OWD license without a doctor's certificate?

[TMHeimer]

If you see a box you should check Yes and you check No, you're taking a chance. The rest is all about liability, doctors, lawsuits. I'll check back tomorrow to find a FEW more posts.

 

[tursiops]

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.

I don't know who said this; the forms are retained for 7 years.

 

[dmaziuk]

So to sum this up,
- the checkboxes are there to alert the diver who has no clue they've smoked pot in the last five years that, hey, they used drugs in the last 5 years,
- but the shop is to file the answers,
- now breaking some local laws by doing so,
- while we either lie
- or ignore the written instructions and don't fill in the checkboxes,
- which some, but maybe not all, WRSTC member agencies allegedly allow,
- but would probably not show up in court to testify on behalf of the shop if that partially filled-in form is introduced in evidence,
- and we all need all that form because not having a standard form will plunge diving industry into chaos.

Did I miss anything?

 

[SapphireMind]

So to sum this up,
- the checkboxes are there to alert the diver who has no clue they've smoked pot in the last five years that, hey, they used drugs in the last 5 years,
- but the shop is to file the answers,
- now breaking some local laws by doing so,
- while we either lie
- or ignore the written instructions and don't fill in the checkboxes,
- which some, but maybe not all, WRSTC member agencies allegedly allow,
- but would probably not show up in court to testify on behalf of the shop if that partially filled-in form is introduced in evidence,
- and we all need all that form because not having a standard form will plunge diving industry into chaos.

Did I miss anything?

Seems about right

 

[SapphireMind]

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.

I did read your story. How much money did it cost you to do all that, including how much time off work, out of curiosity. If you had to go through that every year, would you be as sanguine? If you passed all those tests and had a doctor who was still hesitant to sign you off, what would you have done?

That's the peril of going to dive specific physicians. My conversation with my PCP is shorter, because they are already familiar with me and my history. And then I forget to bring the form with me. Or I bring it and forget it on a trip. Or even after all the normal testing, the doctor still won't sign because of their discomfort in accepting liability. Then you've gone through all the workup and discussions, but still don't have a piece of paper to show for it, so do you just never dive?

 

[JackD342]

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.

@purbeast
Glad to hear you are finally on your way to fully joining this activity, and that you and your MD have confidence you are not at an elevated risk.

Here is the most relevant excerpt from the RSTC document, where there are 3 paragraphs on Pulmonary issue out of the 4 detailed pages of explanations, education, and documented reference. Might be enough "as is" for some doctors to form an informed opinion, others may need to follow up further.

"Any process or lesion that impedes airflow from the lungs places the diver at risk for pulmonary overinflation with alveolar rupture and the possibility of cerebral air embolization. Many interstitial diseases predispose to spontaneous pneumothorax: Asthma (reactive airway disease), Chronic Obstructive Pulmonary Disease (COPD), cystic or cavitating lung diseases may all cause air trapping. The 1996 Undersea and Hyperbaric Medical Society (UHMS) consensus on diving and asthma indicates that for the risk of pulmonary barotrauma and decompression illness to be acceptably low, the asthmatic diver should be asymptomatic and have normal spirometry before and after an exercise test. Inhalation challenge tests (e.g.: using histamine, hypertonic saline or methacholine) are not sufficiently standardized to be interpreted in the context of scuba diving."

As an example of how this is supposed to work, so far I have only had two divers that were ready to start instruction, but were unable to obtain medical clearance:

1. Close friend of mine was already certified, ages ago, but wanted to do it all again from scratch. His primary physician said "no, not until you get your weight down and are not relying on a prescription to manage your hypertension." Second doctor said the same thing. While not advocating doctor shopping, and not knowing myself if that should or shouldn't be a show-stopper, I suggested he contact DAN to find an MD with greater knowledge of dive physiology. And that 3rd doctor said... "no, not until you get your weight down...."
2. One other potential student could not get clearance due to his daily (and expected to be permanent) use of a blood thinner. I was surprised, but he said his doctor explained that his concern was if he started a pressure induced nose or ear bleed, the consequences could be much more severe underwater. He was not interested in contacting DAN for a 2nd opinion, as his doctor's concerns quickly became his own concerns.

 

[tursiops]

So to sum this up,
- the checkboxes are there to alert the diver who has no clue they've smoked pot in the last five years that, hey, they used drugs in the last 5 years,
- but the shop is to file the answers,
- now breaking some local laws by doing so,
- while we either lie
- or ignore the written instructions and don't fill in the checkboxes,
- which some, but maybe not all, WRSTC member agencies allegedly allow,
- but would probably not show up in court to testify on behalf of the shop if that partially filled-in form is introduced in evidence,
- and we all need all that form because not having a standard form will plunge diving industry into chaos.

Did I miss anything?

Nice job of retaining the fantasies and forgetting the facts.

 

[rsingler]

That's the peril of going to dive specific physicians.

Wow! Coming from a medical professional, that's hard to read.
So our New Diver (this is the New Diver forum) reads your comments and maybe concludes a) I shouldn't worry about the form; just check all No's, because it's nobody's business but me and my doctor, or b) if I think I have a problem, I better not go to a physician who has expertise in diving physiology, because it could cost a lot of money and time with no guarantee, whereas my local MD knows all about me and will just sign me off.

Did I get that right?
I'd like to think that my patients get valuable counsel. Most get signed off; some don't.

 

[JackD342]

re: aversion to assuming professional liability

I have to think there are more than a few professions/vocations where the very real elevated risk of professional liability is a given, and anyone getting into that line of work knows that up front, like WAY upfront, but chooses to pursue that profession regardless. So asking someone to provide that service and expertise that they trained for, sometimes trained for years, with ALL that responsibility entails, seems to me pretty much to be a no-brainer. If they have buyers remorse on that career path, they change it.

Manage the risk? Yes.
Avoid at all costs? ....?

 

[rsingler]

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.

Wrong. Whether I trust you or not is irrelevant. After you die, it's your family I worry about. Because, of course (!) it couldn't have been your fault that you dived when you shouldn't have. It had to have been the fault of the dive boat, dive school, instructor, ANYBODY but the diver, their beloved family member.

Under your system, all I'll have is the record of someone who says they saw a doctor, with no doctor's signature to confirm. In today's litigious climate, yeah, that'll fly. If I'm threatening to not let you in the class without your signature promising that your doctor said it was okay, that's the textbook definition of being under duress.

Forget about the educational and safety value of checking a box and being required to follow it up and document it. Strictly from the CYA standpoint that so many seem to be focusing on here, it's a slam-dunk that I'll not take many divers assurances that their doctor said it was okay. Folks just don't know what they don't know, and if something they don't understand is now in the way of their new hobby...?