Let’s get DOT physical(s)! OccMed opportunities for chiropractors

Opportunities have expanded with an additional 2,000 DC certified medical and DOT physicals examiners needed nationwide

There is no other practice and income expansion opportunity that comes close to that of adding U.S. Department of Transportation CDL (commercial driver’s license) physical exams, or DOT physicals. Plus, with all of the new training, practice tests and other helps, it’s easy to become a certified medical examiner (CME), and literally thousands more DCs are needed to become CMEs.

Like the Olivia Newton John song says, now is the time to “Get Physical(s).” As many have learned recently, it’s better not to have all your eggs in one basket.

CDL and DOT physicals: a massive testing backlog

The transportation industry has already proven its resilience against the past economic downturns, and now it’s demonstrating that it will persevere through pandemics as well. Performing “essential” CDL physical exams has permitted drivers to stay behind the wheel to deliver essential food and products to the American public. At the same time, performing CDL physicals provides pandemic “economic” protection by allowing chiropractic offices to remain open in nearly all states.

During the continuing COVID-19 pandemic, commercial drivers have found it difficult to obtain a medical exam due to the closure of many provider offices. The Federal Motor Carrier Safety Administration (FMCSA) had to issue a special exemption giving drivers an extra three months to June 30 to renew their medical certificates. However, that was not enough. FMCSA issued a second exemption to extend that date to Sept. 30. Current CMEs are now struggling to provide literally millions of extra driver physicals as the backlog continues to grow.

DCs among four CME groups

Among the four major groups of certified medical examiners, DCs make up the smallest group. The most recent FMCSA data from 2016-17 shows that there were:

• 3,400 DC/CMEs
• 19,000 MDs/CMEs
• 18,000 nurse practitioners/CMEs
• 13,000 PAs/CMEs
• 4,500 DOs/CMEs

However, at that time, the average DC/CME performed 1,100 exams per year, which is more than twice that of any other profession. Given that nearly all DC/CMEs at that time were starting from scratch compared to offices with well-established clients, the market penetration of the chiropractic profession is unbelievable. When the next set of data becomes available in the next year or so, I expect the same trend to have not only continued, but to have advanced.

During that same 16-month span more than three years ago, DC/CMEs performed 3.1 million CDL physicals. Estimating that the national average charge per exam is around $85, the average DC/CME at that time collected payments totaling $93,500 yearly. Using those statistics, the payout to the chiropractic profession as a whole is estimated at being between $200-300 million. And again, I expect the same trend to have not only continued, but to have advanced with the next installment of FMCSA data. With the cost of training at $350, what other opportunity has that kind of economic result not only year after year after year, but increasing?

Additional income opportunities

Performing commercial vehicle driver physical exams creates opportunities for additional income by training your staff to provide supplementary services such as mandatory randomized DOT alcohol and drug testing. Even when you are out of the office, alcohol and drug testing can be performed by your staff, and any restroom can be used for the collection.

Usual and customary fees range from $40-60 per test. Cost of training is as low as $200 per staff member. Once the door is open to physical exams, alcohol and drug testing, you can proceed to familiarize yourself with other traditional occupational services such as respirator exams, respirator fit testing, and so much more.

Physical exam opportunities continue to develop. They include physical exams for bus and school bus drivers, taxi drivers, utility workers, crane operators, wildland and city firefighters, local and state police, non-commercial driving instructors and non-commercial drivers of motorhomes, even life insurance physicals, and the list goes on and on. Training for scuba diver physical exams is in development with the assistance of the American Chiropractic Board of Occupational Health. We look forward to DCs being included in the U.S. Coast Guard Merchant Mariner medical exam program when the U.S. Coast Guard forms their own certified medical examiner program.

New programs on the horizon

There are even brighter possibilities. One of the programs DCs would like to be included in is the U.S. Department of Defense Civilian Worker program. Civilians who work at military facilities and bases are required to have a physical exam. That program has a $1 billion budget. There is just one thing missing — you.

It is essential for more DCs to become FMCSA National Registry certified medical examiners and to offer the DOT alcohol and drug testing. The chiropractic profession needs at the very least another 2,000 DC/CMEs. Have your staff trained to perform the DOT alcohol and drug testing. In doing so you will fortify your practice against any current or future pandemic or economic depression, increase your revenue, and participate in helping make our highways safer, support driver health, and qualify the chiropractic profession for inclusion in other government and private industry health care services.

The time is now to “Get Physical!”

Michael Megehee, DC, NRCME, is president of TeamCME, a nationwide network of DOT medical examiners. TeamCME provides full-spectrum services to CMEs providing services to the transportation industry. Megehee was a member of the FMCSA team which developed the basis for certification and the physician training core curriculum for the National Registry of Certified Medical Examiners. He can be contacted at 541-276-6032 or through TeamCME.com.