Investigation: Chiropractors and DOT Medical Cards

MINNEAPOLIS - A FOX 9 Investigation is already getting the attention of the federal government which may use it for training -- training of medical professionals allowed examining truck and bus drivers to see if they are healthy enough to be behind the wheel.

When a professional driver has a medical crisis as the driver of a casino tour bus near Austin did last fall it is not just his life at stake. There are passengers.

Just like there could be if a school bus driver collapsed. And imagine the driver of a tanker full of propane blacking out. It’s no imaginary thing for truck driver Brian Nelson.

“I'm thinking to myself I'm dead.” He told us. “I don't want to be the one killing a car load of kids or something.”

But it came pretty close to happening last November when Nelson found himself in the ditch. He may have blacked out.

We don't know if the Austin crash was predictable, but Nelson’s may have been. He had his first heart attack at 47. Since then his doctor gave him a medical card that had to be renewed every 6 months. They're usually good for two years.

“Which I was fine with keeping an eye on it you, you know?” Nelson said.
But when his doctor wasn't available he went to a physician's assistant instead who went ahead and gave him a two year medical card even though he knew his history.

“Oh, I was surprised.” Nelson said.

Three months later, Nelson crashed.

Medical exams for commercial drivers are so important that when a driver goes through a routine inspection if he doesn’t have his medical card on him, proving he’s passed certain medical tests, he can’t drive one more foot. He’s out of service for the rest of the day.

But the FOX 9 Investigators found the medical card is only as good as the person who does the medical exam and that can include doctors, nurse practitioners and chiropractors. Some federal and state safety folks told us they are worried about drivers shopping for easy approval.

“A driver will make a statement well, I'll just go find another examiner to go to and get a DOT physical card so I can continue to drive,” said Captain Ken Urquhart who is with the State Patrol.

Our undercover investigation tested six chiropractors. We focused on chiropractors because some advertise the DOT service, they're easy to get into and some safety officials are especially worried about them.

The federal regulators say a complete DOT physical should include: a vision test that examines both eyes open and each eye individually, a hearing test where the examiner stands away from the patient and whispers, a urine test, a reflex check, range of motion tests, a look at a driver’s pupils, a check of the lungs and heart and a blood pressure check where the medical examiner takes at least two readings,

Dr. Dunne of Park Nicollet explained, the importance of blood pressure, “Because of the associated risks of elevated blood pressure with sudden death.” He went on to say, “The intention of the DOT exam is to disqualify only those individual that are at risk for sudden incapacitation.”

So how do the chiropractors we tested do?
We start with a clinic in Minneapolis where the examiner asks our producer, “Are you really nervous about this test?” She replies, “Yes.” He says, “Don't be. Especially here. I'm the most laid back you'll find.”

Laid back? He isn't kidding. Our undercover producer gets only one letter correct on the line he asks her to read for the vision test. He then misstates her results and passes her.

She asks, “How many did I get right?” He says three or four.” She asks, “Close enough?” She replies, “Yes.”

As our producer's exam comes to a close, the chiropractor realizes he hasn't done the critical urine test to screen for diabetes.

He tells her, “We normally do a urinalysis but we're not going to do one today because I just forgot.”

The doctor gave our producer a medical card anyway. A green light to drive a bus and a truck even though he does not do a urine test and despite our producer’s failing the eye test.
Reporter Trish Van Pilsum asks Dr. Larry Spicer, the Executive Director of the board that licenses and regulates chiropractors in Minnesota, what he thinks.

“She walked out with a signed DOT card.” She tells him. He says, “Then I would be troubled based on the limited information I've seen. I would be troubled by that.”

Next is a clinic in the south metro. Our producer tells the examiner, “I’m a little worried about my eyes.”

A driver is supposed to see 20/40 to pass. Our producer misses two letters on the 20/40 line and passes her.

“You say you're not going to be doing a lot of driving?” He asks.

And there's something else. He asks her if she wants her blood pressure checked.
She says yes knowing it is part of the standards. The producer's blood pressure is high at 148 over 113. It says right on the form that drivers are supposed to have a blood pressure of less than 140 over 90.

The examiner passes her anyway and says, “It's pretty high but I think you might be a little nervous now for whatever