting to put themselves in the liability loop and if I were a doc I'd likely feel the same. But telling me I'm unfit to dive? Tell me to my face, it would take a lot of balls my friend.

Wow, serious testosterone problem here! That scrawny dive instructor is not telling you you are unfit to dive; he is saying you need a doctor's signature, because of your self-assessed fitness. And I'll be happy to tell you that to your face.

 

[redacted]

Which way out is that?

All NO answers and my signature acknowledging my agreement that I am responsible for anything I failed to disclose.


Sorry for the later response and missed discussion. Had dinner guests.

---------- Post added August 18th, 2015 at 09:00 PM ----------

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.

Really not a very big leap if you read the RSTC instructions to the doctor. I suspect his asthma specialist either did not read the RSTC input or was simply unable to provide the overall clearance since he is only involved in the asthma issue. More stupid nut-roll, but easy enough to avoid.