dbf73

The long term health issue is already being addressed by the requirement for a physical. A non-trivial percentage of the population does not see a physician on a regular basis unless they are sick enough to. Count me in the either monitor for compliance with all personal physician prescribed treatments or don’t monitor at all group

Mahler9th

This thread has evolved in interesting ways!

Some of the opinions expressed about OSA, various heart conditions, and diabetes reflect a poor understanding of human physiology and medicine.

And comments on the impacts of poor therapeutic management related to fitness for racing are way off base.

These statements are just wrong:

"OSA is different. If you don't use the machine, there is no direct risk of dying or even serious illness."

"Nobody with OSA, who hasn't used a CPAP consistently, should be on track. Period."

"The necessity of CPAP to race isn't medically debatable."

"A person with diabetes or a serious heart condition will die if they don't take their meds every single day."

"A person with OSA who does not use CPAP has no direct risk to themselves..."

I encourage folks to avoid spreading misinformation about medical conditions-- it is not helpful to anyone, and may lead to untoward consequences.

Perhaps one of you can find several review papers that discuss risks from a variety of chronic medical conditions related to racing (even lawnmower racing). Perhaps not.

To me this is all pretty simple.

Patient compliance with a variety of therapies for a variety of chronic medical conditions is extremely well understood.

This includes medical therapies (e.g., taking pills).

And yes there have been efforts to apply technology to things like pills to try to create proof of compliance for a variety of reasons.

Patient compliance for CPAP has been studied for a long time, and there are likely constant arguments amongst experts regarding CPAP versus other types of intervention.

For example, surgical intervention.

And of course with OSA, we now have an implantable.

PCA and PCA CR will have to figure out what it wants to do about collecting information about Rx compliance from candidates with chronic medical conditions going forward.

I just took a look at the 2002 PCA CR medical form that I had to submit way back when... it not the same as what is used today.

It changed. Perhaps "evolved."

LuigiVampa

YES!

If someone needs to use a CPAP, and over the long term does not, it will show up as diminished capacity in a psychical. The same as eating too many donuts, etc.

Monitoring compliance with any medical condition is not needed when we all have to get a psychical.

linderpat

Like everything else corporate PCA these days, this is another example of a gross overstep, and an organization that has relinquished its autonomy to lawyers and insurance companies, the twin banes of all things wrong in modern America (yes, I am a lawyer, but not an insurance or personal injury lawyer). Sad.

peterp

The only way to win any significant disagreement with an organization is to 1) attack only the areas that are debatable; and 2) use only undebatable facts to support your case. The minute you start presenting arguments that are inaccurate, you lose significant ground and credibility in the argument. Fighting the requirement to provide your personal CPAP data is potentially winnable because you have data points that other race organizations don't require that data. That is what you want to change, and that is your data point.

To continue to imply that not using CPAP is not a risk on track is not valid and moves your fight backwards. The risk, as it relates to track, is NOT long term health (yes, I know that was one of the issues the doctor listed, but not the only thing). The clear issue is that there is fairly immediate impact when people don't use CPAP. While it requiires weeks of CPAP to recover from extended non-use -- if you stop using it for only a day or two, it affects you significantly. You probably know that first-hand if you've ever forgotten your CPAP machine on a trip. This entire line of discussion, trying different angles to dismiss the importance of CPAP, moves your argument backwards.

You are trying to make it a war about the doctor's medical opinion, which is a war you cannot win, because the doctor is 100% right about the potential impact of not using it. The only thing up for debate is whether the doctor is overreaching by requiring that he have access to your personal CPAP data, instead of just having a checkbox on the form that allows the applicant to indicate they are using CPAP. That "overreaching" aspect is what you want changed, and it is potentially winnable because you have precedents of other clubs. That's a clean argument if you just stick to those simple elements. You muddy is up by trying to say CPAP use isn't important for track, because that is simply not true.

LuigiVampa

Wrong.

needmoregarage

In a nut shell (I’m writing this because I want to be clear on my understanding of the argument):

Seems the argument is that there is no minimum standard or existing requirement regarding what was requested by the medical committee. What Luigi is challenging is the request for information, because no (minimum standard) basis for the request exists.

PCA can change this by making it (supplying CPAP compliance data) part of their requirements, and maybe they can change it retroactively - but it seems that Luigi is not debating the effects of OSA or use (or non-use) of CPAP. He is arguing that the basis for their request does not exist within PCA’s existing rules.

Please correct me if I don’t have this right.

Nowanker

Adding to the argument that the data is totally irrelevant.
If it only takes a day or two to erase all the good work... The data that was requested will be useless by the time it arrives. Proving nothing, other that Luigi has a recording CPAP, and did use it at some point.
They've taken an indefensible position, but won't give it up.

peterp

The document lists 11 conditions for which there must be a review. There is nothing I've seen that says they can't choose to do further review based upon any other data on the medical form (nor should there be, since no simple form is a perfect screen for something as complex as medical issues). The fact that OSA is not on the "must review" list does not mean they can't review that, or anything else. I don't think they've violated any of their own rules, happy to be proven wrong.

The simple argument is that they are overreaching by asking for personal CPAP data, and there is precedent given that other racing organizations that don't require it. It can also be argued that PCA largely absolves liability risk (transfers it to the applicant) simply by having the applicant check the box that says they are using the CPAP machine daily. That is the simple argument and the only viable one I see. It is also potentially winnable (though the PCA has the right to ignore what other race organizations do).

I'll step out of the discussion (and try my hardest to stay out). I hope others will offer constructive comments to help this get resolved, which is my only goal.

Examples of non-helpful comments:
1. Saying the data they are asking for is "meaningless" is completely wrong from a legal perspective. PCA absolves its liability by requiring reasonable proof of usage (it's not easy for somebody to fake the data -- they have to wear it consistently for a month or two). If somebody cheated and stopped using it after submitting the data, they have the liability, not the PCA.
2. CPAP machines have only been around for 40 years. How is that relevant? Race cars used to intentionally not have seat belts because the cars were largely made of highly flammable magnesium and it was safer to be thrown from the car. Should we not use seat belts today?

Don't fan the flames, just help guide this to resolution.

LuigiVampa

Wrong.

A minimum standard means that if you meet that standard than you are in compliance. There is no authority for PCA to go beyond the minimum standard. If they want something more than they need to change the minimum standard. By citing the 11 conditions you are making my argument.

Mahler9th

"PCA absolves its liability by requiring reasonable proof of usage (it's not easy for somebody to fake the data -- they have to wear it consistently for a month or two). If somebody cheated and stopped using it after submitting the data, they have the liability, not the PCA."

I suspect that statement is incorrect.

And this thread is NOT about about resolving anything. It started out with a person describing an experience related to maintaining a license to race with PCA.

And at the center of that experience was a question asked by the OP about the need to provide additional information demonstrating some type of anecdotal compliance with a medical therapy.

And of course also in that center was an "official" response from PCA CR.

I also doubt there is any need debate various levels of risks related to chronic medical conditions and treatment compliance with respect to racing in the CR program or for that matter any kind of racing at any level.

Or for that matter, driving on track, driving on public roads or trucking.

All of this is well understood. Extremely well.

There is also no need to debate or speculate about insurance risks and/or costs, and legal risks/risk reduction related to the granting of racing licenses at the PCA CR level.

All of this is well understood. Extremely well.

I think the OP has identified "opportunities for improvement" for PCA CR, and I believe that PCA CR will seize the opportunity.

For example, the current PCA form "defines" "the functional requirements of a driver in a competition automobile..."

And one listed "requirement" is as follows:

"Ability to recognize the colors of traffic signals and devices showing the standard red, green, blue, and yellow."

Is that "definition" consistent with information about vision required on the form?

This will all get sorted--it is not that complex.

Mahler9th

The concept of "objective minimum standard" likely does not apply with the typical context in this situation.

Nor does the term "standard of care," which we use in medicine.


Some perhaps interesting perspective.... if the PCA CR team feel that the trucking industry's considerations/standards/what have you regarding OSA and CPAP therapy are an important reference or benchmark, how about such considerations/standards/what have you related to diabetes?

The ADA has some things to say about this, and perhaps a demonstrated history of advocacy.

See for example:

https://diabetes.org/tools-resources...rivers-license

There is a link to the CFR on that page as well as a link to an ADA FAQ.

Changes as recently as 2018!

Manifold

Maybe the crux of this is that if someone discloses OSA and says they're using CPAP, they should be trusted to use the CPAP every night. There's no practical way to verify future compliance prospectively, so you just have to trust people to do what they say they will do, and which is in their best interest anyway. This applies to all treatments for medical conditions. It also applies to being trusted to not drink alcohol and use illicit drugs before going on track.

Rather than showing trust, PCA is trying to go in a paternalistic direction, which doctors, bureaucrats, and leaders in non-profit clubs often tend to do, and which is why many of their demands are arbitrary, inconsistent, and nonsensical.

dgrobs

Stop giving them ideas. We've been through this before. They wanna pick on Club Racers, so be it. Stop egging them on to come after DE next. Please.

dgrobs

Wait, what? They crossed illegally?