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	With all of the recent posts about PFOs, dive doctors, etc. I
decided to post this recent study of Dive Doctors to see if they followed
there own guidelines when assessing patients ability to safely dive. 
						Rick


	Med J Aust 1999 Dec 6-20;171(11-12):595-8
	Scuba diving medical examinations in practice: a postal survey. 
	Simpson G, Roomes D 
	Department of Medicine, Cairns Base Hospital, Cairns, QLD. 
	OBJECTIVE: To assess variability of opinion regarding fitness to
dive among doctors currently doing diving medical examinations. 
	DESIGN: Anonymous, reply-paid postal survey containing 15 clinical
scenarios for which respondents were asked to declare the prospective scuba
diver fit, unfit, fit after investigation or to offer specialist referral. 
	PARTICIPANTS: All 81 doctors in Queensland, identified as members of
the South Pacific Underwater Medical Society, who had completed approved
training in underwater medicine, and who were doing diving medical
examinations in June 1998. 
	MAIN OUTCOME MEASURES: Variability in responses, and agreement with
our interpretation of the action recommended by Australian Standard (AS)
4005.1-1992, the medical standard for fitness to scuba dive for recreational
divers. 
	RESULTS: 52 of the 81 questionnaires were returned (64% response
rate). There was a wide variety of opinion about fitness to dive for all 15
hypothetical cases, with 70% consensus about unfitness in only four cases
(one of which should have been referred according to AS guidelines) and
fitness in only two cases (both of which should have been referred according
to AS guidelines). No case was considered either fit or unfit by all
respondents. Only 17.6% of responses recommended specialist referral,
although the AS guidelines suggest that 10 of the 15 cases should be
referred. One doctor failed 13 of the 15 potential divers outright and
another passed seven outright and failed only four. For each case that the
AS guidelines firmly indicate as unfit to dive, at least one respondent
passed the hypothetical prospective diver as fit. 
	CONCLUSIONS: There is no consensus among doctors who perform diving
medical examinations as to what constitutes fitness to dive; current
guidelines need to be improved.



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