Sexually Oriented Businesses? Oh Yeah! Truck Driver’s Clinics? Heck No!

By Sandy Long

“Dec 09, 2011 (BUSINESS WIRE) — TravelCenters of America LLC (TravelCenters) has announced the opening of the first on-site Statcare medical clinic within the TA and Petro Stopping Centers branded travel center network.  The Statcare clinic, operated by Family Statcare of Northeast Ohio, LLC, is located at the TA travel center at 8834 Lake Rd., Seville, Ohio.”

That sounds great does it not.  It was great; a trucker’s clinic right in the middle of a major hub for trucking, but it did not last long though.  Shortly after the above press release, the Westfield Township zoning inspector visited the clinic and shut it down for not meeting the zoning code.  Come to find out, the area is zoned for eating places, motels, truck stops and repair shops, and even sexually oriented businesses, but not medical clinics!

Ken Filbert, the owner of Family Statcare, said that he met with a chiropractor who was located at the TA just before his clinic opened. When he asked the zonong inspector why the chiropractor was allowed to operate, but not the clinic, the zoning inspector informed him, “that he didn’t know the chiropractor was there, but we caught you.”

Filbert is well-intentioned concerning truckers, he says, “truckers do so much for this country, I wanted to start this clinic providing low cost, affordable, reachable medical services for the truckers in return, I wanted to give them something back. This clinic is close to home for my company, so we are in hopes of fine tuning it here, then expanding across the country to help truckers.”

Filbert reported that Westfield Township has not offered any quick solutions to the zoning issue.  “They did not offer a temporary zoning permit while we work in the paperwork, or to have a special session of the township to expedite the permit process, it will take three months or more to get the zoning changed once we get the paperwork done.”

Some of the services the clinic will offer are drug testing, DOT physicals, illness care, and minor wound care.  Filbert even arranged with a local pharmacy to deliver medications directly to the truck stop within an hour of calling the prescription in for truckers who needed them. “I understand both the difficulty of getting a 70 foot rig to a drug store and the problem of drivers getting home for doctor appointments with their own doctors so that many run out of medications.”  He said.

Tongue in cheek, Filbert quipped, “Here I am trying to help truckers and perhaps other travelers by providing fast access to healthcare, and rather than cooperation on the part of the city, I get closed down immediately. Yet, if I had opened adult video store or a strip club, Westfield Township would not mind a bit. Go figure!”

Filbert has a petition at the TA truck stop in Seville OH if you stop by there, or you can sign an online petition at http://www.ipetitions.com/petition/re-open-the-truck-drivers-clinic/ .  By gathering signatures, Filbert hopes that Westfield Township will see how much people do care about trucker’s health and expedites the process or at least does something positive.  “This is the cold and flu season and trucker’s need medical care now!”  Filbert says, “We have to get this clinic open so we can provide those truckers that care.”

 

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Going Around to the Back Door

By Sandy Long

In 2006, the FMCSA Medical Review Board was chartered to look at different medical conditions relating to highway and truck driver safety and then make recommendations to the FMCSA.  The FMCSA can then choose, or not choose, to pursue those recommendations and then propose regulations concerning them. When Dr. Barbara Phillips M.D. (at the time also Chair of the National Sleep Foundation) took the chair of the board, sleep apnea and body mass index (BMI) came to the forefront of the board’s attention.

With the meetings heavily populated by medical device manufacturers and sleep clinic corporations, and after having sleep apnea seminars around the country, the board recommended that truck drivers needed to be sleep tested according to BMI and neck size.  Their supposed premise was that many truck drivers were obese therefore at risk of high incidence of sleep apnea and fatigued driving.  While it is true that many obese people may have sleep apnea, fatigued driving is not a major factor in crash causation; statistics show fatigue to be about 1.4% of the causes of crashes involving truck drivers.

While the FMCSA chose not to pursue this recommendation into regulatory process other than guidelines to doctors performing DOT physicals, the damage was done.  Fearful of losing drivers in mass if regulations came thru, companies started pushing sleep studies for their obese drivers, some going to the extent of posting on their websites, that if a driver was such or such BMI do not bother to apply.  Occupational clinics brought out their tape measures and started measuring necks then sending drivers for sleep studies arbitrarily to receive their DOT physicals.  Some companies are refusing to hire people who use a c-pap machine, the only device allowed truck drivers to treat sleep apnea outside of surgery.

The newest head of the Medical Review Board is Benjamin H. Hoffman, M.D. M.P.H. (Texas) who is the Global Chief Medical Officer at GE Energy.  GE Energy develops and markets c-pap machine parts.  Once again, sleep apnea and BMI are in the news.  The Medical Review Board is now recommending that truck drivers with a BMI of 35 or more be mandatorily tested for sleep apnea or they will not be allowed to drive.

Ignoring other statistics that shows that roughly, 16% of normal sized people have sleep apnea and other treatments for sleep apnea such as dental devices and medication, the board recommends that truck drivers use only c-pap machines that can be monitored thru recordings of the machine, and that cost $5000.  Add the cost of the sleep study, $2,000, and the amount of truck drivers who do not have adequate or any insurance, it is a given that many truck drivers will have to leave the industry.

Some industry experts are hoping that the FMCSA once again, chooses not to pursue regulations concerning sleep apnea and BMI, but as has been seen the damage is done; once again, truck drivers are being unfairly discriminated against, many because of the occupational hazard of weight gain.

What will obese truck drivers do if they cannot afford sleep studies and c-pap machines?  For older drivers, retirement is the only option or for them to go onto disability, most have been truck drivers all of their lives and have no other job skills.  Younger drivers may be able to lose enough weight, unless heredity or disease is the cause of it, to continue to drive after the weight loss or learn new job skills…how do they live until then?  Does anyone care?  Does not look like it to me.

On a personal note, a friend of mine and I got into a discussion about obesity, BMI and sleep apnea.  She asked me if I did not want truck drivers to get healthy.

In my opinion, many things would need to change in the trucking industry for truckers to become healthier.  Companies would have to stop having just in time freight so drivers had the time to exercise and eat properly during the workday.  Companies would also have to start treating their drivers as the valuable skilled people they are so stress levels from company interactions and policies would lower.  Truck stops would have to do away with junk food and fast food, and offer better service and choices in their restaurants.  Law enforcement would have to start targeting cars that act stupid around trucks.  The government would have to get out of our cabs and quit expecting so much from us thru unrealistic goals and regulations for us.

Finally, truck drivers would have to regain their pride not only in their jobs, but also in themselves; then their health would be between them and their personal doctors instead of having biased regulators try to make money off our backs thru medical regulations that are unreasonable, unfounded and unnecessary.

Will any of the above happen, perhaps, but until then we will have to put up with money hungry, discriminatory review boards that use whatever means to do what they want to do to further their agendas, even if they have to sneak those agendas thru the back door to achieve them.

 

 

 

 

 

 

 

Health, Safety or Money Grab

By Sandy Long

On February 6, 2012, a meeting was held between the FMCSA Medical Review Board and the Motor Carrier Safety Advisory Committee to discuss, once again, sleep apnea, BMI and truck drivers.  The upshot of that meeting, citing the possibility of fatigue related accidents, is that drivers with a BMI (body mass index) of 35 or more will have to have a mandatory sleep study done if the FMCSA takes the recommendations to regulation.  This though studies and statistics show that fatigue is related to approximately 1.4% of all truck related crashes. What is really going on?

Health

It is a fact that Americans are growing larger in both height and weight.  Three of the major factors in an increase of weight are availability of food, decrease of physical activity and a prevalence of car usage.  However, there are other factors; (from wikidpedia.com) “(1) insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking, because smoking suppresses appetite, (5) increased use of medications that can cause weight gain (e.g., atypical antipsychotics)…”  Then there is stress.

Stress causes an increase in a hormone called cortisol that can cause obesity.  People’s bodies, those who experience high levels of work related stress, release cortisol in response to the ‘flight or fight’ factors found in the brain.  Cortisol causes excess belly fat.  A study done on the difference between regular shift workers and irregular shift truck drivers shows a marked increase in cortisol production for irregular shift truck drivers.

Sleep apnea is the current disease du jour and much has been written on this condition.  While obese people are perhaps more susceptible to developing sleep apnea, it is not only fat people who do get it; many are susceptible.   “According to the American Sleep Apnea Association (quoted at yahoo voices), people who are at a “normal” weight (with a BMI of less than 25) are at a 16.4 percent risk of sleep apnea. People who are “overweight” (with a BMI of 25 to 30) are at a 38.1 percent risk of sleep apnea, while those who are “obese” (with a BMI of more than 30) are at a 45.5 percent risk of sleep apnea.  Other factors that can cause sleep apnea are high blood pressure, being over the age of 65, being male, a large neck circumference, alcohol, tranquilizer and sedative use, smoking, sitting for long periods of time, stroke, brain tumor or heart disorders.”

Safety

In a webinar presented by Ralph Craft, Ph.D., Senior Transportation Specialist, FMCSA Office of Analysis, Research, and Technology (ART) with Kirse Kelly, Web Conference Host, FMCSA ART, Kelly spoke about misconceptions involved in large truck crash statistics.  In the presentation, Kelly stated, “Being unable to perform the task of driving means you are asleep, you are in diabetic shock so you can’t drive, or you have had a heart attack, or passed out, or any other medical condition that hits you and now you are no longer able to perform the task of driving.”  Notice that being obese was not mentioned.

Finland did a study on truck crash causation as did the FMCSA using statistics from the Michigan State Patrol, neither showed a predominance of fatigue as factors causing the accidents cited.  Finland 2%, Michigan 2.4%.   Overall, accidents involving commercial vehicles has gone down and stayed relatively flat over the last 3 years.

Money

Sleep apnea is a big business ticket.  NPR reports, “Medicare payments for sleep testing increased from $62 million in 2001 to $235 million in 2009, according to the Office of the Inspector General.”  In the same report, “Dr. Fred Holt, an expert on fraud and abuse and a medical director of Blue Cross Blue Shield in North Carolina, says some patients aren’t having basic exams done first and are therefore being prescribed expensive tests they don’t need.  Not everyone who snores has a chronic disorder, he says. In other cases, Holt says, the labs prescribe CPAP machines right away without first suggesting other strategies that could reduce apnea, such as losing weight or sleeping on your side.”

Sleep apnea became an issue under the first head of the FMCSA’s Medical Review Board Barbara Phillips, M.D. who was also the Chair of the National Sleep Foundation (NSF).  NSF receives funding from sources including foundations, corporations and federal agencies.  Dr. Phillips has also been affiliated with Astra Zeneca, Boehringer-Ingelheim, GlaxoSmithKline, ResMed, and Sanofi-Aventis; has participated as a consultant for Ogden, Newell & Welch, PLLC; has received speaking honoraria from Boehringer-Ingelheim, GlaxoSmithKline, Cephalon, JewishHeart Lung Institutes, Orphan Medical, Pfizer, ResMed, St. Joseph’s Hospital, Swedish Medical Center, and Sepracor.

Today’s head of the Medical Review Board is Benjamin H. Hoffman, M.D. M.P.H. (Texas) who is the Global Chief Medical Officer at GE Energy.  GE Energy develops and markets sleep apnea aid parts.

A sleep study costs between $2,000-3,000.00.  A C-PAP machine, the only corrective device suggested by the Medical Review Board, can cost over $5,000.00.  Some insurance companies pay for the studies and machines, some do not.

Summary

It is true that obesity is on the rise overall in America.  It is true that there are many factors that cause a truck driver and others to be obese.  It is true that obesity can cause health issues such as sleep apnea.  It is true that many who are not obese may suffer from sleep apnea.  It is untrue that sleep apnea or fatigue causes a substantial amount of unsafe driving among truck drivers.  It is very true that there is a huge amount of money to be made from the promotion of regulations requiring truck drivers to have to take mandatory sleep studies using BMI as an indicator.  Therefore, it is true that it is about money.

American’s Part in American Job Loss

By Sandy Long

When I was a kid, I remember getting my first transistor radio; made in Japan, then people were starting to get concerned about Japan’s role in electronics development followed by their entry into motorcycle and automobile manufacturing.  In response, buy American programs were instituted by companies such as the American automakers to encourage people to keep buying American made cars.  Sam Walton prided himself on providing American made goods in his pilot discount stores.  Americans kept working, American manufacturing thrived and wages went up, as did the price of goods.

During the 50 years since then, Americans forgot the reason it was essential to buy American made goods, that of keeping America working and self-sufficient, instead demanding cheaper and cheaper goods to buy.  A new term appeared in relation to everything from razors to diapers, ‘disposable’.

As people spent more for housing and services, the demand for cheaper goods grew.  There were other factors in play too. The government pushed for a more ‘global economy’.  Unions struck for more money for their members for them to be able to afford the increasingly costly housing, goods and services.  The EPA pushed tougher regulations onto American manufacturing.  The increase in cheap labor from illegal aliens put Americans out of work.  Manufacturing concerns became more global corporation operated rather than single proprietor ownership.  Corporations took a hard look at their bottom line and with the blessing of the government who took the country to free trade instead of fair trade, decided to take their manufacturing overseas for the cheaper labor to increase their bottom lines and satisfy their shareholders.

This led to a domino effect throughout the country.  Because the manufacturing of cloth moved overseas, the American cotton and wool growers went out of business for the most part; garment making soon followed.  Metal fabrication plants that made small parts such as nails and screws could no longer compete with foreign competitors and went out of business.  Discount stores who bought almost all of their goods from overseas manufacturers destroyed the small dime store model of businesses and small grocery stores that could not compete.  The upshot was a loss of jobs for Americans.

Look at the produce and canned goods in your local grocery store.  What is the difference between a Fuji apple and an American grown apple, very little, yet apples from all over the world take the place of American grown apples.  The same goes for everything from asparagras to zucchini, grown and shipped in from overseas.  Read the label on that can of fruit and you will see that the fruit was grown somewhere overseas.  Even the meat in American stores is imported, we send our beef overseas and import the beef sold in American stores from overseas.  American fields lay fallow while lower quality agricultural goods abound on grocery store shelves, American agricultural jobs once again gone overseas.

How can this disaster for the American workers be overturned, by buying American made goods whenever possible.  Buy your foodstuffs from American growers at farmer’s markets or those who sell directly from their farms.  Read the labels on things you might want to buy, if you do not see ‘made in America’ on the label pass it by.  Support your locally owned businesses that try to at least sell as many American made goods as possible, this not only encourages American manufacturers to keep manufacturing here, but it also provides jobs.

Finally, write your representatives and strongly suggest that the reins be pulled back on the EPA and a lessening of EPA regulations towards American manufacturers.  Write companies that have sent their manufacturing overseas taking American jobs from Americans and tell them that you will not buy their products anymore until they bring back the jobs to America and increase the quality of their products.

The American people are part of the problem and have to be a major part of the solution to the losses of American jobs and putting American’s back to work.  By working together, Americans can once again be the proud, self-sufficient country that it once was.