It’s time for your next Department of Transportation (DOT) physical to get your med card. Oh, that dreaded physical. Does anyone like going to the doctor? Not really. Especially when you’re relying on that doctor to give you the green light to continue your career as a truck driver.
That’s right, the doctor has the power to make or break your career with the results they give you. It can feel like the power is in their hands (when it’s really your body that’s in control) so when you get a diagnosis you don’t like and that prevents you from getting a medical card, you can be tempted to go to a different doctor to get a better answer…
…And so starts the process of doctor shopping.
It happens more than you would think and it’s a huge problem in the trucking industry.
As the safety and compliance manager here at ATS, I’m here to help you understand what doctor shopping is, the consequences of it, and why you are harming yourself by doing it.
- What is doctor shopping?
- How do drivers doctor shop?
- What are the consequences of doctor shopping?
- Med card best practices
What is Doctor Shopping?
Doctor shopping occurs when truck drivers seek multiple medical examiners to obtain a DOT medical card after receiving an adverse result from a previous examiner. This happens when a driver is either disqualified (DQ) or given a determination pending (DP) status due to a medical condition that needs further evaluation or treatment. Instead of addressing the issue, some drivers attempt to find a more lenient medical examiner who will grant them clearance to drive.
Drivers receive a DP status when they have a condition that needs to be addressed by a medical doctor before the driver can receive a med card. This often happens when a driver has an unmanaged condition like high blood pressure or diabetes. The DOT-certified medical examiner will recommend the driver visit their primary care physician (PCP) to get their blood pressure under control with medication.
Once the condition is under control, the driver should revisit the DOT-certified medical examiner to receive their medical card.
Drivers are given a DQ status when they have a medical condition that would make it unsafe for them to be behind the wheel. For example, if they have a condition that makes them faint, have a seizure, or otherwise become unconscious for segments of time.
Note: If drivers receive more than one temporary medical card, they should receive a DQ.
The Federal Motor Carrier Safety Administration (FMCSA) has a list of conditions that disqualify drivers from receiving a medical card and operating a commercial motor vehicle (CMV).
Common Conditions Where Doctor Shopping is Prevalent
The most common reasons drivers attempt to doctor shop include:
- High Blood Pressure: If a driver’s blood pressure is excessively high (well above 120/80), they may receive a DP status requiring them to seek treatment and prove they’re managing their condition before obtaining a medical card.
- Diabetes Management: If a driver’s A1C levels indicate poorly managed diabetes, they may not be granted certification until they demonstrate control over their condition.
- Examiner Discretion: Some medical conditions, like diabetes (when not requiring insulin) or certain medications, fall under examiner discretion. If a driver is denied a card due to an examiner’s judgment, they may seek out another examiner who is more lenient.
How Do Drivers Doctor Shop?
You might be wondering how drivers get away with this practice against federal regulations. Don’t medical examiners report results to the DOT or some other organization?
Medical examiners maintain their own records and report their results to the FMCSA. However, since DOT auditing processes are not highly rigorous, there is no centralized system that immediately flags a driver who has failed a previous DOT physical.
Instead, drivers visit multiple examiners until they find one willing to issue a medical card. They may seek out clinics, such as those run by chiropractors, that may not be as strict as those operated by internal medicine doctors.
Additionally, they may misrepresent their medical history on the required long-form questionnaire, particularly when asked if they have ever been issued a medical examiner certificate for less than two years.
They’ll say they haven’t, and the medical examiner doesn’t have a reason to think twice. (Note: If the driver did say they’d received a temporary medical card in the past, the medical examiner would be required to ask further questions.)
The Right to a Second Opinion
It’s important to note that a driver can pursue a second opinion if they for any reason feel like the medical examiner is not giving them a fair result.
For example, some drivers, depending on their condition, can get a medical variance waiver from their PCP. This waiver provides documentation that their condition is under control and being actively managed.
However, if a driver does pursue a second opinion, they must be honest about their full medical history. Drivers should not leave out key medical details that caused them to fail the physical the first time.
Remember: There’s a difference between your right to a second opinion versus being completely untruthful about your health history.
The Risks and Consequences of Doctor Shopping
Doctor shopping poses significant risks to both the driver and the public, including:
- Safety hazards
- Legal issues
- Trust concerns
Safety Hazards
The number one consequence of doctor shopping is the undue risk to the driver and the motoring public; it’s a huge safety issue. If a driver is unfit to operate a vehicle due to a serious medical condition, they pose a danger to themselves and others.
These cases pop up all the time in the news. A truck driver has a medical episode behind the wheel and causes an accident. Unfortunately, some of those accidents are tied to doctor shopping behaviors. The results can be deadly.
Truck driving is an extremely stressful job. It can intensify a lot of medical conditions. If those conditions aren’t properly managed, it can lead to dire consequences for both the driver and the motoring public.
Now, if you do have a medical emergency on the road and you’re far from home, it becomes an even bigger issue. First, you have to find a way to get home. Then you have to consider how much money you’re losing out on by being home and not on the road.
Before you can return to work, you have to complete a return-to-work process which includes consulting with a medical review officer (MRO) and completing their recommended steps. Those steps may include seeing your PCP, getting on a management plan, and staying on that plan for a set time.
The driver is accountable for completing this entire process without the help of their carriers and it’s on their own dime too. It can take weeks to get appointments scheduled with a PCP and get a management system in place.
Drivers also have to complete another physical for a med card when they return to work.
Legal and Compliance Issues
Doctor shopping undermines the integrity of DOT regulations. If a driver is caught falsifying medical records, they could face penalties, disqualification, or termination.
Many carriers follow rigorous hiring standards that prevent drivers from getting away with doctor shopping. For instance, if a driver has a medical card that’s due to expire within six months, they’ll make them get a new physical when they come to orientation. They may not accept drivers who only have temporary medical cards, either.
Trust and Integrity Concerns
Carriers rely on drivers to be honest about their medical conditions. If a driver is willing to mislead a medical examiner, it raises concerns about their honesty in other aspects of their job.
What Should Drivers Do Instead of Doctor Shopping?
Rather than seeking a lenient examiner, drivers should:
- Follow Medical Advice: If given a DP status, address the medical concerns by working with a primary care physician.
- Stay on Top of Health Requirements: Proactively manage conditions like blood pressure and diabetes before they become disqualifying issues.
- Be Honest on Medical Forms: Transparency is crucial for safety and compliance.
Related: How to maintain a med card
Maintain Your Health on the Road
Doctor shopping for DOT physicals is a dangerous gamble that puts both your career and public safety at risk. While it may seem like a quick fix to a frustrating situation, the long-term consequences — legal trouble, loss of trust, and potential accidents — far outweigh the short-term benefit of getting back on the road. Instead of searching for an easier answer, take control of your health by managing medical conditions properly and being honest with medical examiners.
By prioritizing your well-being, you’re not only protecting your livelihood but also ensuring the safety of everyone on the road.
Check out these tips for help both preparing for a DOT physical and maintaining your health on and off the road.