How do you get to your spare tire with the camper on?

I have had the same experience with my Igloo and Ram 2010 and Ram 2018. Worst case for another camper, you would need to jack up the camper by a few inches.

Not sure what you have for a camper but with my Northstar Igloo I can drop the spare with the camper on the truck no problem. I have tried just to make sure. The Igloo doesn't hang low enough to interfere with the access hole for the spare.

On our 01 I rotated the hoist assembly to point at right wheel well.
Fairly easy on early superduty. Dont know about recent years

You can rotate the mount 90 degrees and access it from the wheel well. At most, I'd have to lower my jacks.

If you are in a parking lot, turn your pickup the best way so you can the tool in the hole and crank.

If not, you may have to disconnect the truck.