1. NRCME Truck Racing “Formally The Brass Ring” Michael Megehee, DC Steve Conway, DC JD

2. The Brass Ring:

3. The National Registry of Certified Medical Examiners 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.

4. National Registry of Certified Medical Examiners THIS IS NOT A FMCSA APPROVED OR ENDORSED PRESENTATION. Ideas expressed in this presentation are forward looking, based on current thinking, and may not represent the Final Rule of the NRCME.

5. The National Registry Mission To improve highway safety by producing trained, certified medical examiners who can effectively determine if a commercial motor vehicle operator’s health meets Federal Motor Carrier Safety Administration standards.

6. Who are Medical Examiners? FEDERAL DEFINITION – “Medical Examiner” includes but not limited to: Mds, DOs, ANPs, PAs and DCs (DCs in 49 of 51 US jurisdictions)

7. Certified Medical Examiner: Th e FMCSA makes no distinction between “non-medical” and “medical” providers. To be a CME your state must have a licensing board, and your scope of practice must include performing physicals. UAs are required (can be referred out).

8. We are in a Race! DC “Drivers” Wanted! FMCSA Projects To Train And Certify 40,000 Medical Examiners in Two Years

9. Winner’s Circle Regardless of the economy: All Drivers must have a medical exam at least every 2 years. Due to health conditions, 42% must have a exam at least yearly. Also required: 50% tested f/drug, 10% f/alcohol yearly. FMCSA estimates 4.2 Million driver physicals will be performed yearly (+ CDL/MC 2012) Estimated Market: $500,000,000 yr Drug and Alcohol: $300,000,000 yr. Non DOT Drug/Alc: ?????? 7X more estimated

10. We have the fastest Car! DCs Offices often Underutilized, more flexible scheduling Lower Overhead allows Competitive Pricing Staff Underutilized- ½ of exam, 99% Drug/Alcohol Testing Equal Status- Level playing field for all CMEs Ethical Practice Building –get paid for potential patients to come to your office Helps Chiropractic into other Programs. AME, MRO, CS

11. “Drivers”…..actually CMEs ● DCs are enthusiastic, but inexperienced at performing the CMV medical Exams ● Most DCs starting from a dead stop ● “Other” Drivers are experienced, but they may be too busy driving on other racetracks.

12. Race Preparation ● You don’t win races by starting preparations on race day. Advanced preparation is needed for continuing education hour acceptance. ● The other professions have CE acceptance already in place. They have the advantage at this time. ● Those that start driving early, have a detering effect on the “other” drivers before race day.

13. “Driver” Training Certified Medical Examiners will: – Complete “required” training – Pass a “certification” examination To perform Driver’s Examinations in the future, all Medical Examiners will need to be become Certified.

14. “Required” Training FMCSA approximates: 8+ Hours Allowance for additional training specific to a profession – DC training longer. – Training is intensive

15. Training Providers Providers must be “accredited” by a nationally- recognized profession accrediting body to provide CEUs. Such as: Accrediation Council for continuing Medical Ed. American Nurses Credentialing Center American Academy of Physician Assistants American Osteopathic association Council on CME Chiropractic Providers of Approved Continuing Ed

16. Accrediting Organizations Purpose: Maximize Consistency Provide Quality Assurance Specific to gaining acceptance of approved training for CEs and MEs. (Objective: Remove obstacles to physicians becoming certified)

17. Removing Barriers to Racing Cross-Professional CE/ME Acceptance Examples: MDs attending DC training DCs attending MD training Does your state accept ME credits? Limited?

18. Removing More Barriers Reduce Cost to the Physician Pre-Constructed Powerpoint Courses Available to training providers Allowed: On-Line courses On-Line Conferences Live Presentation Does your state allow on-line courses/web conferences? Limited hours?

19. The “Pace”Car is on the Track PACE is a nationally-recognized medical profession accrediting body to provide CEUs. Are there others? “Cross-acceptance” may be more likely between professions. Board Review of individual Programs Unnecessary On-line vs Live issue simplified?

20. State Board Choices ● PACE Accepted ● MEs Acceptable (or increased) ● CE acceptance streamlined (due to expected #) ● On-line Accepted (or increased) ● Do none of the above (race car hitting the wall) ● Completed by: NRCME Final Rule (Spring ‘10)

21. Keeping the Car on the Track ● State Boards are the Pits (figuratively speaking) ● Recurrent training is required at least every 3 years ● Recurrent testing is required every 6 years.

22. Winning Races ● We have the fastest car on the track, but any Driver will tell you: ● Races are won, or lost in the Pits.

23. The NRCME really is The Brass Ring…

24. Questions Steve Conway, DC JD Chirolaw@aol.com 715 803 4646 Michael Megehee, DC www.TeamCME.com drmegehee@yahoo.com 541-276-1938 Contact me for any DOT assistance.