Become certified yourself or hire an associate to perform both chiropractic and DOT physical exams in your office
DC certified medical examiners have proved themselves to be effective, knowledgeable and cost-effective, and perform on average more than twice as many commercial driver medical exams as any other medical examiner professional.
Doctors of chiropractic in 2012 were included in the National Registry of Certified Medical Examiners (NRCME), allowing them to perform DOT physical exams for commercial drivers. This created a tremendous opportunity, and now the opportunity and future looks even brighter according to recent statistics.
DCs and the NRCME
When DCs were included in the NRCME in 2012, most commercial drivers and trucking companies were either not aware that DCs were eligible to provide commercial driver medical certification or were unsure of whether DCs could competently provide the DOT physical exams and make the proper determination of whether a person is safe to drive. Thanks to the DCs who chose to move forward, those concerns are dead, defunct and outdated.
For the longest time, it was not unusual to hear about a driver sitting in an express care waiting room for three hours for their medical exam. DCs have significantly changed the landscape regarding this issue. Truckers began to realize that many DCs were able to offer same-day or next-day appointments.
Chiropractic certified medical examiners have proved themselves to be effective, knowledgeable, timesaving and cost-effective.
DCs performing DOT physical exams
A new study found that the quality of driver medical exams performed by DCs is on par with those performed by all other medical professionals. In addition, recent data indicates that DCs are passing the certification test with passing scores in line with the medical professions. This combination has caused trucking companies and independent drivers across the nation to seek out DCs for their DOT physical exams.
Starting in December of 2021, medical examiners (MEs) who became certified in 2012 must retake and pass the ME certification test before the end of 2022 as required by federal regulation. Many changes have occurred to the regulations and guidelines since their initial certification. As each provider’s certification nears expiration, there will be those that decide to drop out. This has already started to occur as a significant number of non-chiropractic medical examiners have informed FMCSA that they are no longer performing driver exams.
Throughout the current pandemic, many DCs have kept their doors open by performing the “essential services” of DOT physical exams and drug and alcohol testing. Many have reported an increase in exams performed due to the lack of health care providers who were either closed or too busy. Drivers were having such a difficult time obtaining a medical certificate that the Federal Motor Carrier Safety Administration allowed drivers additional months to renew their medical certificate. This occurred four times. During this same time, the number of new drivers increased to meet consumer demand.
Certified examiners nationwide
There are approximately 70,000 certified medical examiners (ME) nationwide, and DCs make up the smallest group of the five major professions performing DOT physical exams (NP, DO, MD, PA, DC). In addition, the chiropractic profession has the lowest percentage of participating providers in their profession compared to the other four major professions.
This is a true enigma. The most successful group of MEs should not be the smallest group by number or by percentage of participation of their profession.
There are currently 6.8 million drivers of commercial vehicles that are required to have a medical certificate. Nearly 12 million driver medical exams are completed annually. However, many other professions use the driver medical certificate as their fitness-for-duty physical exam for employees. These include powerline workers, crane operators, wildland fire fighters, state and local firefighters and police, and more. These are in addition to the number of driver medical exams performed.
The DOT medical certificate for drivers is required at least every two years, with half of them occurring annually due to the drivers’ medical conditions.
Exams generally take 15 minutes of the medical examiner’s time to complete. No special equipment is needed other than routine physical exam instruments. The average charge for an exam varies depending on location but the average amount charged by DC MEs is estimated to be $85 per exam. Driver medical exams are not routinely covered by insurance. The driver or the driver’s employer usually pay the provider directly.
Exams increase your client base
Having drivers and trucking companies as clients increases the value of your practice. They will most likely still be your clients when you retire, which makes your practice more attractive to interested buyers.
Evidence of this can be seen in my own practice. I was the first DC to be appointed as a Walmart distribution center medical examiner for their DOT physical exams, drug and alcohol testing. That practice was sold to a young local DC who is currently the designated Walmart medical examiner for three Walmart distribution centers.
To become a ME and be listed on the national registry, health care professionals must complete training and pass the national registry certification test.
Providers must meet the following criteria:
- Possess a valid and current medical license in the jurisdiction where they will perform these examinations, in accordance with applicable state laws and regulations
- Complete a FMCSA-accredited national registry training course ($199 to $349) and obtain a certificate of completion
- Obtain a personal national registry number from the FMCSA by registering on the FMCSA National Registry of Certified Medical Examiners website.
- Pass the NRCME Certification Exam ($79) provided by an FMCSA-approved testing organization
Take advantage of the window and opportunities in place now to either become certified yourself or hire an associate to perform both chiropractic and DOT physical exams in your office or at the trucking company’s location. Next, have your staff and/or associate trained to provide the federally-required alcohol and drug testing for commercial drivers. When your office is providing all of these services under the same roof, your practice will grow exponentially, and it is very unlikely they will ever look for another provider. The more involved you get, the better it gets.
Extra income and service
There is also great value in providing these services for the benefit of the trucking industry, drivers, the American public and our country.
According to a conversation with Louis Sportelli, DC and past president of NCMIC (someone I admire and try to emulate), “Service should be the reason to participate in this important national program.”
There are not many instances where a service benefits the provider, the profession, the public and the nation. This is one of those rare instances.
MICHAEL MEGEHEE, DC, was appointed by the Federal Motor Carrier Safety Administration in 2005 as a subject matter expert for the National Registry Survey Working Integrated Product Team and the National Registry Education Team that developed the core curriculum for the certified medical examiner training. He is a nationally published author and radio show guest and has traveled the U.S. training physicians regarding the DOT physical exam. He was the first doctor of chiropractic to be designated as a Walmart distribution center medical examiner. He founded the TeamCME® National Network of DOT Examiners in 2010. As past president of the nation’s largest provider network of national registry certified medical examiners he is the medical examiner expert resource to 800 TeamCME member clinics. TeamCME is an Accredited National Registry Training Organization. Learn more at TeamCME.com.