Making the highways safer

Drivers have to meet certain standards, including a medical exam, and with so many trucks on the road, that’s seemingly a comforting factor. The U.S. Department of Transportation requires that all Commercial Drivers License holders receive periodic physical examinations, known as DOT physicals, to make sure they have the ability to operate a commercial vehicle safely.

With spring not too far away and the construction season starting in full swing, more drivers are in need of a renewal of their medical certification or a first-time approval. Dr. Howard Reeve, a board certified family practitioner who specializes in occupational medicine, a branch of medicine that deals with the prevention and treatment of diseases and injuries that occur in the workplace, is the one drivers visit when they need DOT physicals.

A DOT physical exam includes a medical questionnaire, a hearing and vision exam, a blood pressure and pulse check, and a urinalysis. The urinalysis is not a drug test, Reeve pointed out, but is designed to check for blood or sugar in the urine that might indicate an underlying medical problem like diabetes.

“Drivers with diabetes can be certified as long as it’s well-controlled through diet or oral medication. They can’t be on needle-injected insulin,” he noted. The reason for that is because of the possibility of the person having low blood sugar and passing out, which is felt to be a safety issue, Reeve explained. However, people taking oral medication for diabetes are OK because their blood sugar doesn’t significantly drop, he said.

“Vision must be 20/40 or better,” Reeve said about the requirements. “Blood pressure has to be under 140 over 90. It’s fine to be on medication for high blood pressure, but it has to be kept under control.”

The DOT physical is valid for up to two years, Reeve noted, but medical providers may issue a certificate for less than that if they feel a medical condition needs to be monitored.

If a person fails the DOT physical exam, the person may be able to try again later, but it also depends on why he or she failed in the first place. “If someone fails the eye exam and then gets glasses and passes, then that’s OK,” Reeve said. “But if the person has epilepsy, then that’s disqualifying.”

People can also have a federal waiver signed if they fail part of the exam, he noted, but obtaining one is very difficult and it’s rare that anyone needs a waiver. Reeve said he usually only sees that once a year and it’s mostly for vision.

“The most common failures are vision or blood pressure, and we can usually work around it if the person gets it taken care of and comes back and meets the standards,” he said.

Reeve sees many new patients each month and it’s not uncommon for drivers to come in for a DOT physical and stay with him for years as their primary care provider.

“I take care of a lot of them,” he said. “They need to see someone and it’s hard to find doctors. I do regular family medicine and geriatrics.”

Reeve said he does one-third occupational medicine, one-third family practice and one-third geriatrics.

There are some advantages for people getting the DOT physical exam from a medical doctor who specializes in occupational health. Reeve has been in the medical field for 20 years and stays current in his field, usually acquiring 15 to 20 hours of continuing medical education in his occupational medicine specialty each year. The physicals are straightforward, but it’s best to have them performed by someone with expertise, he said.

Reeve has been conducting a lot more DOT physicals, although not just for workers in the oilfield. Other businesses are growing and needing more drivers, too, and there has been a lot of turnover, he said.

“There has been quite an increase in employment and DOT physicals all over,” Reeve added.

Additionally, there has been a wide variety of patients who Reeve has seen recently, including men and women drivers ranging in age from 18 to 80. It’s a good opportunity to meet people and give them the opportunity to receive a good health screening, Reeve said, and it might be the only time they come in for a visit.

“It gives me the opportunity to check peoples’ health,” he said. Reeve also said that he has discovered colon cancer and other diseases in people who have come in for a physical, so the physical can actually save a life. Or when a person takes the urinalysis test, Reeve said it has been discovered that the person has diabetes when the sugar in the urine tests sky-high, and they can get that taken care of.

“These exams are very important,” Reeve emphasized. “Commercial drivers are people who spend long hours on the highway. The last thing we want is for someone to have a seizure or heart attack or to fall asleep. It’s really a safety issue. I always think, ‘Is this someone I’d be comfortable with having on the highway when my daughter is driving down the road?'”