A driver presents with a large reducible inguinal hernia. What should the Medical Examiner do?

The situation regarding a driver with a large reducible inguinal hernia requires careful consideration of safety and medical standards for driving. The correct course of action is to refer him for evaluation and hold certification until treatment is confirmed.

A reducible inguinal hernia, while it may not cause immediate discomfort or urgent medical issues, poses potential risks. Hernias can become strangulated, leading to serious complications that could arise unexpectedly, particularly during activities that require physical exertion, such as driving. The medical examiner has the responsibility to ensure that any medical condition does not impede the driver's ability to operate a vehicle safely. Therefore, it is prudent to refer the driver to a healthcare provider for a thorough evaluation and appropriate management of the hernia before granting or renewing a medical certification.

This cautious approach prioritizes the safety of both the driver and the public. It is essential to base certification decisions on a thorough understanding of the medical condition and its implications for driving capabilities, rather than solely on the driver's personal assessment of discomfort or on the opinion of a personal physician who may not specialize in occupational health.