Thursday, June 8, 2017

Unfit system of issuing Fitness Certificate


One of the most common things that doctor’s specially family physicians and physicians come across is issuing fitness certificate.
Honestly one of the most difficult things to do.
The patients who seeks it does not value it much, “just a formality” . At times they come in group, and say we all want “just” simple certificate without bothering to know whether they are your regular patients or not.
The authorities who asks for it, most of time considered it part of check list.
The types of fitness certificate commonly issued includes
·         For job
·         For school or college
·         For sports activity
·         For outdoor activities like  trekking camps, expedition
·         Appearing for certain special exams like police recruitment etc
·         For Air Travel
·         For Special tours which involves high altitudes etc.
·         For Driving license
The problem is there are no prescribed guidelines for judging fitness of the person or set of predefined tests before issuing such fitness certificates. 
No fixed laid town standards.
Everybody has got its own set of format which they want doctors to sign.
There are no guidelines –which are must to assessment physical and at least cardiac status of individual.
How you can expect us to certify an individual who is going on high altitude doing trekking or going to run for kms in a physical exam with only clinical examination? Everyone feels that they are fit and does not need any investigations for obtaining certificate. 
There are chances that on clinical examination patients may look apparently healthy and only clinical examination may not suffice in many of cases.
Call centers want ENT assessment, someone wants Eye assessment, some want cardiac fitness etc.
Ideally
1.    There should be fixed criteria for assessment and patients must be subject to certain investigations based on the fitness certificate required.
2.    The companies/institutes should consult or take opinion of doctors before designing format for medical fitness certificates.
3.    Patients should understand that this just not a formality, it is a legal document and doctor can in trouble if something goes wrong.
4.    As per requirement, for Government programs or pilgrimages, the government hospitals should be made to issue certificate after proper work up.
5.    There should some schedule or reference table which guides on issuing fitness certificate.
Your suggestions, feedbacks are welcome.

Dr.Pragnesh Vachharajani

Family physician.

9 comments:

  1. Very well elaborated.
    Really people think it as formality.
    Can we add "on clinical examination person appears healthy. "

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  2. Very good article sir.. It is need of hour

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  3. You are absolutely right. The patient thinks that issuing such certificate is just a formality. They are very reluctant to pay for it. There should be definite guidelines for it.

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  4. Very true we are always pressurized by patient to do what may be right or may not be right they always feel that it is their previlage to obtain fitness certificate

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