FMCSA Is Looking To Improve Medical Certification Of Truck Drivers
According to the NTSB, there are 'serious flaws' in the current medical certification process.
Oliver B.Patton
Washington Editor
Federal officials have begun an effort to address one of the industry's most troublesome long-term safety problems: medical certification for truck drivers.
The Federal Motor Carrier Safety Administration wants to set up a National Registry of Certified Medical Examiners. The aim is to identify who the examiners are, make sure they are qualified and understand the truck driver's working environment, and that they are up to date on current medical standards.
Right now, the agency has only a guess about how many examiners there are - perhaps 400,000. It does not know who they are and it does not know how much training they have had.
Agency administrator Annette Sandberg said she wants the public to know that the truck driver on the highway has been medically certified, but "we can't say that right now with any confidence or certainty."
The quality of medical certification has been a concern for a long time, she said at a public meeting on the issue in June - the first of several that the agency plans to hold.
According to the National Transportation Safety Board, an independent federal agency that serves as a safety watchdog, there are "serious flaws" in the current medical certification process. Many drivers have serious medical conditions that are not reported to licensing authorities, and enforcement officials cannot gauge the validity of medical certificates, the board says.
In a departure from past practices, the agency is going public with its ideas before it drafts a proposal. This is the approach Sandberg promised recently when she declared that the agency had learned a lesson from its effort to rewrite the hours of service rules. That process set a new standard of contentiousness in industry rulemaking: After five years of political brawling and litigation, it has yet to produce a rule upon which truck drivers can rely.
The idea now is to share the agency's "early thinking" and engage the transportation community in dialogue on the issue, with the aim of addressing difficult issues early in the process.
"We are looking for (the industry's) best thoughts before drafting a rulemaking," Sandberg said.
At this stage, the agency is proposing that registered examiners be required to take a training course that uses a standard curriculum, and pass an exam. Examiners would have to be recertified, as well, to ensure that they remain qualified and competent.
FMCSA would pay for the curriculum and testing of examiners.
In addition, the agency is suggesting that its new registry web site (www.nrcme.fmcsa.dot.gov) be the clearing house for the program. The website would list all examiners, and provide information about medical certification to examiners and the public. The information would be available by phone, as well.
Examiners today are licensed by the states. They typically are medical doctors, osteopaths, physician assistants, advanced practice nurses or chiropractors.
The impact this system would have on current examiners and drivers is not clear. According to Dr. Ellison Wittels, a medical consultant to FMCSA, the idea is not to shrink the pool of either examiners or drivers, but to make sure that they are qualified.
"The state of affairs is not good," Wittels said. The safety agency does not know how many examiners there are, whether or not they understand the rules or whether or not they understand the conditions in which drivers work.
The current system is complex: Examiners must follow 13 medical standards established by law. Of the 13, four are specific, such as vision and hearing, and nine are more general and subject to interpretation. In addition, there are medical guidelines that in effect provide recommendations to the examiners, but those guidelines were issued in 1988 and are outdated, Wittels said.
On top of that, the driver population is aging, which brings in a new set of medical issues - the increased risk of sudden incapacitation due to heart disease or hypertension, for example. This requires examiners to be more astute, Wittels said.
Sandberg said that the agency has authority to create the registry, but is seeking specific language in the pending highway reauthorization bill. That bill, which may clear Congress this summer, also contains a provision that will create a medical review board - five experts who will advise the agency.
Meanwhile, the agency has begun the process of integrating medical certification information into the Commercial Drivers License database. A rulemaking on that issue is scheduled for next year.
In a related development, at least one private, non-profit group is seeking to provide the types of services that the registry would offer. The National Academy of Medical Examiners, as it is called, aims to provide standards and training materials for examiners, administer the exam and compile the registry of examiners.
FMCSA's target date for completion of this project is 2009.
Washington Report continued...
