Keeping “PACE” with the NRCME FMCSA National Registry of Certified Medical Examiners Michael J. Megehee, DC FMSCA Working Integrated Product Team Member

Who are Medical Examiners? Per FEDERAL DEFINITION – “Medical Examiners” means Medical Doctors, Osteopaths, Nurse Practitioners, Physician Assistants and Chiropractors (nearly all 51 US jurisdictions)

We already do this Doctors of Chiropractic are already legally performing DOT physicals in most US jurisdictions – along with 4 other professions But safety issues mean the requirements are changing

National Registry of Certified Medical Examiners Medical Examiners will be required to – complete “certified training” and – pass examination to perform Commercial Motor Vehicle Driver Medical Examinations (estimated late 2007)

“Nearly All States” Means: Chiropractors’ State Scope of Practice must allow performance of physical examinations. State laws (DMV) can also affect the participation of the chiropractic profession. State laws may not deter interstate commerce, therefore it appears that an exam performed lawfully by a chiropractor practicing in one state must be accepted in every other state regardless of that state's chiropractic Scope of Practice.

Certified Training and Examination The FMCSA has a number of options to choose from to implement the NRCME. The range of possibilities is WIDE: Allow Anyone to Provide Training (ex: Drug Collector training) Provide Training at a DOT Facility (ex: FAA Aviation Medical Examiner) Or, anything in between!

“Anything In Between” Considerations Certified Training may be “cross-profession” Example: MDs might attend training conducted by DCs Adequate numbers of CMEs needed (50,000) Need to promote participation DCs can apply training to CE requirements. Training: CMEs to have an appropriate level of skill, education and training specific to regulations and performance of driver's exam.

ONE OPTION: PACE for certified training PACE offers a sound chiropractic based standard for third party providers, education, credentials, content, and continuing education credits. PACE provides nationally recognized assurance to DC that program is acceptable “continuing education” credits, also assurance that program is “Certified Medical Examiner” training.

PACE represents a level of credibility more easily recognizable and acceptable by other professions -- since they have PACE-type programs also – with centralized approval under uniform standards ONE OPTION: PACE for certified training

State Licensing Boards must… Insure recognizable standards of accreditation and examination (i.e., NBCE and CCE) to demonstrate adequate skill, clinical expertise, education of the chiropractic profession. Regulate State Scope of Chiropractic Practice (including permitting / not permitting physical examinations) Establish Continuing Education requirements Accept/Reject CEs from other professions

NRCME The NRCME represents the greatest opportunity for the chiropractic profession in our time. In regard to government and professional acceptance, financial and personal achievement, it is unsurpassed.

So where do you fit in? ● Go to and register to be part of the survey that builds the basis for the certification exam – whether you already do DOT exams or notwww.acacoh.com ● Go to to learn about the certification programwww.nrcme.fmcsa.dot.gov ● Be sure your board understands how this program fits into your scope of practice ● Help spread the word!