Medical Approval Issues

[RJP]

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.

Lighten up, Francis.

No one said you are unfit to dive. You're simply not yet medically cleared to dive; anger issues notwithstanding. (Which is too bad, because it's become abundantly clear that you'd be an absolute joy to have as a student.)

 

[RandomGuy1]

Have you looked into if the asthma meds you take may create an issue when breathing higher ppo2? There are other issues besides cardiovascular fitness at play.


Sent from my iPad using Tapatalk

 

[ev780]

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.

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.

I tire of trying to explain the consumer side of privacy to you. I know you are just trying to make a decision together with your client about the suitability of the client for dive instruction. You correctly assert that you need that information to make a decision and I agree with you. But what I am having trouble articulating is that privacy laws and customs are there for a reason. Because not everyone in the world is as conscientious as you seem to be. You are not a healthcare provider ( you may be, but not in this context of being a SCUBA instructor) thus not bound by any ethical canon or law to protect our relationship nor is anyone else in your shop. Some of us have literally sworn to do just that. I seriously doubt that any oath is included in the PADI IDC.

There is an invasion of privacy when a person is forced to fill out a questionnaire under the duress of not being able to dive/train unless you disclose information that is either none of anyone's business or irrelevant to the task at hand. Therefore as a consumer I have a decision to make. Waive my right to privacy to protect myself, or lie on the paperwork!

Not a good place to be which is why we need to change the system.

 

[RJP]

There is an invasion of privacy when a person is forced to fill out a questionnaire under the duress of not being able to dive/train unless you disclose information that is either none of anyone's business or irrelevant to the task at hand. Therefore as a consumer I have a decision to make. Waive my right to privacy to protect myself, or lie on the paperwork!

Or not pursue scuba diving.

I know that's not what you want to hear, but that's a choice too. It's a trade off you have to make. I'm certainly not saying the data should not be protected. But the decision for someone to provide a little bit of information is not made "under duress" because getting certified to dive is an entirely voluntary activity. If someone feels that strongly about it... they can go snorkeling.

 

[tursiops]

There is an invasion of privacy when a person is forced to fill out a questionnaire under the duress of not being able to dive/train unless you disclose information that is either none of anyone's business or irrelevant to the task at hand.

I would agree, if this were true. No disclosure of information is necessary, just the doctor's signature. I'm kind of tired of writing this down, it feels like Whack-a-Mole.

 

[Hawkwood]

All "no's"?...give me the questionnaire.

A "yes"?...just give me the doctors' certificate...no questionnaire.

Don't want to give me the questionnaire even if you'd answered no?...just give me the doctor's certificate then.

Where is the "privacy" issue?

 

[ev780]

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.

Read this form for the first time including the MD guidance. Luckily it has this statement at the bottom.......

The information I have provided about my medical history is accurate to the best of my knowledge.​

I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition.​

Perfect!!!

---------- Post added August 19th, 2015 at 08:39 AM ----------

I would agree, if this were true. No disclosure of information is necessary, just the doctor's signature. I'm kind of tired of writing this down, it feels like Whack-a-Mole.

And I am tired of writing this down so I will just quote myself........

I never disagreed with that. I am railing at the checkbox form not the physician form. You are right in this context. And you and I agree. But, that is not the real world and that is not the forms that are shoved in our faces. If we require a doctor’s note to dive then lets get it on. Otherwise these ops should mind their own business

 

[tursiops]

Read this form for the first time including the MD guidance. Luckily it has this statement at the bottom.......

The information I have provided about my medical history is accurate to the best of my knowledge.​

I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition.​

Perfect!!!

This was first brought up 54 posts earlier. Glad you had a chance to read the thing you've been arguing about.

 

[ev780]

All "no's"?...give me the questionnaire.

A "yes"?...just give me the doctors' certificate...no questionnaire.

Don't want to give me the questionnaire even if you'd answered no?...just give me the doctor's certificate then.

Where is the "privacy" issue?

Correct! In a perfect world the questionnaire would be given to the student or diver (for the record I have seen dive ops require this form for recreational reef diving trips as well as instruction) and either the student will return it with all “no” answers on the form or a doctor’s note. But that is not the real world. If I refused to fill out the questionnaire but presented a doctor’s certification I would venture a guess that would not be sufficient for the vast majority of operators. Some maybe, but my guess would be that more would require the form be filled out anyway. There is an example of this in the thread about a change in the form.

That is where the privacy issue comes from. HMMMMM why is there a doctor’s note in lieu of questionnaire? Then the inquisition would begin or the refusal of service would happen if I didn’t disclose why I have a doctor’s note.

Some have questioned my use of the concept of duress. Granted we are not talking life or limb here and at the end of the day all of this is rather moot. Just interesting bar talk without the bar. Now I have had the following scenario happen to a friend on a trip.

We went to a popular Mexican dive island and the dive op shoved these forms at us and told us to fill them out. A buddy of mine (no really) checked affirmative on the medications section. He takes a small dose of high blood pressure medication and has since high school. Well, let the drama begin. I wish I would have caught him before he did it but I didn’t. Threats of refusal of service, call to physicians, and all of this for no medical reason. Eventually the dive ops “go to doctor” gave the all clear but that was an unnecessary level of drama. So after spending a couple grand on a dive trip and threatened with a refusal of service you don’t think that is duress? Now he is smart enough to just answer "no" since his doctor gave him the all clear years before.

 

[Hawkwood]

At that point you are dealing with an individual and not the requirements of an Agency.

If if I am provided with a Doctor's Certificate, I have no reason, right, or anything else to probe further. I have no reason, right, etc. to ask you why you have that Certificate.