Opinion: Preparing for DOT’s Driver Physical
By David D. Durand
Medical Director
Company Care
This Opinion piece appears in the April 14 print edition of Transport Topics. Click here to subscribe today.
For most truckers, the U.S. Department of Transportation physical is just an inconvenience, but for some, it can be a major hurdle. Commercial drivers are understandably concerned, because without the Medical Examiner’s Certificate, they would be out of a job. As a doctor who performs many DOT physicals, I want to make some suggestions to drivers about planning ahead to make the next physical less stressful.
• Two weeks before the physical:
Get your paperwork in order, gathering any reports or documents that might be helpful.
Diabetic truckers may need to bring in a copy of the results of their blood-sugar testing or hemoglobin A1C — a test that shows the average blood-sugar level over the past three months.
Drivers with heart problems, particularly those who have had heart attacks, may need a copy of their latest stress test report. A letter of recommendation from their heart doctor also could help.
Truckers with sleep apnea should be prepared with a copy of their latest sleep test results.
If you’re not sure which reports will be needed, call the testing doctor’s office beforehand and ask.
Drivers with unusual or special medical conditions need to be prepared with a copy of their medical records — not just before a physical exam but always. For example, if you have a heart murmur, i.e., an abnormal heart sound, having the papers that explain your condition and what effect it may have on you makes a big difference in how quickly you pass the physical — or if you pass at all.
Keeping medical records close at hand also helps in the event your boss sends you to the doctor’s office for a “surprise” physical and tests.
If you have a DOT medical waiver, keep a copy with you to show the examiner.
• One week before the physical:
List all the prescription medicines you take, including strength and dosage. If you regularly take over-the-counter medications, such as antacids or allergy pills, list them, too.
If high blood pressure — hypertension — is a problem, consider cutting down on your salt intake for the week before the exam. That will help to lower your blood pressure and avoid spikes in this number. Avoid adding salt to your food and especially avoid foods you know already have a high salt content, such as potato chips, pretzels and French fries. In many people (but not all), salt tends to increase blood pressure, which may put you over your target level and above DOT’s blood-pressure guideline.
Cutting back on caffeine and nicotine also can help improve your blood-pressure reading. If you take medication for hypertension, make sure you haven’t run out and remember to take it as ordered.
Try to avoid situations where you might catch the flu or a cold that could be full-blown by the day of the test.
• On the day of the physical:
Remember to bring all the medical records you’ve prepared for this day, including the list of medications.
Don’t drink beverages containing caffeine — such as coffee, colas or “energy” drinks — or use tobacco just before your physical. These activities can raise blood pressure.
Remember to take your blood-pressure medication on schedule. If you have forgotten, most doctors recommend taking it as soon as possible (if in doubt, talk to your doctor). If you’re significantly late taking your medication, try to delay or reschedule the exam so it has time to work. If you can’t reschedule, be sure to tell the examiner conducting the physical you forgot to take your regular medication. If your blood pressure is too high, ask to have it rechecked later that day — or even the following day.
• What happens if you’re ill the day of the physical?
If you are more than a little sick on the day of your physical, try to reschedule rather than risk failing. For example, if you have a full-scale case of the flu with a lot of coughing, fever, chills and all the other miseries that go along with it, ask your boss and/or company to delay the physical for a few days until you feel better. In a situation like this, it helps to have some time left before your old medical card expires.
• If you don’t pass the physical:
If the worst happens and you don’t pass the exam, don’t give up. Ask for one of the examining clinic’s business cards and for a written list of what you will need to do to pass the next attempt. Tackle every issue so that next time, you can sail through the DOT physical.
If the problem is missing paperwork, call your own doctor and ask to have a needed report or letter faxed to the clinic administering the physical. If you need a routine test, ask if you can have it done on the spot by the examining clinic or another facility nearby to save driving all the way home.
Finally, always be sure to check with your doctor before making any changes that might affect your health, but remember that the best way to pass the DOT physical is to take the time and make the daily effort to stay healthy.
Company Care clinic is part of Saint Elizabeth’s Regional Medical Center, Lincoln, Neb. The author is on the board of the National Association of Occupational Health Professionals.
