Big Change Ahead for Truck, Bus Drivers: Mayo Expert Explains New Medical Exam Rule

ROCHESTER, Minn. -- Big changes are coming to the medical evaluations required for many commercial driver’s license holders, including truckers and bus drivers. Under new federal requirements, the medical examinations will only count if they are performed by a health care provider specially trained and certified to do so. The goal is preventing medical emergency-related truck and bus crashes through what likely will be more intense health exams, says Clayton Cowl, M.D., of Mayo Clinic.

“Often, the medical evaluation is the only opportunity for preventive care that a driver will receive,” says Dr. Cowl, a physician in Preventive, Occupational and Aerospace Medicine at Mayo Clinic who learned how to drive a semi so he could better understand the physical stress truckers face. “Granted, it’s more regulatory burden on the drivers and their examiners, but I also view this as an opportunity for health care providers to make a difference in their lives. It’s their chance to emphasize the importance of preventive health care and get them pointed in the right direction in terms of pursuing healthier lifestyles.”

Eye strain and chronic stress are two obvious health issues long-haul truck and tour bus drivers face, but job-related and performance-affecting medical issues can go far beyond that to include such diverse problems as sleep apnea; diabetes; high blood pressure; obesity; painful, chronic hemorrhoids; and muscular and skeletal strain. Many truck drivers smoke or use other forms of tobacco, putting them at higher risk of cardiovascular disease and lung disease.

Yet, for many, the medical exam required at least every two years is the only time they will see a health care professional. The Federal Motor Carrier Safety Administration estimates 40,000 qualified medical examiners will be needed to perform roughly 3 million exams a year under the new rules. Dr. Cowl performs commercial driver’s license medical exams and is the course director for a new series of training programs offered to examiners across the country. He and Mayo Clinic colleagues from a variety of medical subspecialties will train medical examiners with classes in Rochester in October and November and an online course. The federal requirements take effect in May 2014.

Mayo Clinic can use telemedicine and other resources to help truckers who would otherwise fail their medical exams promptly address potentially disqualifying conditions and get back on the road.

The federal rules adopted earlier this year also mean it may be more difficult for drivers who fail their medical exams to “doctor shop” to find examiners who will pass them, and examiners will likely be held more accountable if they aren’t thorough or let someone slide by who shouldn’t, Dr. Cowl says.

“If something bad happens, if an accident occurs and property or individuals are somehow affected, the examiner may get added scrutiny if they haven’t done a comprehensive medical evaluation or a glaring medical condition was not addressed,” he says.

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