Medical Privacy Concern

[Standingbear56]

OK - well, for lack of any actual evidence to the contrary, I'm forced to discount your claim accordingly.

There is no lack of evidence - it's a documented court case and is well known to all who participated, including myself, so your statement of lack of any actual evidence is totally incorrect. It's strictly a case of you not having the authority and/or credentials to get it. It's amazing that on one hand you have an issue with medical confidentially and then turn around around and want me to violate a court order AND HIPPA to give you information. I suggest you contact your local bar association to find out what information you can get on similar cases.
The point is that the medical statements are required to take a class. They do contain valuable information for the instructor and can protect him/her as well as many others if there is an incident. As to why the records must be held after the student is certified, even if they never again deal with that instructor and/or dive center - it's because if there is an incident years after, the lawyers can still come after the original instructor/dive center and anyone involved in any way with the plaintiff's training. I've been told that the records must be kept for a minimum of 7 years, but this can change from state to state. If the student is a minor, then the records must be kept for 7 years from the time they reach legal age. In the case of a 10 year old student, this means a total of at least 17 years!
I agree with you totally that alot has to do with legal and insurance issues - no argument there. However there are many times where an MD has just skimmed the form and signed off the student as cleared when in fact there is a dangerous existing condition. This is why the instructor must have knowledge of the various conditions and possible consequences and if they do not, they should call either DAN or another source which can give the correct information. The student who was 1 month pregnant was cleared by her physician. If I just took the MD's clearance as the ultimate authority and let her continue the class, and then the baby was born totally disabled - I could be in deep trouble. The medical statement informed me she was pregnant. It was the only way I found out even though I went over the medical statement in class. She didn't tell me, but fortunately put it on the form. Thus is serves several purposes - informs the instructor of potential medical problems which may need to be looked into closer as well for the legal/insurance issues we all love.
If you have such a problem with the medical form, then why don't you start a campaign to have it eliminated or at least changed to where you feel comfortable with it. That could produce a much more positive result for you than just arguing about it here where nothing will change. You'll continue to hate em, I'll continue to use them for the safety of my students and the lawyers/insurance companies will continue to use them to screw all of us.
Take care,
George

 

[DBailey]

I agree with you totally that alot has to do with legal and insurance issues - no argument there. However there are many times where an MD has just skimmed the form and signed off the student as cleared when in fact there is a dangerous existing condition. This is why the instructor must have knowledge of the various conditions and possible consequences and if they do not, they should call either DAN or another source which can give the correct information. The student who was 1 month pregnant was cleared by her physician. If I just took the MD's clearance as the ultimate authority and let her continue the class, and then the baby was born totally disabled - I could be in deep trouble. The medical statement informed me she was pregnant. It was the only way I found out even though I went over the medical statement in class. She didn't tell me, but fortunately put it on the form. Thus is serves several purposes - informs the instructor of potential medical problems which may need to be looked into closer as well for the legal/insurance issues we all love.

I am interested in how this was actually handled. Did you bar her from class or did you strongly recommend a second opinion on the medical clearance?

 

[Standingbear56]

After she handed in her form I had a private meeting with her and fully explained to her how and why diving while pregnant could hurt not only her, but the baby also. I then called her MD and had a 3 way conversation with him and her. He apologized and honestly stated that he made a mistake and agreed that she shouldn't dive at that time. Once this was cleared up, I gave her the option of coming back to class as soon as she is medically cleared by both her own MD and a consultation with DAN. I also told her that I would honor the current price in case of any price changes. If she did not want to do that, I would have, of course, given her a refund. She agreed and about a year later, she came back, got proper medical clearence and took her course which she passed with flying colors.
It probably helped that being in EMS, I knew the physician and the whole thing was handled discretely and professionally. Even if the MD didn't want to change his mind, I would have then had a DAN MD explain to her why she shouldn't dive at that time and I would not have allowed her in that particular class. Of course she would have been allowed in any future class once her pregnancy was over and she had proper medical clearance.
Take care,
George

 

[adurso]

There is no lack of evidence - it's a documented court case *SNIP*

A court case has a docket number and is a matter of public record. Should there have been an out of court settlement with a non-disclosure agreement in a civil matter the docket number would still exist with the minutae of the court still available with the disposition not available.

 

[OldNSalty]

Yea, I think there might be a case but arguing with from a 'I have proof but I can't show you.' is a little weak-kinda like claiming to protect Americans by spying on them.

Anyway, can we go diving now?

 

[NudeDiver]

There is no lack of evidence - it's a documented court case and is well known to all who participated, including myself, so your statement of lack of any actual evidence is totally incorrect.

Great. When I see the evidence, I'll believe it exists.

it's because if there is an incident years after, the lawyers can still come after the original instructor/dive center and anyone involved in any way with the plaintiff's training.

Exactly. As many of us have been saying ALL ALONG - it has nothing to do with class safety and everything to do with lawyers, liability and lawsuits.

However there are many times where an MD has just skimmed the form and signed off the student as cleared when in fact there is a dangerous existing condition.

And shame on him. Esp. since the doctor is provided with an "RSTC Medical Statement and Guidelines for Recreational Scuba Diver's Physical Examination" to consider as part of the review process.

If you have such a problem with the medical form, then why don't you start a campaign to have it eliminated or at least changed to where you feel comfortable with it.

Why? I treat the form according to the value in it that I see - like any other form I encounter in life. I Recommend others do the same.

Now...as it so happens, I went and got the RSTC form from a local dive shop. It is exactly as I suspected. Here is what it actually says:

The purpose of this Medical Questionnaire is to find out if you should be examined by your doctor before participating in recreational diver training. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there is a preexisting condition that may affect your safety while diving and you must seek the advice of your physician prior to engage in dive activities.

So - the stated purpose of the form is to inform you to go see a doctor if necessary, and why that might be necessary. There is absolutely NOTHING on this form to indicate its purpose is allow a "faster/better response" to you, should something happen in the class. NOTHING! Furthermore, directly above the student signature, it states:

This information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition.

So, "lying" on the form and going to see a doctor to get the scoop if you need to fulfills the stated purpose of the form - and, as indicated on the form, the student accepts responsibility for doing so.

Further, I see NOTHING on this form indicating anything about student privacy, document retention, how the shop may use this information, who it may share it with, or anything else.

Privacy issues - indeed.

 

[bjexpat]

After filling out one of these for my daughter, I struggled with whether I should be honest or not because there was one item that could technically be considered a pre-condition. The form helped me think through whether we a) lie and trust our judgement b) lie and get a verbal opinion from her doctor or c) be honest and jump through the subsequent hurdles and expose private info.

First of all, if I were a pediatrician and some parent asked me to sign the PADI form claiming that someone's 10 yr. old daughter was safe to dive, I'd say "no friggin' way" even in the absence of any of the listed conditions. A Dr. would have to be either an experienced diver themselves or a total idiot to sign that document.

Secondly, from reading the fine print, it's clear that PADI has created a bulletproof waiver because it would be nearly impossible for most people to answer honestly or subsequently be allowed to dive by their Dr.

I agree with others on this thread that a person should use the checklist to reflect on existing conditions and make a wise choice whether to talk to their doctor about a condition (if one exists).

In our case, we chose option B and were able to bounce questions off a family member who is an MD without asking them to put themselves at risk with a written consent form. We just want to know if it's safe or not...we aren't interested in cashing in on a family member's demise.

The only problem I can see is when some dumbass lies on the form and doesn't talk to his/her doctor and then flatlines on the boat. It creates a traumatic experience for everyone around them.

 

[OldNSalty]

The only problem I can see is when some dumbass lies on the form and doesn't talk to his/her doctor and then flatlines on the boat. It creates a traumatic experience for everyone around them.

...and there is nothing you can do about dumbasses except maybe encourage them before they reproduce.

 

[matt_w]

I am not going to commit to memory any medical conditions of my students for three reasons:

1. It won't alter my resuce plans.
2. I don't want to confuse different condition with different students. All students look the same underwater.
3. It is not possible for me to learn the proper resuce techinques for condition XYZ.

I agree with you here, all rescues by any professional in the Dive community should be performed consistently based on their training. (BLS/EFR, etc). Going beyond your training and changing your rescue efforts based on medical information without any formal training will most likely provide no benefit to the "distressed" diver and will most likely significantly increase your personal liability.

The one case stated here where the instructor questioned a doctors release of a pregnant student is about the only time that information is useful to a dive instructor. I think refusing to train a diver who has a medical release might make you vulnerable to a future case when you do train someone with a doctor's clearance, but at some point you have to draw the line and do what you feel is right.

If you are not a Doctor/Nurse or even an EMT, the middle of a dive emergency is not the time to start pretending like you are.

 

[rstofer]

After filling out one of these for my daughter,

.

OT & Hijack...


Has your daughter finished the class? If so, how does she like diving? My 10 year old grandson got certified last fall. We're going to spend the majority of spring break (next week) driving at Monterey.

Richard