OWD license without a doctor's certificate?

[tridacna]

I think that PADI should clarify this and remove all doubt. OLPC 2 could obviate all of this.

 

[tursiops]

Sigh.... speaking of narrow readings, sounds like you have your own that you believe supports your personal preference.
I have now provided the specific explanatory and unambiguous PADI language on the subject. ALL of it, not SOME of it.
And that is the reference that PADI directed me to, I did not come across the content in Guide to Teaching on my own. (Only so much time to spend on these things.)

So feel free to have your own alternate, unsupported reading of the standards and guidelines, but perhaps it is better to check with the authors themselves to be sure. That is what I did this week.

Separately, I have no idea what potential consequences, if any, there might be in doing your paperwork differently than instructed/expected. Probably no big deal, for the vast majority of the time. But those extreme exceptions do eventually come up sometime, somewhere, to bite someone in the butt if not followed.

Whatever. I've checked with PADI too. Perhaps I asked the right question of the right person.

 

[doctormike]

How about a lawyer saying you failed to inform the personnel of a pre-existing medical condition, violating the instructions printed on the form? Can you imagine that?

But that's exactly the point. No scuba professional, from a divemaster up to an agency training director, is qualified to assess your medical history or current conditions. This has come up time and time again - you can't expect them to say that this guy's asthma is well controlled enough to dive, or that guy's diabetes is too brittle to allow him to dive. They can't, and if they are, they shouldn't.

All I'm saying is that from the point of view of the dive professional's liability (and the agency's liability), they HAVE to rely on a medical opinion, and if they have a doctor's note saying there is no contraindication to diving, nothing that they can do should contradict that.

If I check off that I have condition "X", but my doctor says I can dive, then why do I need to divulge something personal like that to a non-medical professional if the AGENCY says that I can still dive, despite the "yes" on the form? If it doesn't change anything, why do I need to fill out this form if it's not required? Believe it or not, many people are touchy about those sort of data leaks. Do you know what PADI does with those forms? Are they on secure servers after scanning? Do they share them with anyone?

Please note that this has NOTHING to do with the advisability of diving with certain conditions, or the advisability of letting people you are diving with know about SPECIFIC relevant issues. That's not the same thing as being required to dump your entire medical history into data limbo when the agency itself says that the check marks don't matter if you have a note. Also note that this is very different from LYING on the form by checking "no" to avoid having to get a doctor's note.

Now, as has been mentioned upthread, no instructor has to train someone that they don't feel comfortable training. And not every doctor's note is worth the paper it's printed on. It is - as we have discussed ad nauseum - an imperfect system. But if you don't accept that a doctor's note is worth something, then how would you decide if ANYONE was fit to dive...?

 

[TMHeimer]

But that's exactly the point. No scuba professional, from a divemaster up to an agency training director, is qualified to assess your medical history or current conditions. This has come up time and time again - you can't expect them to say that this guy's asthma is well controlled enough to dive, or that guy's diabetes is too brittle to allow him to dive. They can't, and if they are, they shouldn't.

All I'm saying is that from the point of view of the dive professional's liability (and the agency's liability), they HAVE to rely on a medical opinion, and if they have a doctor's note saying there is no contraindication to diving, nothing that they can do should contradict that.

If I check off that I have condition "X", but my doctor says I can dive, then why do I need to divulge something personal like that to a non-medical professional if the AGENCY says that I can still dive, despite the "yes" on the form? If it doesn't change anything, why do I need to fill out this form if it's not required? Believe it or not, many people are touchy about those sort of data leaks. Do you know what PADI does with those forms? Are they on secure servers after scanning? Do they share them with anyone?

Please note that this has NOTHING to do with the advisability of diving with certain conditions, or the advisability of letting people you are diving with know about SPECIFIC relevant issues. That's not the same thing as being required to dump your entire medical history into data limbo when the agency itself says that the check marks don't matter if you have a note. Also note that this is very different from LYING on the form by checking "no" to avoid having to get a doctor's note.

Now, as has been mentioned upthread, no instructor has to train someone that they don't feel comfortable training. And not every doctor's note is worth the paper it's printed on. It is - as we have discussed ad nauseum - an imperfect system. But if you don't accept that a doctor's note is worth something, then how would you decide if ANYONE was fit to dive...?

Yeah that says it all. Must admit I don't give much thought to divulging medical info.--can't figure what anyone could do with that, unless they wanted to kill me. I don't worry too much when my computer says my virus protection has expired. What do I have in there that people would want to steal? One of these days I'll probably regret that attitude.

 

[tursiops]

Do you know what PADI does with those forms? Are they on secure servers after scanning? Do they share them with anyone?

PADI never sees those medical questionnaires with all that personal info. The form is retained by the instructor for 7 years. It seems unlikely all those forms are well protected.

 

[doctormike]

PADI never sees those medical questionnaires with all that personal info. The form is retained by the instructor for 7 years. It seems unlikely all those forms are well protected.

I believe you, but as a practical matter, a data leak is a data leak. Everyone signing up for dive training doesn't know for sure what happens to that information.

This isn't a trivial issue. There is a whole body of law devoted to PHI (personal health information, or protected health information). The most well known law is HIPAA (the Health Insurance Portability and Accountability Act), although of course this would be US jurisdiction only.

I'm actually not sure if a dive operator, instructor or agency would fall under HIPAA as a covered entity. You could certainly make the case that by asking for and archiving your PHI, the RSTC is acting as a "health care clearinghouse" because they are "a public or private entity ... that either process or facilitate the processing of health information received from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction, or receive a standard transaction from another entity and process or facilitate the processing of health information into a nonstandard format or nonstandard data content for the receiving entity"

 

[tridacna]

I suggest that form should be restructured by PADI:

“Check this box if you have a YES answer to any of the previous conditions”. If so, go get a doctor’s note.

No HIPAA violation. No public sharing. If an instructor wants to get nosy, they can try.

 

[Jcp2]

I think that as long as the diver is the one filling out the form then the dive operator is not a clearinghouse as the diver himself is not an “entity” (health care provider, health plan, health care clearinghouse). Similarly RSTC cannot be a clearinghouse if it receives information from a diver operator as the dive operator is not an “entity” as defined above.
I think the intent of the law was to extend the idea of the professional medical duty of confidentiality to other operational components of health care that a physician is required to interact with in order for health care to be delivered and paid for in the United States. It’s similar to the professional duty of confidentiality in law, psychotherapy, and pastoral care. All of these have some legal protections. There’s no such special professional duty required of a dive instructor.

 

[tursiops]

I suggest that form should be restructured by PADI:

“Check this box if you have a YES answer to any of the previous conditions”. If so, go get a doctor’s note.

No HIPAA violation. No public sharing. If an instructor wants to get nosy, they can try.

100% agreement.

 

[doctormike]

I think that as long as the diver is the one filling out the form then the dive operator is not a clearinghouse as the diver himself is not an “entity” (health care provider, health plan, health care clearinghouse). Similarly RSTC cannot be a clearinghouse if it receives information from a diver operator as the dive operator is not an “entity” as defined above.
I think the intent of the law was to extend the idea of the professional medical duty of confidentiality to other operational components of health care that a physician is required to interact with in order for health care to be delivered and paid for in the United States. It’s similar to the professional duty of confidentiality in law, psychotherapy, and pastoral care. All of these have some legal protections. There’s no such special professional duty required of a dive instructor.

No. The diver is the patient. The diver is the one with the PHI. In any HIPAA consideration, the patient themselves is obviously not a "covered entity", that term only has meaning in terms of who the PHI is shared with.

I'm not an attorney, but I'm not sure how a dive operator, instructor or anyone else who has access to a completed RSTC form wouldn't possibly fall into the clearinghouse definition above. If you put your PHI on a RSTC form and give it to your instructor, wouldn't your instructor be "an entity that facilitates the processing of health information received from another entity"..?