3 A Vehicle for Greater Access to Chiropractic
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Dynamic Chiropractic – April 1, 2014, Vol. 32, Issue 07

A Vehicle for Greater Access to Chiropractic

What the NRCME has done for chiropractors lately.

By Michael Megehee, DC

You've already heard that the National Registry of Certified Medical Examiners (NRCME) represents a great opportunity to help the effort to increase safety on our national highways.

And if you've kept up with the articles in this publication over the past several years, you are also aware that adding commercial driver medical exams, school bus physicals, and DOT drug and alcohol testing to your practice can be a significant source of revenue. And because that revenue comes from another source of potential chiropractic patients, the benefits are even greater.

As great as that is – and it really is that great – I'm hoping that even more DCs will become certified in the NRCME once they've heard what it has done for them and for the chiropractic profession lately.

It's essential to point out that the Federal Motor Carrier Safety Administration does not favor any specific profession. But in all cases in which you are included in a federal program, there are added benefits that can come with being part of the "in crowd." Chiropractors are included in the registry because of change in 1992 that allowed doctors of chiropractic, nurse practitioners and physician assistants to participate as DOT medical examiners.

From the very beginning in 2005, chiropractors were invited to participate on the FMCSA teams that helped establish the registry. The ACA was immediately supportive, and along with efforts from publications like this one, many members of the profession have rallied around the NRCME banner.

From the beginning, the NRCME represented more than just an economic opportunity. Recognized immediately was how the ability and recognition to perform a physical exam could have significant effects on the acceptance of and inaccurate perceptions about the chiropractic profession.

Because many drivers have medical conditions that are treated by the medical profession, communication between the medical examiner and the driver's treating physician is sometimes needed. This communication is a two-edged sword (but in a good way): It makes our medical counterparts more familiar with us, and it make us more familiar with them. The great majority of these communications result in a cooperative and more understanding relationship.

There is great hope that this requirement to work together will narrow the gaps between health care professionals. MDs, DOs, ANPs, and PAs have a long history of working together. As a result, they are familiar with the training and skills of other medical professions. But when it comes to knowledge about chiropractic training and skills, the typical provider is woefully uninformed. You might say that the chiropractic profession has been the "missing link."

Now that a communication link is sometimes required, and with DCs serving as certified medical examiners, there is no doubt that a different side of chiropractic training and skills will be in view. This can only be a good thing for chiropractic.

There are other ways that the NRCME has affected chiropractic. Over the past eight years, numerous states have either tried to eliminate DCs from performing school bus driver physicals exam, or have had regulations that excluded chiropractic participation in this or other types of physical exams. Georgia, California, Texas, Nevada and Kentucky are a few of the states where DCs can now perform school bus driver and/or other types of driver exams.

In addition, because of our inclusion to perform commercial driver physicals, it's more difficult to find reasons why DCs can't or shouldn't be able to perform other types of physical exams, including school sport physicals. The effort to gain inclusion in performing Coast Guard merchant mariner physicals is supported by chiropractic inclusion in the NRCME and in the Department of Defense. Still, it is an uphill battle and there are other federal programs to gain inclusion into, such as the civil surgeon program for performing immigration physicals, and public entities that involve physicals such as auto racing and crane operators.

Regardless of the application, chiropractic inclusion in federal programs makes a convincing presentation for legislatures that can't be argued, the only option for retort being baseless and void of data.

As of May 21, 2014, only certified medical examiners in the NRCME will be able to perform the physical exam for commercial drivers. In some states, that also includes the ability to perform school bus driver exams. If you have attended the required training, but have not taken the certification test, I strongly encourage you to study and go pass that test. If you wait, there may not be enough capacity at testing organizations to accommodate the demand. The other reason to get certified as soon as possible is that companies are already starting to look for those who are certified before the deadline.

We need DCs to step forward now. Do it for yourself. Do it for your driver patients. Do it for safer highways. Do it to be part of a federal program. Do it for your profession.

Dr. Michael Megehee was appointed by the FMCSA in 2005 as a member of the National Registry Brainstorming Sessions. He served on the NRCME Survey Team that established the basis for NRCME certification, and was a member of the NRCME Education Team that developed the core curriculum for the accredited physician training. Dr. Megehee is president of TeamCME, a nationwide network of DOT medical examiners.

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