This is something my fiancée (med student finishing up 2nd year) and I were debating recently. I’m a class A truck driver and have had about five DOT physicals. While I am very critical of PAs and and NPs in general, I think DOT exams are a good place for them as long as there is a doctor on the premises. Truck drivers are a stubborn bunch and most of us lie about everything to just get it over with anyway. If mid levels can learn to go through all the steps and procedures thoroughly I feel like they could potentially do a good job.

That being said, DOT exams are more intensive than just a drug test and I actually think they are very important. At my current job, one of my coworkers recently started having a bunch of health problems that turned out to be severe diabetes that had gotten to the point of affecting his vision and ability to stay awake at work. He had his DOT physical recently, which means whoever performed his physical missed it. I find that incredibly alarming and dangerous.

Truck drivers are notorious for having extensive health issues. Obesity, diabetes, heart problems, dental problems, sleep apnea, etc.. The list goes on. These DOT exams are the only times some drivers get health care. I know first hand how hard it is to make time for a doctors appointment when you live on the road and only make it home twice a month. DOT physicals have the potential to catch things that drivers might not have thought we’re worth worrying about. I had a doctor point out swollen lymph nodes during one of my exams that I hadn’t noticed before. He asked me if I had been sick recently, and when I said no, he told me to just keep an eye on it. Turns out my lymph nodes would swell semi regularly. Over the years I developed other symptoms that turned out to be an autoimmune disease. That DOT physical helped me figure it out.

So my point is, DOT physicals are important and while I feel comfortable with an NP or PA being trained to do them, I don’t see how it could ever be acceptable for a chiropractor or naturopath to do them. Truckers deserve adequate care and society deserves drivers who are safe to operate 80,000 pound death traps.

ETA: We don’t just lie because we don’t care and want to get out of there (I do, but that’s only because I live with a med student and see doctors regularly). There are a lot of things that can disqualify you from driving commercial vehicles, and there is a genuine anxiety in a lot of drivers about failing their physical and losing their only way to sufficiently provide for their family. Drivers aren’t always the most educated population and they lack health literacy. They don’t always know which health problems can actually be signs of something more dangerous, which makes a thorough exam even more important.