Providing healthcare and fitness to drive assessments for long-haul truck drivers: A qualitative study of family physicians and nurse practitioners

Introduction: Long-haul truck drivers are exposed to many workplace stressors that put them at greater health risk than the general population. Transport truck driving is currently the most common occupation for men in Canada and among the top most common occupations for men in the US, the United Kingdom and Australia. Literature to date suggests long-haul truck drivers have poor access to health care including primary care. Primary care reduces health inequity and has significant impact on the health of both individuals and populations. How primary care practitioners provide this important resource to their long-haul truck driver patients has not been well studied. In this study, we probed the responses of family physicians and nurse practitioners to the health experiences reported by long-haul truck drivers and explored their insights providing primary care to this occupational group. Methods: In-depth semi-structured interviews were conducted with three focus groups of primary care providers recruited from urban and small towns in Ontario, Canada. Analysis of the audiotaped and transcribed interviews was conducted using descriptive qualitative methodology. Results: Two themes emerged from the analysis that reflect the challenges participants had forming therapeutic patient-physician relationships with their long-haul truck driver patients: lack of knowledge of the continuous complex environment of trucking; and responsibility for conducting drivers\u27 medical exams at the expense of primary care. Conclusions: Nurse practitioners and family physicians appear to be conflicted in their dual roles of providing medical care and assessing fitness to drive for their long-haul truck driver patients. Designating separate health providers who are specially trained to determine medical fitness may allow family physicians and nurse practitioners to focus on providing good quality primary care to long-haul truck drivers who are in great need of resources to reduce their significant health inequity