Dive Doctors

Questions relating to medical issues and treatment. Where possible and appropriate, we will request comment from qualified and reputable NZ-based diving doctors. If your query relates to a personal medical issue, we recommend you contact your GP or relevant medical specialist.

Is there any real reason for the NZ required COC to be an active Instructor

YES
5
63%
NO
3
38%
 
Total votes : 8

Postby Andy » Tue Jul 10, 2007 1:00 pm

I'm thread hijacking again.... sorry!!

"Gain" is a very loose word, unfortunately. So theoretically you would need a CoC as a "volunteer" DM helping on a course if you got a free fill, and didn't pay for your ride on the boat. I'm sure OSH wouldn't pursue this, but they could if they chose to...
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Postby Azza » Tue Jul 10, 2007 2:00 pm

Andy wrote:I'm thread hijacking again.... sorry!!

"Gain" is a very loose word, unfortunately. So theoretically you would need a CoC as a "volunteer" DM helping on a course if you got a free fill, and didn't pay for your ride on the boat. I'm sure OSH wouldn't pursue this, but they could if they chose to...
How is that a gain? You cant volunteer unless you are there so you have to get a ride and an airfill...If you got free airfills for EVERY dive in exchange for volunteering, then that could be gain...
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Postby Andy » Tue Jul 10, 2007 2:07 pm

Azza wrote:How is that a gain? You cant volunteer unless you are there so you have to get a ride and an airfill...If you got free airfills for EVERY dive in exchange for volunteering, then that could be gain...


It's receipt of something (air & boat ride) for services rendered.... so I guess more "payment" than "gain".

It's grey.

OSH definitions are;

Occupational Divingdiving performed in the course of employment for gain or reward (irrespective of whether or not diving is the principal function of employment or merely an adjunct to it). It has
the same meaning in these guidelines as diving work.


Recreational Divingdiving carried out by individuals or groups for their own pleasure and does not involve any commercial activity for gain or reward and an at work situation does not apply.


To my mind, voluntary DM fits between those two definitions, but could easily be construed to "not be recreational" as commercial acivity is involved, making it de facto an occupational diving situation and a CoC would be needed.
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Postby Azza » Tue Jul 10, 2007 2:16 pm

Andy wrote:
Azza wrote:How is that a gain? You cant volunteer unless you are there so you have to get a ride and an airfill...If you got free airfills for EVERY dive in exchange for volunteering, then that could be gain...


It's receipt of something (air & boat ride) for services rendered.... so I guess more "payment" than "gain".
Its not even payment...its enabling the person to volunteer. Are they expected to PAY to volunteer?

If they gave the volunteer a free boat ride and an air fill for a "Pleasure" dive later on then that would be Payment or Gain....

You could also start a limited company and not pay yourself, then recieve shareholder divedends at the end of the finacial year...then you are not recieving Payment...
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Postby DiveDiva » Tue Jul 10, 2007 2:26 pm

I agree with you Azza but many DMs are offered air and boat trips as "payment".

When I wanted to "volunteer" as a DM in Australia, immigration said no because working for any form of payment requires as work permit or residency.

I'm sure many volunteers are out of pocket after giving their services because not all companies pay expenses either.

DD
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Postby Azza » Tue Jul 10, 2007 5:20 pm

DiveDiva wrote:I agree with you Azza but many DMs are offered air and boat trips as "payment".
If its for a dive at another time then I agree its payment.
If I ask Katie to DM for me, and fill her tanks and pay her charter fee then that is not payment...
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Postby DiveDiva » Tue Jul 10, 2007 5:33 pm

Azza wrote:
DiveDiva wrote:I agree with you Azza but many DMs are offered air and boat trips as "payment".
If its for a dive at another time then I agree its payment.
If I ask Katie to DM for me, and fill her tanks and pay her charter fee then that is not payment...


It is not payment in cash but it is payment. It is not a "comp" or gift because she is giving you something in exchange. That's how I understood it.

I assume that DMs are classed as 'occupational divers' and would, therefore require a COC?

DD

See below:

http://www.osh.govt.nz/publications/fac ... iving.html
What You Need to Know About Occupational Diving

Occupational Diving

Diving is a particularly hazardous activity and requires all those involved to be competent and medically fit. The Department of Labour administers the health and Safety in Employment Act 1992 and Regulations 1995. These determine the requirements for certification of occupational divers. Occupational Diving is defined as diving that is carried out at work, for gain or reward. It Involves the diver breathing gases (usually air) at greater than atmospheric pressure under water.

The Regulations require that Occupational Divers be
Last edited by DiveDiva on Tue Jul 10, 2007 5:41 pm, edited 3 times in total.
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Postby Azza » Tue Jul 10, 2007 5:37 pm

DiveDiva wrote:
It is not payment in cash but it is payment. It is not a "comp" or gift because she is giving you something in exchange. That's how I understood it.

I assume that DMs are classed as 'occupational divers' and would, therefore require a COC?

DD
I cant see how that is payment? If I didnt do that then she wouldnt be able to be there.... If I gave her a lift in my car to the dive site, is that considered payment as well?

DM's, if they get paid, are classed as Occupational divers. I first did my CoC back when I was a DM
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Postby Flipper » Tue Jul 10, 2007 5:47 pm

As I understand it, in most situations (e.g. charity work), its fine to cover reasonably incurred expenses, without this being considered payment. To get something over and above the directly incurred expenses (such as an additional free dive trip) then this would be payment.
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Postby Deepsea » Wed Jul 11, 2007 1:51 pm

jase wrote:I think it is a bit of a joke that the navy are the self proclaimed "center of excellence" for diving. I do not doubt that they have a very good team of doctors and the facility is fantastic up there, but i don't believe that a single doctor up there should be giving the final ok, especially when he is reviewing what a diving doctor has recommended. I may be wrong here, and have no doubts that someone will put me in my place ....But i bet that the doc in Davenport is not the most highly qualified diving doc in NZ, on that assumption ( again i am cringing someone will have a strong argument here)they should not be the person that gives the final OK.
Still, i guess i will pay the $75, and get on with life. There endith the bubbles.

PS, am still keen to find a good Diving Doctor in lower north island, so let me know pease.


Yep you are wrong ... pay your $75 dollars or what ever it costs and get on with diving. If you knew the level of training for the average diving doctor you would want your records reviewed at Devonport.
We are finding out there is a lot more going on during a divers diving career than previously thought, pass the extra cost of medicals onto your students or employers it can't be that expensive.
As far as Professor Des Gorman in Devonport is concerned you have a world authority on diving. New Zealand should be bloody grateful the guy is still even working in the country.

Cheers Deepsea
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Postby Andy » Wed Jul 11, 2007 3:40 pm

Azza wrote:Its not even payment...its enabling the person to volunteer. Are they expected to PAY to volunteer?


I'm not saying it's right, Azza.... but YES! If you want to remove all of the grey from the interpretation of the OSH guidelines, then paying a nominal $0.05 for the air, and $0.05 for the boat would ensure that you are not diving occupationally.

The alternative is to get a CoC....!!
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Postby jase » Wed Jul 11, 2007 3:49 pm

Hi deepsea, yeah thought some one would say something like that. Is it you opnion that alot of the diving doctors are not up to standard? Are you in that part of the industry? What things does the Prof find that the others have overlooked? Is there some in particular that we should be avoiding?I understand if you are not able to be to specific, but i would be interested to know, as would others im sure. This hopefully will explain the COC grey zone to the dummies like me out there.
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Postby Andy » Wed Jul 11, 2007 4:16 pm

Hi Jase,

Going back to basics - why do you actually want a CoC??
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Postby Dr Simon Mitchell » Wed Jul 11, 2007 4:37 pm

jase wrote:Is it you opnion that alot of the diving doctors are not up to standard? What things does the Prof find that the others have overlooked? Is there some in particular that we should be avoiding?


Hello,

The arguments for the benefit of central arbitration as performed by Des (and soon to involve myself again) at Devonport are complex. To be honest, the philosophical and practical arguments around this issue are more Des' bag than mine; he is a diving physician and an occupational physician whereas I am a diving physician and anaesthesiologist. Nevertheless, here are a few points.

Central arbitration is not intended to detect mistakes made by "incompetent" diving doctors. The issues are more subtle.

First, in performing occupational diving medicals, some doctors lose sight of the fact that they are acting as the commissioned agent of a third party (the employer) rather than establishing a doctor-patient relationship between themselves and the diver. Opting for the latter frequently leads to inappropriate advocacy behaviour on important issues, that is, the doctor wants to please the diver (who is often the one who is paying for the service) and may avoid making the hard calls. A recent audit of aviation medicals in NZ (where they don't have a system of central arbitration) found a poor state of affairs in this regard. Some horror stories came out of that actually.

Second, it is not unknown for divers who are the subject of an unfavorable decision to go to another doctor and lie about the issue that attracted the negative response previously. Central arbitration prevents this from happening unless the diver goes to extraordinary lengths to disguise their identity.

Third, lets say you are obese and want an occupational diving medical. You go to a diver mate and ask who you should see. He knows of a doctor who is a bit "soft" on fatties and urges you to see him or her... so you do. In this manner, a doctor who is prepared to take a softer line on various issues develops a reputation for same, and attracts more business... and so on. Often such things are not conscious decisions on the part of the doctor, but rather are trends that develop over time. This results in uneven application of standards within the one country, unfair financial advantages for certain doctors, and all sorts of related problems. Central arbitration prevents uneven application of standards, and provides an avenue for appeal in the even that there is a dispute.

I hope this gives you some insight into the issues.

Warm regards,

Simon M
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Postby Deepsea » Wed Jul 11, 2007 4:52 pm

jase wrote:Hi deepsea, yeah thought some one would say something like that. Is it you opnion that alot of the diving doctors are not up to standard? Are you in that part of the industry? What things does the Prof find that the others have overlooked? Is there some in particular that we should be avoiding?I understand if you are not able to be to specific, but i would be interested to know, as would others im sure. This hopefully will explain the COC grey zone to the dummies like me out there.


Basically dive doctors, the kind in regional centers are trained to look for events of interest or relevancy during a diving medical they have a set questionaire to follow and questions to ask. The dive specialist training given to a doctor at this level is minimal by diving specialist standards but perfectly adequate to examine a candidate. Assesssment of the examination results is reviewed by a diving specialist doctor, probably Des Gorman.
There are a lot of medical issues with diving outside the average diving doc's knowledge but well within the specialists area hence the review.
I have taken department of labour medicals in NZ and UK HSE overseas I don't see the issue with compliance for medicals. If you want to be a scout helper these days the amount of money and time required to comply with health and safety is even more.
I have seen divers with current medicals die during a dive, its not perfect but screening by people like Des helps pick up at risk candidates the conditions of interest are huge and too varied to list by someone like me.
Google Des Gorman you will get the picture if he does not reveiw the files he certainly has oversight considering his position its cheap advice

As far as avoiding things ... hell don't dive is the only way to be sure ... but thats not an option. Any diving using aggressive decompression profiles is an indicator for a diving doc avoid them as much as possible.

Cheers Deepsea
Last edited by Deepsea on Wed Jul 11, 2007 4:54 pm, edited 1 time in total.
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