Question
Back in May, I had to get my DOT physical recertified.
(scene)
Day off, many appointments to keep, DOT physical is last one before noon. I smoke and drink Pepsi for breakfast instead of coffee or something else.(this is normal for me)
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I had a particularly busy morning, with 4 meetings and rushing to my other appointments and was kind of stressed out.
I get to the clinic and take my physical ($65 bucks goes POOF). My blood pressure was 160/90 after exercise.
The Dr. gives me a 90 day medical card. He says that I need to be under a Drs. regular care for high BP. I explain to him that I have never had a problem with high BP (I honestly haven't). It doesn't matter to him, and he sends me on my way.
That afternoon I asked the nurse at the school my mother works at to check my BP. It was normal.
3 months later I take another day off to get another physical done. (another $65 bucks goes POOF!!!) BP is NORMAL.
Dr. now gives me a medical card good for only 1 year.
I have spoke with other drivers that have gone to this clinic, and they have had similar problems with DOT physicals.
Is this just a "ploy" for more $$$ for the clinic?
[This message has been edited by Hoss (edited October 29, 2000).]
Answer
Your gonna hate this;
Blood pressure. Record with either spring or mercury column type of sphygomomanometer. If the
blood pressure is consistently above 160/90 mm. Hg., further tests may be necessary to determine
whether the driver is qualified to operate a commercial motor vehicle.
and from the new exam sheet:
Blood pressure (BP). If a driver has hypertension and/or is
being medicated for hypertension, he or she should be recertified
more frequently. An individual diagnosed with mild hypertension
(initial BP is greater than 160/90 but below 181/105) should be
certified for one 3-month period and should be recertified on an
annual basis thereafter if his or her BP is reduced. An individual
diagnosed with moderate to severe hypertension (initial BP is
greater than 180/104) should not be certified until the BP has been
reduced to the mild range (below 181/105). At that time, a 3-month
certification can be issued. Once the driver has reduced his or her
BP to below 161/91, he or she should be recertified every 6 months
thereafter.
That is word for word from 391.43. And it sound like you were FINE the first time. But basicly, you are screwed for life into the annual exam. Just be thankful it wasnt any higher, then you would have been unemployed until it came down, then subject to exams every 6 months for life!!!!
Simply put, the new regulations are a gold mine for the unscrupulous operator. Annual and semi annual exams, EKG and stress tests, the list will end up being long and expensive. And the ones who will suffer the most will be the drivers and the legitimate practitoners, who will be painted with the same brush as the quacks.
Of course, you could always switch to flying a 747. The physical isn't nearly as demanding.
A few more questions;
1. After exercise?? When did we start doing BPs after exercise??
2. When did the threshold chang from 160/100 to 160/90??
[This message has been edited by psycho (edited October 30, 2000).]
Answer
Psycho, once again you are right on the ball. His B/P should have been taken BEFORE exercise, not after.
To my knowledge, the DOT has always embraced 160/90 as the magic line for hypertension. You are thinking of what you were taught in Paramedic school. The general rule of thumb for practitioners is 160/100, but not where the DOT is concerned.
Now, at my clinic, if a driver's B/P is over 160/90 initially, we procedd with all of the other components of the exam, then check it again. If it remains the same or seems to be coming down, we will allow that driver to sit quietly, read a magazine, etc. then recheck in a half hour. We will continue this if we see a downward trend in that B/P. Why do we do this? White Coat Syndrome. So many people just automatically get anxious at the Dr.s office and will spike an abnormal B/P.
My suggestion to this driver is to have another physician perform his physical when it is time to recertify. Don't mention that you had a limited card. Make the appointment for first thing in the morning, if B/P is high, insist on a recheck in a half hour.
Now what should be kept in mind is that your pressure IS going above the norm when stressed. This means that you MUST keep a closer check on your blood pressure. If you see atrend where it is above that 90 mark quite often you may need to consider some dietary changes, stress management, lifestyle changes, etc. It' s a warning sign that you need to pay closer attention to your health.
As for a ploy to get more of your hard earned bucks....could be, but the physician was walking a real fine line with that first blood pressure.
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Keeping you safe, healthy, and on the road.
Nurse Red
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Answer
They took my BP before and after exercise. It was lower before. (although I cant remember by how much)