OWD license without a doctor's certificate?

[caruso]

In my experience, it's usually not a question of divers with known medical conditions checking No to avoid some hassle.

Well yeah, because the divers that check "No" don't come to you for medical clearance!

apart from the legal expense, neither the dive op nor the doctor loses.

Right. The medical form is all about liability. If the diver lies and dies, odds are that the defendant will ultimately prevail. That much is not in dispute on this thread or probably anywhere else. The medical form is for all practical purposes, a CYA document, nothing more. Sure there might be a small handful of divers who read the form and think "Hmm I guess I checked the box for emphysema I better rethink this" but how often does that happen?".

 

[rsingler]

Well yeah, because the divers that check "No" don't come to you for medical clearance!

Lol, you don't quit, do you @caruso ?
Don't forget, I also teach scuba. I can often tell when someone has shaded me on their form. Then I have to decide whether to call them on it. So, in my experience, more people check yes and have an exam, than lie and dive anyway.

 

[rsingler]

The medical form is for all practical purposes, a CYA document, nothing more.

I respectfully disagree

 

[caruso]

, in my experience, more people check yes and have an exam, than lie and dive anyway.

That may very well be true. I don't know the numbers or the percentages, and this isn't really what this is about. Some divers lie and dive without incident, others lie and learn to dive and have fatal accidents on their very first checkout dives (how often does that happen I wonder), others check the boxes and get medical consults- some of whom subsequently never dive, and still others dive for 20 years, gain 100 lbs and diabetes or heart problems or other medical conditions they didn't have when they started diving and are the biggest contributors to fatal scuba diving accident statistics.

You can't control human nature, most people will probably lie or deceive to further their own goals at one time or another, and others will tend to always to play by the book and do as their told. Either way the medical form is useful for liability reasons and may also get some or a lot of student divers to think about their medical conditions. It's not a bad thing.

 

[lv2dive]

I have refrained from speaking to what I do/have done... but I do feel like this is a relevant option, and it’s only been discussed last in passing so far.

I leave the stuff about the facility/ instructor blank on page 1, bring the whole form including the instructions for the doctor, and get the doctors sign off on the second page. Then I make a copy of the original when needed, and fill in the shop/instructors details on p1 of the copy, and I do NOT fill out the checkboxes. I DO discuss any potential relevant issues with instructors. In this day and age, I don’t want what equates to my personal health records being stored randomly in a dive shop or with an instructor. I haven’t had any issues doing it this way in almost 20 years of diving.

 

[SapphireMind]

Again, it's not about whether people should discuss things with their doctor - they absolutely should. It's whether having a piece of paper that someone would photocopy/email to a bunch of people changes anything when there are people who have spoken to their doctor, are safe to dive, but the added hassle of the form (and forcing me to place liability on my doctor, instead of me) means they just answer 'no' for simplicity's sake.

I'd be fine with a waiver line along the lines of "I am certifying that I have discussed my conditions/medications with my physician and I acknowledge that failing to do so could endanger others and could kill me, and after that discussion, I am safe to dive."

Making a system where people feel they have to hide their conditions because they forgot a piece of paper at home or are 2 weeks past their annual check up, or don't have the time/money to spend for non-covered medical testing and visits is not going to help safety. Everyone should be carefully evaluating their medical fitness to dive, every time they get near water.

One side is focusing on the people who shouldn't be allowed to dive and are lying on the form because they are not fit and don't want to be kept from diving, even if they should.

The other side is focusing on the people who have been evaluated for their medical conditions, been found fit to dive and just have issues with the extra paperwork.

There are going to be the first type of diver, no matter what system you have - short of having a physician giving an in depth exam prior to every dive. The second type though is who have to deal with the fallout from the first type of diver. I'm an adult and I don't need permission slips anymore. Except with diving.

 

[SapphireMind]

My responsibility as a diving physician

Out of curiosity: do you provide diving exams for free, and if not, how much do they cost, presuming you are in the US?

 

[tursiops]

I'm an adult and I don't need permission slips anymore. Except with diving.

You are an adult who is trying to game the system because you don't like it.
The doctor's signature is the only way an instructor has to verify that a discussion took place. Yes, it might have been a useless discussion; that's unfortunate. But your system requires the instructor to believe you when you said you had a discussion with your doc and you are good to go. Why should I believe you? If you are happy to lie on the form, then I suppose you are happy to lie to me, too.

You keep calling it a permission slip. I call it a verification of a discussion.

 

[SapphireMind]

You are an adult who is trying to game the system because you don't like it.
The doctor's signature is the only way an instructor has to verify that a discussion took place. Yes, it might have been a useless discussion; that's unfortunate. But your system requires the instructor to believe you when you said you had a discussion with your doc and you are good to go. Why should I believe you? If you are happy to lie on the form, then I suppose you are happy to lie to me, too.

You keep calling it a permission slip. I call it a verification of a discussion.

It's a permission slip, signed by a doctor. If you want to verify that I've talked to my doctor, ask me. I don't think the discussion with the doctor is useless, I think the form is useless. Either you are trusting me to self-disclose medical conditions and that I've discussed it with my physician, or you don't. Again, it's more than just instructors who are requiring the form.

Edited to add: I will reiterate that I openly disclose my medical issues to those diving with me, I just don't put it on the form.

If the forms are not retained as someone else said, there's a whole other level of legal liability, because then you don't have proof the form was actually signed or filled out.

 

[purbeast]

While I'm not certified yet, I have gone through the process of trying to get medical approval twice. I grew up with bad asthma but the past decade+ it's been very well controlled and pretty much I have grown out of it. I still use Advair like 4-5 times a week (its recommended 2x a day) and I haven't used my rescue inhaler in over a decade.

Back in 2011, the first time I went to a doctor that DAN recommended that was way out of the way for me. He was about 45 minutes away. I went to him about 2 weeks before I was going to Mexico where I was planning on doing SCUBA.

Before I visited him he had me do a bunch of tests and to basically bring the results in. The tests included chest x-ray, pulmonary function tests, blood tests, and like 2 other tests I don't even remember. He didn't have me do the physical part of it because he saw the kind of shape I was in and said it would be pointless since he knows I'd pass it. In the end he said that he would not sign off the waiver just because he doesn't do it. He flat out told me that I can answer NO to all the questions because I clinically didn't even have asthma, like by the definition of it.

I left disappointed, and the next day he called me and said that if I did SCUBA in Mexico and everything felt fine, to come visit him again and he'd sign off. Well I went and I did a 1 tank resort dive and loved it, however I was dumb at the time and never went back to see him.

Fast forward 7 years later to this past August, I decided that I was going to actually do it this time and went to see my asthma/allergy doc. I explained the situation to her and she said she doesn't really have education on it and recommended me to see a pulmonary specialist. So I went and saw him, he had me do some breathing tests, I did this "6 minute challenge" where they test me before/after walking fast for 6 minutes and I passed that just fine. He then said that he wanted me to go to a hospital and do tests they can't do there, as well as get a chest x-ray.

So I did the x-ray, went to the hospital and did a pulmonary function test 3 days. They then took my oxygen levels in my blood, put me on pure oxygen for 30 minutes, and took my blood again. After I was done with all of the tests, the guy giving me the test asked me why I was doing these tests and I told him because I want to get SCUBA certified. He thought that it was odd because he hadn't heard of it being needed and then I told him I had asthma. He looked at me with almost a double take and was dumbfounded, and was like "you have asthma?" I told him yes and he was shocked and said he never would have guessed.

A week or so later, the results made it to the pulmonary specialist and he signed off on my waiver. So I'm now waiting for my classes to start next weekend then heading to Grand Cayman for the checkout dives.

I feel better knowing that I can answer YES to the asthma question on there as well as taking medication, and then give them my waiver. I will also gladly explain to anyone that I have very mild asthma and it's controlled very well and it should not be an issue at all. I workout and exercise regularly too which I'm sure helps.

I write all this out because in the end I was glad I went through all of this. Sure it took more time, but it also educated me about the risks associated with asthma and diving, and due to my asthma and how it is very mild/controlled, I'm at very minimal risk, pretty much no more risk than anyone without asthma. I did get a bit frustrated at having to go somewhere, then go somewhere else, then somewhere else, etc, and in the end I wasn't sure if I'd get it signed off, but it all worked out.

You all may have seen my story on this forum here about all of this as well, as I made a post back in 2011 and updated it recently.