PCA medical committee revoked my race license
08-21-2024, 11:22 AM
#1876
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08-21-2024, 11:33 AM
#1877
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I would completely disagree with this. There is a committee, inside the club, that was never officially formed, with no actual authority, making decisions for the members. Further, apparently this committee makes decisions for club racing and other parts of the club, none of it documented or known to the members. That sounds like government, not a car club (you do know the other motto of PCA, right?).
And I would point out that PCA has had problems with decisions and votes not being made inside of the by law requirements before, some of them quite significant.
And I would point out that PCA has had problems with decisions and votes not being made inside of the by law requirements before, some of them quite significant.
Broader question: has anyone besides Luigi had a serious complaint about PCA CR handles medical clearance? Is there a pattern of a problem here?
08-21-2024, 11:54 AM
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08-21-2024, 12:00 PM
#1879
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From what is told to me, yes. I don't know how many people are willing to make their medical history or issues with PCA public though. Plus, through the action of suspending Luigi, I'm not sure most people would speak up against PCA at this point.
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08-21-2024, 12:01 PM
#1880
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One of the biggest reasons that I'm so upset by this whole ordeal is that PCA has not been transparent at all in their dealings with a member and have acted vindictively against that member. They appear to be taking the position of it's my way or the highway and if you want to challenge anything you will be punished. If some punishment is warranted and you can transparently see why, I'm ok with that but to hide behind the curtain and issue what appear to be nonsensical punishments is WRONG.
Last edited by Mike Roblin; 08-21-2024 at 12:02 PM.
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08-21-2024, 12:09 PM
#1881
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(For me the answer is NO)
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08-21-2024, 12:14 PM
#1882
WRONGLY ACCUSED!
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That's a very lawyery way of looking at it. Regardless of its formal status, the medical committee performs a function, and everyone seems to understand and agree on what that function is. PCA can change the formal status of the committee if necessary. Hard to argue that the medical committee should not be the one making decisions on medical clearance, and that others who are not doctors should override them.
No other car club agrees with how PCA runs their medical clearance. Where are all the disasters, emergencies, accidents, injuries and deaths in those other groups?
The purpose of having good rules of governance is to avoid the situation I am in. When the rules are unclear they can mean anything someone wants them to mean.
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08-21-2024, 12:26 PM
#1883
Three Wheelin'
Give me a break. You are splitting hairs at best and are being disingenuous at worst. Look here:
https://www.health.ny.gov/statistics/chac/glossary.htm
They say:
Contributing Factors (Direct and Indirect): Those factors that, directly or indirectly, influence the level of a risk factor (determinant). A risk factor (causative factor) that is associated with the level of a determinant. Direct contributing factors are linked with the level of determinants; indirect contributing factors are linked with the level of direct contributing factors.
Risk Factors: See Determinants. A factor associated with the occurrence of disease. This is an association and not necessarily causal. A behavior or condition that, on the basis of scientific evidence or theory, is thought to influence susceptibility to a specific health problem.
Determinants (or Risk Factors): Direct causes and risk factors which, based on scientific evidence or theory, are thought to influence directly the level of a specific health problem. Broad causal factors involved in influencing health and illness, including social, economic, genetic, perinatal, nutritional, behavioral, and environmental characteristics. A primary risk factor (causative factor) associated with the level of health problem: i.e., the level of the determinant influences the level of the health problem.
Even this group interlinks "contributing factors" and "risk factors" so closely they say that a "contributing factor" can be defined as "A risk factor (causative factor) that is associated with the level of a determinant."
https://www.health.ny.gov/statistics/chac/glossary.htm
They say:
Contributing Factors (Direct and Indirect): Those factors that, directly or indirectly, influence the level of a risk factor (determinant). A risk factor (causative factor) that is associated with the level of a determinant. Direct contributing factors are linked with the level of determinants; indirect contributing factors are linked with the level of direct contributing factors.
Risk Factors: See Determinants. A factor associated with the occurrence of disease. This is an association and not necessarily causal. A behavior or condition that, on the basis of scientific evidence or theory, is thought to influence susceptibility to a specific health problem.
Determinants (or Risk Factors): Direct causes and risk factors which, based on scientific evidence or theory, are thought to influence directly the level of a specific health problem. Broad causal factors involved in influencing health and illness, including social, economic, genetic, perinatal, nutritional, behavioral, and environmental characteristics. A primary risk factor (causative factor) associated with the level of health problem: i.e., the level of the determinant influences the level of the health problem.
Even this group interlinks "contributing factors" and "risk factors" so closely they say that a "contributing factor" can be defined as "A risk factor (causative factor) that is associated with the level of a determinant."
WRONG.
Not really even a "good try."
As I stated, it is possible that one or more of "risk factors" play a role in BOTH dx and rx.
NOT just dx.
I have been in the room when a "sleep doctor" explained the results of a sleep study to the patient.
"Risk factors" like those you referenced played a role in his recommended rx.
This is true in other areas of medicine as well.
In this case, the OP posted a "sleep study report."
I am not sure whether the study was performed in a lab, with the responsible HCP reviewing the COMPETE study report and the patient's chart, or at home, and then results were later interpreted by a "sleep doctor."
Home sleep testing (HST) is relatively new... folks can read journal articles that compare results to lab tests (there is more than one type of the latter), and also about insurance coverage information for HST--- more on that later.
I think it is possible that only part of the report was posted.
I cannot tell whether the pAHI, pRDI and O2 nadir, along with perhaps other "results" that were not shared, were achieved by the patient while the patient was using CPAP.
IF the patient "argues" that the achieved pAHI of 8 should mean that PCA CR should no longer require compliance data because it proves CPAP therapy is no longer required, and IF that pAHI was achieved during the study whilst the patient was using CPAP, how much sense would that argument make?
What would be the pAHI without any therapy at all?
Clear as mud?
The diagnosis listed on the report is OSA. Why isn't it UARS?
https://stanfordhealthcare.org/medic...-syndrome.html
How is differential diagnosis achieved?
May 2024 article:
https://emedicine.medscape.com/artic...7-differential
What would be the dx if AHI is 5 and pRDI is 20? Is that even possible?
Clear as mud?
See also:
https://aasm.org/resources/clinicalg...esting-osa.pdf
Clear as mud?
I can see why PCA CR might not want to get into the weeds, hoping that candidates from whom they demand data all simply comply. But perhaps they should not be at the edge of the weeds in the first place.
Perhaps "proof" of ongoing "successful management/control" of OSA is LESS STRAIGHTFORWARD than the "proof" of ongoing glycemic control.
Curious folks might want to take a look at what has happened with respect to the latter and trucking.
All should know by now that in the trucking space, there are apparently medical examiners that have to be certified somehow, and perhaps have "guidelines" to follow. Not sure what the heck PCA CR is doing in this regard, except ostensibly acting in an analogous capacity.
Not familiar with all of PCA/PCA CR's "considerations" on these topics, but it sure seems a bit messy once one candidate says "wait a minute here!"
Same as I did not know why PCA CR required a test from a CLIA lab of my urine back in '02, and then somehow through the years no longer cared.
I don't think they issued a press release on this, but I could be mistaken.
Last edited by Mahler9th; 08-21-2024 at 12:34 PM.
08-21-2024, 12:49 PM
#1884
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WRONG.
Not really even a "good try."
As I stated, it is possible that one or more of "risk factors" play a role in BOTH dx and rx.
NOT just dx.
I have been in the room when a "sleep doctor" explained the results of a sleep study to the patient.
"Risk factors" like those you referenced played a role in his recommended rx.
This is true in other areas of medicine as well.
In this case, the OP posted a "sleep study report."
I am not sure whether the study was performed in a lab, with the responsible HCP reviewing the COMPETE study report and the patient's chart, or at home, and then results were later interpreted by a "sleep doctor."
Home sleep testing (HST) is relatively new... folks can read journal articles that compare results to lab tests (there is more than one type of the latter), and also about insurance coverage information for HST--- more on that later.
I think it is possible that only part of the report was posted.
I cannot tell whether the pAHI, pRDI and O2 nadir, along with perhaps other "results" that were not shared, were achieved by the patient while the patient was using CPAP.
IF the patient "argues" that the achieved pAHI of 8 should mean that PCA CR should no longer require compliance data because it proves CPAP therapy is no longer required, and IF that pAHI was achieved during the study whilst the patient was using CPAP, how much sense would that argument make?
What would be the pAHI without any therapy at all?
Clear as mud?
The diagnosis listed on the report is OSA. Why isn't it UARS?
https://stanfordhealthcare.org/medic...-syndrome.html
How is differential diagnosis achieved?
May 2024 article:
https://emedicine.medscape.com/artic...7-differential
What would be the dx if AHI is 5 and pRDI is 20? Is that even possible?
Clear as mud?
See also:
https://aasm.org/resources/clinicalg...esting-osa.pdf
Clear as mud?
I can see why PCA CR might not want to get into the weeds, hoping that candidates from whom they demand data all simply comply. But perhaps they should not be at the edge of the weeds in the first place.
Perhaps "proof" of ongoing "successful management/control" of OSA is LESS STRAIGHTFORWARD than the "proof" of ongoing glycemic control.
Curious folks might want to take a look at what has happened with respect to the latter and trucking.
All should know by now that in the trucking space, there are apparently medical examiners that have to be certified somehow, and perhaps have "guidelines" to follow. Not sure what the heck PCA CR is doing in this regard, except ostensibly acting in an analogous capacity.
Not familiar with all of PCA/PCA CR's "considerations" on these topics, but it sure seems a bit messy once one candidate says "wait a minute here!"
Same as I did not know why PCA CR required a test from a CLIA lab of my urine back in '02, and then somehow through the years no longer cared.
I don't think they issued a press release on this, but I could be mistaken.
Not really even a "good try."
As I stated, it is possible that one or more of "risk factors" play a role in BOTH dx and rx.
NOT just dx.
I have been in the room when a "sleep doctor" explained the results of a sleep study to the patient.
"Risk factors" like those you referenced played a role in his recommended rx.
This is true in other areas of medicine as well.
In this case, the OP posted a "sleep study report."
I am not sure whether the study was performed in a lab, with the responsible HCP reviewing the COMPETE study report and the patient's chart, or at home, and then results were later interpreted by a "sleep doctor."
Home sleep testing (HST) is relatively new... folks can read journal articles that compare results to lab tests (there is more than one type of the latter), and also about insurance coverage information for HST--- more on that later.
I think it is possible that only part of the report was posted.
I cannot tell whether the pAHI, pRDI and O2 nadir, along with perhaps other "results" that were not shared, were achieved by the patient while the patient was using CPAP.
IF the patient "argues" that the achieved pAHI of 8 should mean that PCA CR should no longer require compliance data because it proves CPAP therapy is no longer required, and IF that pAHI was achieved during the study whilst the patient was using CPAP, how much sense would that argument make?
What would be the pAHI without any therapy at all?
Clear as mud?
The diagnosis listed on the report is OSA. Why isn't it UARS?
https://stanfordhealthcare.org/medic...-syndrome.html
How is differential diagnosis achieved?
May 2024 article:
https://emedicine.medscape.com/artic...7-differential
What would be the dx if AHI is 5 and pRDI is 20? Is that even possible?
Clear as mud?
See also:
https://aasm.org/resources/clinicalg...esting-osa.pdf
Clear as mud?
I can see why PCA CR might not want to get into the weeds, hoping that candidates from whom they demand data all simply comply. But perhaps they should not be at the edge of the weeds in the first place.
Perhaps "proof" of ongoing "successful management/control" of OSA is LESS STRAIGHTFORWARD than the "proof" of ongoing glycemic control.
Curious folks might want to take a look at what has happened with respect to the latter and trucking.
All should know by now that in the trucking space, there are apparently medical examiners that have to be certified somehow, and perhaps have "guidelines" to follow. Not sure what the heck PCA CR is doing in this regard, except ostensibly acting in an analogous capacity.
Not familiar with all of PCA/PCA CR's "considerations" on these topics, but it sure seems a bit messy once one candidate says "wait a minute here!"
Same as I did not know why PCA CR required a test from a CLIA lab of my urine back in '02, and then somehow through the years no longer cared.
I don't think they issued a press release on this, but I could be mistaken.
I don't need to hear about the labor. Just show me the baby.....
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08-21-2024, 12:55 PM
#1885
Rennlist Member
Originally Posted by dgrobs
Any chance you have a set of Cliff Notes for your posts? I mean, I wanna read them, but Jeez Louise...
I don't need to hear about the labor. Just show me the baby.....
I don't need to hear about the labor. Just show me the baby.....
08-21-2024, 12:57 PM
#1886
Three Wheelin'
I have to thank you Mahler as you are now the reason to keep hitting the treadmill, in order to increase my health further and lose another 10 - 15 pounds, so that I can get a finding of no OSA. That will end the debate since you have made all sorts of outlandish assumptions based on a pretty straight forward test and results.
I have asked questions, and made observations.
A finding of "no OSA" is a point in time. A finding that CPAP therapy is no longer a recommended rx is a point in time.
In either case, a sleep study with no use of any therapeutic intervention would be necessary, and a trained HCP might take into account multiple health factors, some measured during the study and some reviewed from the patient's chart, might be considered.
Medical diagnostic "decisions" are separate and distinct from dx and rx coverage decisions/benefit determinations. There can be gray areas in either or both, and they can be confused.
Here is an example of benefit determination guidelines:
https://www.avmed.org/media/mznlovcv...cpap_bipap.pdf
All that being said, all of this is messy, and whilst I can see there may be "hope" to avoid the weeds, now that a person (the OP) has stated "wait a minute," perhaps there should be some rethinking.
"Hopes" seem to have been dashed, and perhaps unintended consequences have been experienced, and will continue to manifest (for example candidate racers that decide NOT to disclose OSA to avoid a can of worms).
I think the OP should be reinstated immediately.
If PCA CR personnel feel that they have be "assailed" or "disrespected" in posts the OP made in this thread, I would encourage careful reconsideration, empathy for the OP, and perhaps a get together with a beverage and a handshake.
And maybe some of the Swedish fish I seem to hear about in this forum.
Last edited by Mahler9th; 08-21-2024 at 12:59 PM.
08-21-2024, 01:01 PM
#1887
Three Wheelin'
08-21-2024, 01:04 PM
#1889
Three Wheelin'
I would completely disagree with this. There is a committee, inside the club, that was never officially formed, with no actual authority, making decisions for the members. Further, apparently this committee makes decisions for club racing and other parts of the club, none of it documented or known to the members. That sounds like government, not a car club (you do know the other motto of PCA, right?).
And I would point out that PCA has had problems with decisions and votes not being made inside of the by law requirements before, some of them quite significant.
And I would point out that PCA has had problems with decisions and votes not being made inside of the by law requirements before, some of them quite significant.
08-21-2024, 01:06 PM
#1890
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