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.
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.