Dale Johnson: Time for The Conversation Starts Here on KFOR FM 103.3, 1240 AM. I welcome in Dr. Sandra Miller from Complete Hearing. Good to have you back from your convention time.
Dr. Miller: Good morning. Glad to be back.
Dale Johnson: I mentioned that to the listeners last week, the fact that you were at a convention. Can you share some of what you learned and some of the subjects?
Dr. Miller: Absolutely. So we try to stay very educated in terms of finding out what’s new in the industry always, but also how can we be better providers overall. For us, this conference was about getting together with other audiologists who own private practices like we do and to talk about how to best serve our patients in the most professional and ethical way. We talk a lot about trends that are happening. We just had a discussion about how currently we do pay a lot for healthcare and we are really demanding more from our providers. When people come in and see us, they expect a certain amount of care but also a good experience, and so we always want to make sure we’re delivering that and how we can most effectively do that. So it was really interesting to talk to other providers and just really get a feel for what’s happening just in healthcare in general and how can we be a better part of providing a great service?
Dale Johnson: Good. Good to have you back on the show.
Dr. Miller: Thanks.
Dale Johnson: We have two people in this room, Dr. Miller of course, and Dr. Curtis Fletcher from Fletcher Chiropractic. Two people in this room whose profession is very important to me. Obviously I need hearing for radio.
Dr. Miller: Right.
Dale Johnson: And I am such a huge fan of chiropractic for all the right reasons, and we’re going to get into that a little bit today with Dr. Fletcher. Thank you very much for coming in.
Dr. Fletcher: Well thank you for having me.
Dale Johnson: Good to have you here. But connect the dots between what we are actually going to talk about, and that is Department of Transportation physicals for over-the-road truck drivers and how that ties into hearing and chiropractic. Connect the dots, doctor.
Dr. Miller: Right. I know. So a lot of times what we see in our offices, the patient is coming to us for a DOT physical, the hearing portion of it. And that just means they’ve not passed their whisper test at five feet and that means they can’t hear, and so that just means that they have to be able to hear out of one ear. And when they get to us, we just have to do an assessment to make sure that they can… What will they have in terms of results when we do a hearing test for them.
Dr. Miller: So there’s a criteria they have to meet in order to drive this truck or over-the-road truck. And so we want to make sure that when they do fail that portion of their screening what’s happening and then we do an evaluation to see where they’re at. While we complete those results, and if for some reason they are going to have to have devices to help them hear well and be able to pass that test, we go ahead and provide that intervention.
Dr. Miller: What I think is really great is that I never knew that chiropractic and Dr. Curtis was involved with this. I always thought these referrals came from a primary care physician and they were the only ones who could see these, and so I wanted to bring him in today just to talk about, educate us, because I love to be educated, just about like what does this mean, how does this work on your side of things in terms of… He told me lots of great things that I want him to share with you today just about being on the national registry and what does that mean, and really the advantages of working with somebody like him in this area.
Dr. Fletcher: Yeah. So when I came out of school, I took the classes in order to be on the national registry for certified medical examiners, and you take the test and once you pass you’re able to do the DOT exam. With the DOT exam, you do have to do retraining after five years and then you have to after 10 years do more retraining and then take another test.
Dr. Fletcher: But yeah, then when you get into DOT physicals, like you said, they have to be able to pass the hearing portion of the exam with the five feet at least whisper test and that’s with or without hearing aids, but then if they can’t pass, that’s where a good referral to someone like Dr. Miller because they can get the appropriate care they need.
Dr. Miller: So I think what’s so interesting is we talked about, Dale earlier before the show started, about the level of sound and loudness that happens with our over-the-road drivers, and so I don’t think it’s even sometimes thought about. My patients will typically tell me the cab I think is pretty quiet, but it might be that when I’m stopping to maybe assess my truck, something might be going on, can I hear that? The noise levels can be just really, really loud, like into the danger levels. And we talked about last time, what are those danger levels and where does that occur? And then we talk about if you’re having normal hearing, is it time for some hearing protection? And so we have to kind of assess that to see when is this appropriate, how would you use it, what does that look like?
Dr. Fletcher: The standard diesel engine produces about 100 decibels of noise. So put that in… that doesn’t mean anything to me. I have no idea of range.
Dr. Miller: Right. Let’s say that’s probably 10 DB louder than your lawnmower. Another assessment might be at the Husker Stadium when we’re maybe on fourth down and we have to cheer a little louder, it probably gets louder than 100 decibels in the stadium or if you’re at a concert situation, imagine how loud that can get. And for these drivers, depending on the length of time they’re exposed to that level of sound, are we doing some potential damage to the hearing? So we want to make sure we assess their work environment to say, is this a healthy place in terms of that? And then also is there something we need to be doing about it?
Dale Johnson: And so I can hear listeners now. Well, my lawnmower is not very loud. I mow my yard an hour, hour and a half. You’re in a truck 12 hours a day, people. Sometimes longer.
Dr. Miller: Yeah.
Dale Johnson: So 100 decibels can do some damage correct, Dr. Fletcher?
Dr. Fletcher: I would agree. It’s something that I don’t deal with a lot, but Dr. Miller does and it’s one of those things when you do DOT exams, you have to make sure that you pass that. And so like Dale said, if you’re around that all the time, wearing proper protection, just protecting yourself so that way you don’t have ear damage later on.
Dr. Miller: Yeah. Well I got some great statistics recently too in regards to there are more female drivers that are getting into over-the0road trucking, believe it or not. And so I’m wondering if you’re seeing any of that in your practice.
Dr. Fletcher: We have actually seen quite a bit of that recently. We’ve seen a lot more married couples that have been wanting to drive together, which, I mean, that’s a good way to see the country I guess. But, yeah, that is a trend that we have been seeing lately.
Dr. Miller: I heard they actually have a class that you can take as a couple together like for over-the-road drivers. I was like, that is so interesting. And I heard that it’s kind of becoming this second career. So we’re done with our first career, we’re going to take this on as a second career and not only just like we love being together, so we’re going to go out and drive and then we may leave our truck and go do something and then come back. It’s just such an interesting concept to me.
Dr. Fletcher: Well, I know a from a few patients that they basically said the reason for that is they can go, if they got to take something out to California, they can go see, you know, San Francisco or whatever. But then if they’re going maybe to Florida, they can go to Disney World, something they’ve never been to before that when they’re out working, they can have a little fun.
Dale Johnson: Dr. Miller, is there any difference between male and female hearing?
Dr. Miller: That’s a really good question. I think that when you see… It’s so individualized per patient, and so what we see is that it just depends honestly what the cause is. And the cause can be the same, it can be different for everybody, and how that manifests itself into hearing loss is different for everybody. So we don’t see that women or men have more or less hearing loss, it’s just really the dynamics behind how did that occur? You would think that, oh, well men are more exposed to noise, so they should have more noise induced hearing loss. Well that could be job-related. Right? So it just really depends on that part of it. We see an equal number of male and female patients in our office, so it just doesn’t mean… They just may have different configurations of hearing loss.
Dale Johnson: All right, that’s good to know. My wife says I don’t hear her, so I was just wondering.
Dr. Miller: Dale, that’s a whole another topic.
Dr. Fletcher: I was going to say, is that selective hearing?
Dale Johnson: A lot of listeners were thinking that, especially you guys out there. How many DOT physicals do you do in any given period, Dr. Fletcher?
Dr. Fletcher: You know, it really depends. It depends on if they have any conditions going on. So if like let’s say they have blood pressure issues, they can only get like a year certificate. If they are completely normal, it might be two years certificate. So I mean it just kind of up and down, it depends on the month and time of year.
Dr. Miller: He said something interesting to me earlier too is that if you’re changing jobs, right, you change from one industry… Or one trucking company to a different, or you’re doing something where there’s different employment, what happens then?
Dr. Fletcher: Yes, we’ve seen that before too where they might switch jobs and the employer wants a new DOT physical done and so basically the employee just has to come in and get a new DOT physical.
Dr. Miller: My favorite part about this is that I love… Tell me what you told me earlier about what your patients say about coming to a chiropractor for this type of service.
Dr. Fletcher: Well, I say this, that there’s a lot of people that said I can usually get you in pretty quick, at least within a day or so. But they like it because they come in, fill out the long form and they don’t have to sit around a bunch of sick people or a full waiting room and wait for hours on end, and that’s something that’s kind of for me as my personal preference, I don’t like waiting and so I don’t want you to wait out there forever.
Dr. Miller: See? It goes back to having a good patient experience. So that’s definitely something I think is so valuable, and just understanding that this is available and that you can go to like doctor… to a chiropractor and say, “Hey, I can have this done there.” But tell them what has happened previously where people have come to you and said, “Oh I just went here and had this done and it didn’t qualify.”
Dr. Fletcher: Well, with being on the National Registry of Certified Medical Examiners, you can go to their website and see who is all qualified and we’ve seen that in the past where someone has gone to someone for a DOT physical and they’re not on the National Registry and so basically that DOT physical did not count, and so then they had to get a new one with someone like myself or a different provider that does DOT physicals.
Dr. Miller: And so how our relationship kind of works is that Dr. Curtis would refer to me before the failing of the hearing portion and then I would provide those results back to him essentially, so that we could work as a team just to say, “Okay, this is what we found. And then does any intervention need to be taken?”
Dr. Fletcher: I would say that is always great. If you have any hearing issues, if you go see someone like you before and get the paperwork and bring it back to me, that makes my job a lot easier.
Dr. Miller: Exactly.
Dr. Fletcher: With a lot of conditions, that’s a good way to do that. Like even a CPAP for instance, we have to have results showing that you’ve used it at least 70% of the time. So bring some paperwork with you like that. That is always great.
Dale Johnson: How does someone find out where they can go to get tested by a qualified… Someone on the register?
Dr. Fletcher: You can just type in on Google National Registry of Certified Medical Examiners.
Dale Johnson: It comes up with a list.
Dr. Fletcher: You can type in your location with zip code and stuff and search so many miles from there.
Dr. Miller: Isn’t that interesting?
Dale Johnson: It is.
Dr. Miller: I never knew that.
Dale Johnson: No, and I have a son that… He’s not an over-the-road trucker, he’s a farmer but he has a big rig and I believe he wears ear protection, Dr. Miller.
Dr. Miller: Well good for him.
Dale Johnson: Don’t know where he got that, because I jammed with headphones my entire life. So I probably have a little bit of hearing loss. Too many Zeppelin records, Dr. Fletcher.
Dr. Fletcher: Probably.
Dale Johnson: Over the years. That’s my issue. How can someone get a hold of you?
Dr. Fletcher: Well, you can look at our website at fletcherchiropracticllc.com. Otherwise, You can give us a call at (402) 261-5766.
Dale Johnson: And of course, Complete Hearing is at 4200 Pioneer Woods Drive. That’s in Southeast Lincoln, just north of 70th and Pioneers. Dr. Miller, always a fast conversation. Thank you for bringing in Dr. Fletcher.
Dr. Miller: Absolutely. Thank you, Dr. Fletcher.
Dr. Fletcher: Thank you.
Dale Johnson: And join us every Saturday morning at this time for The Conversation Starts Here.