Why the annual physical exam is essential for members of the fire service
Changing the culture of an entire profession can be a daunting task, but I’m convinced that when it comes to annual physical exams the fire service has no choice—it’s time to change, and it’s time to acknowledge that an annual exam is a critically important part of the job.
I recently attended a meeting of the Western Massachusetts Firefighter Health and Wellness Initiative, a regional group dedicated to improving firefighter health. We spent a considerable amount of time discussing why many firefighters refuse to get annual physical exams, and what to do about it. Many firefighters, the group concluded, resist the exams because they fear they’ll have to share the results with their departments, and that consequently they risk being removed from active duty if a previously unknown health condition is discovered.
Whenever I hear that concern, it makes me pause, because I know exactly how they feel. Knowing how dangerous our profession is, and knowing about all of the hazardous and toxic substances we are exposed to regularly, why would firefighters not want to be examined regularly? That’s the obvious, rational question. But if I’m being honest, when I reflect back on my career and how I felt the two times I was injured, I can understand why firefighters might resist such a requirement.
I remember the sinking feeling of listening to my shift respond to incidents while I was home recuperating from an injury. I felt as if I had abandoned my brother and sister firefighters, and I missed the camaraderie. I missed being at the station responding to calls. On top of that, I felt like I wasn’t supporting my family because I wasn’t able to work extra shifts and build up our rainy-day fund. I’m convinced that every firefighter feels as connected to their duties as I did and will do almost anything to ensure they are not prevented somehow from being a firefighter, even, in some cases, at the cost of their health. But we need to shift that mind-set so firefighters understand that regular medical exams are necessary to ensure that they can remain on the job, not just today, but long into the future.
Right now, fire department compliance with NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments, is all over the map. The Western Massachusetts group I met with recently conducted a survey to see how many fire departments in its region followed NFPA 1582’s recommendation for firefighters to receive a physical exam every year from a provider who understands the nature and demands of firefighting. The results showed wide variation, from regular department-provided exams to no exams at all.
There are things you can do even if your department may not have the means to provide you with regular physical exams. If you are a firefighter in a department that cannot afford regular wellness exams, take advantage of your insurance benefits—each time you have an exam, tell your examining physician that you are a firefighter. This is an important part of your medical history that your doctor needs to know.
A wider acceptance of the annual exam will depend heavily on local groups like the one in Massachusetts, which was organized not by a big fire department or national organization but by a line fire officer, Captain Rebecca Boutin. Through her fire service network, Capt. Boutin reached out to find others with an interest in firefighter wellness and was able to convene a group of firefighters, fire officers, chiefs, and support providers. Firefighters advocating to their peers for more frequent medical exams is the best way to get more firefighters to commit to the initiative—no one understands how to motivate firefighters better than firefighters. It will take this kind of grassroots advocacy to move the needle and get more firefighters to understand that the cost of skipping the annual exam is just too high.