Admission To Hospital Question

[BladeSlap]

I actually know a gal to whom this happened. So should she, no. Did she, yes.

No previous anything.

Jesus…
Yeah, some changes are badly needed at the FAA

 

[Keithlewis1900]

I actually know a gal to whom this happened. So should she, no. Did she, yes.

No previous anything.

That’s disgusting.

 

[Keithlewis1900]

1.3vso (from what I know about fixed wing) is based on science and math.

I don’t think anyone said anything bad about you, as for me, I asked if you made money with the HIMs people, I am curious the yearly amount a doctor makes off the airman without hims compared to a hims airman, this isn’t a insult to you, as you said it is what it is, and the numbers are what the numbers are. Why would you take offense if someone asked the obvious question as to if you had any financial gain on a subject, they ask jurors questions to make sure they won’t favor one side for the same reason, my contract where I work it even asked if I had a interest in the competitors.

After falling into this post, I think the FAA medical really needs some reform, I think the FAA is spending their limited resources going after people who don’t have a real medical problem, taking time away from the airmen who have a real doc gave them a diagnosis type problem.


I’m not going to link this post out of respect to the poster who started it, however I would like to reach out to those who have influence over the FAA, who are the elected representatives who have oversight over the FAA and the medical branch?

It’s nothing personal. It’s just a fact. Similar to how I don’t agree with DPEs getting paid what they do. In some regions, it’s a racket.

 

[BladeSlap]

Would these two be the ones who have oversight over the FAA?


https://en.m.wikipedia.org/wiki/David_Price_(American_politician)


https://en.m.wikipedia.org/wiki/Mario_Díaz-Balart


I would propose that in the event of a airman induced safety incident where alcohol was involved.


The FAA can request the airman go to a state certified doctor for a alcohol assessment, using the most scientifically proven and medical industry wide accepted and recognized method, to see if the airman has a medical alcohol problem.


The findings of that assessment are binding, if the airman is shown to be dependent or addicted the FAA puts him into hims, if not the FAA deletes the records of the request and the matter is closed.


I would think medically and logically it would be hard to argue with that.

 

[Tools]

Hmmm... how most scientifically and medically is the diagnosis...

“I’m going do diagnose you with alcohol use disorder severe. You have a right to a second opinion, that’ll come from the doctor next door. He works for me and his opinion doesn’t matter. If you don’t agree with my diagnosis you’ll never fly again. So do you agree?”

N. Bedi, 2018, Talbott Recovery Campus

uh, it’s pretty easy to disagree with these yahoos.

actually I think the NTSB does. I’m not sure how you get this scam any proper attention.

 

[Tools]

Oh, and as previously noted, there’s NOTHING medically relevant about these assessments. They use outdated criteria. They cook up DSM 5 diagnoses so insurance will cover it.

I only know of one instance where it was done properly, not surprisingly the guy was paying out of pocket. The rehab center said since his “treatment” was not medically required, he had to sign a waiver! And it wasn’t, it was needed to appease the FAA.

 

[Tarheelpilot]

This entire discussion just highlights the problems with FAA policy. No one can argue the rules are not written the way they are written. The debate is whether or not the rules are appropriate. To those that argue it’s the faa’s sand box any any discussion is a waste of time I suggest you move to China. You’ll like the government.

 

[Daleandee]

The point isn’t how the FAA finds out a pilot has an alcohol problem. The FAA has to respond in the same way to abuse of alcohol regardless of how the story comes out.

Working in a school district I learned that they have a pretty strict policy about how a person's social life effects their work. Public life drives the perceptions people have of them as teachers, staff, and administrators. Thus a few have been fired or reprimanded for getting a DUI, drug bust, or posting threating stuff on social websites.

While the FAA may seem quite cryptic in their approach it is pretty well known that deviant (for want of a better term) behavior is seldom restricted to only one part of a persons life. What the district is doing is very much like the FAA approach.

I have known at least one man that drank only at home and had a strict policy that once he cracked open his first beer he was not leaving the house for any reason. But he would be an exception and not the rule.

 

[BladeSlap]

Working in a school district I learned that they have a pretty strict policy about how a person's social life effects their work. Public life drives the perceptions people have of them as teachers, staff, and administrators. Thus a few have been fired or reprimanded for getting a DUI, drug bust, or posting threating stuff on social websites.

While the FAA may seem quite cryptic in their approach it is pretty well known that deviant (for want of a better term) behavior is seldom restricted to only one part of a persons life. What the district is doing is very much like the FAA approach.

I have known at least one man that drank only at home and had a strict policy that once he cracked open his first beer he was not leaving the house for any reason. But he would be an exception and not the rule.

“Deviant behavior”?

 

[bflynn]

This entire discussion just highlights the problems with FAA policy. No one can argue the rules are not written the way they are written. The debate is whether or not the rules are appropriate. To those that argue it’s the faa’s sand box any any discussion is a waste of time I suggest you move to China. You’ll like the government.

in the US, Congress has ultimate oversight of the FAA. “All” you have to do is convince them to tell the FAA to lighten up. Personally, I think your odds are not good.

consider the paths you might take - try to convince the FAA directly, convince Congresscritters directly, lobby via someone like AOPA, use the courts, or create a grass roots groundswell in the public. In each case, you’re unlikely to get nothing more than laughter at the suggestion to ease up on alcohol abuse by pilots. But consider…if you can’t convince any significant number of people in these groups, maybe the problem doesn’t lie with the regulations, but rather that your wish is out of line with what everyone else wants.

 

[Jeff Oslick]

in the US, Congress has ultimate oversight of the FAA. “All” you have to do is convince them to tell the FAA to lighten up. Personally, I think your odds are not good.

consider the paths you might take - try to convince the FAA directly, convince Congresscritters directly, lobby via someone like AOPA, use the courts, or create a grass roots groundswell in the public. In each case, you’re unlikely to get nothing more than laughter at the suggestion to ease up on alcohol abuse by pilots. But consider…if you can’t convince any significant number of people in these groups, maybe the problem doesn’t lie with the regulations, but rather that your wish is out of line with what everyone else wants.

The only route that could ever have a chance of succeeding is to convince Congress that the FAA should not be allowed to use different medical standards than the rest of the professional medical community. This should apply across a broad swatch of both mental and physical health criteria the FAA uses. If the docs the FAA use step beyond the boundaries of current professional standards, there should be remedies via removal of their professional certifications/licenses.

 

[Tarheelpilot]

in the US, Congress has ultimate oversight of the FAA. “All” you have to do is convince them to tell the FAA to lighten up. Personally, I think your odds are not good.

consider the paths you might take - try to convince the FAA directly, convince Congresscritters directly, lobby via someone like AOPA, use the courts, or create a grass roots groundswell in the public. In each case, you’re unlikely to get nothing more than laughter at the suggestion to ease up on alcohol abuse by pilots. But consider…if you can’t convince any significant number of people in these groups, maybe the problem doesn’t lie with the regulations, but rather that your wish is out of line with what everyone else wants.

I write lots of letters to the people responsible for oversight. Unlike some I do understand how a representative republic works.

Your hypothesis that most pilots don’t agree with my position based on response here is very anecdotal. There is a very small group of pilots active on this board.

 

[Salty]

I write lots of letters to the people responsible for oversight. Unlike some I do understand how a representative republic works.

Your hypothesis that most pilots don’t agree with my position based on response here is very anecdotal. There is a very small group of pilots active on this board.

I think he’s saying that it would not be popular among those you’d have to convince, not people here. It would be pretty hard to convince a politician to be “against” being strict on drinking and flying. It just doesn’t make a good sound bite. The ignorant masses are not going to know or care about the details.

 

[BladeSlap]

in the US, Congress has ultimate oversight of the FAA. “All” you have to do is convince them to tell the FAA to lighten up. Personally, I think your odds are not good.

consider the paths you might take - try to convince the FAA directly, convince Congresscritters directly, lobby via someone like AOPA, use the courts, or create a grass roots groundswell in the public. In each case, you’re unlikely to get nothing more than laughter at the suggestion to ease up on alcohol abuse by pilots. But consider…if you can’t convince any significant number of people in these groups, maybe the problem doesn’t lie with the regulations, but rather that your wish is out of line with what everyone else wants.

Just make sure you record them when the laugh at the voting professional pilot who was stabbed, only to lose his career, or the woman sexually assaulted just to be victimized again by the FAA.

 

[BladeSlap]

The only route that could ever have a chance of succeeding is to convince Congress that the FAA should not be allowed to use different medical standards than the rest of the professional medical community. This should apply across a broad swatch of both mental and physical health criteria the FAA uses. If the docs the FAA use step beyond the boundaries of current professional standards, there should be remedies via removal of their professional certifications/licenses.

Accountability

I sign with my certificate every time I pull collective, any mistake I make will hit me and my future career.

The FAA doctors who put people into HIMS should have to put their medical license on that choice, and if it was inappropriate their state license board should make that determination and any remedies

 

[Daleandee]

“Deviant behavior”?

I noted "for want of a better term." BTW ... Google can be your friend:

Deviant behavior is conduct that deviates from the societal norm. By this definition alone, deviance is neither good nor bad, but must be evaluated on a case-by-case basis. Such behavior may be described as "different," or "unexpected," and may elicit positive or negative responses from other people.

 

[bflynn]

Your hypothesis that most pilots don’t agree with my position based on response here is very anecdotal. There is a very small group of pilots active on this board.

My hypothesis is that most people won’t agree with lessening alcohol standards for pilots.

But, best of luck.

 

[bflynn]

The only route that could ever have a chance of succeeding is to convince Congress that the FAA should not be allowed to use different medical standards than the rest of the professional medical community. This should apply across a broad swatch of both mental and physical health criteria the FAA uses. If the docs the FAA use step beyond the boundaries of current professional standards, there should be remedies via removal of their professional certifications/licenses.

except…

the FAA isn’t regulating the people from the rest of the world. They’re focused on pilots, with specific attention on promoting flight safety and a pretty good track record on the outcome. You don’t like how they accomplish it…for the record, I don’t either. But it’s their method and lowering the standards must mean lowering the results.

 

[Daleandee]

But it’s their method and lowering the standards must mean lowering the results.

I've often wondered how they could/would accomplish such a feat as that. FWIW many of us would like to see a system that is not as strict as the current one. How to do that is the challenge.

But consider a scenario where a pilot has been on a three day bender that is narrowly, yet legally, 8 hours from bottle to throttle (some airlines use 12 hours) flying your wife and children over the mountains at night in hard IFR and turbulence with a hangover & headache to match. Wouldn't you want someone that was clean, sober, well rested, and wholly focused on the task at hand?

 

[Jeff Oslick]

except…

the FAA isn’t regulating the people from the rest of the world. They’re focused on pilots, with specific attention on promoting flight safety and a pretty good track record on the outcome. You don’t like how they accomplish it…for the record, I don’t either. But it’s their method and lowering the standards must mean lowering the results.

Following modern, up to date, health care diagnoses and treatments, and typical outcomes, is not "lowering standards". If many of their methods were subject to independent peer review I suspect they would be heavily critiqued by outside professionals.

This is not an issue restricted to the FAA. In a number of other situations I am aware of, government workers at both state and federal levels are protected from being subject to normal professional standards.

 

[bflynn]

I disagree. Having a standard tougher than the medical norm for detecting alcohol abuse means using the medical norm would result in some pilots not being identified.

We don’t have to guess. How many alcoholics don’t get identified under the normal medical standards and kill someone in a car crash? How many pilots under the FAA system?

 

[Tarheelpilot]

My hypothesis is that most people won’t agree with lessening alcohol standards for pilots.

But, best of luck.

It’s not so much about lessening alcohol standards. I would love to have this conversation but this not the venue. I understand what you are saying but I’m not able to fully express myself here. Apologies if it appears that I’m being obtuse.

 

[Tarheelpilot]

except…

the FAA isn’t regulating the people from the rest of the world. They’re focused on pilots, with specific attention on promoting flight safety and a pretty good track record on the outcome. You don’t like how they accomplish it…for the record, I don’t either. But it’s their method and lowering the standards must mean lowering the results.

That logic only works if one assumes the safety record is due to their policies. That’s a very big assumption.

 

[Half Fast]

Following modern, up to date, health care diagnoses and treatments, and typical outcomes, is not "lowering standards". If many of their methods were subject to independent peer review I suspect they would be heavily critiqued by outside professionals.

This is not an issue restricted to the FAA. In a number of other situations I am aware of, government workers at both state and federal levels are protected from being subject to normal professional standards.

BUT,..

It isn’t the job of the FAA to “diagnose and treat” and they don’t.

The FAA’s job is to examine pilots against a set of standards for airmen and thereby control who can be in control of an airplane.

Different purposes, hence different criteria.

 

[pilot445]

The FAA seems to think its their job to mandate alcoholism medical treatment in the HIMS program regardless of the case. It doesn’t make much sense to send someone with a 10 years in the past pre-flying DUI to rehab in every case, yet that’s exactly what occurs.

 

[Lachlan]

The FAA seems to think its their job to mandate alcoholism medical treatment in the HIMS program regardless of the case. It doesn’t make much sense to send someone with a 10 years in the past pre-flying DUI to rehab in every case, yet that’s exactly what occurs.

DUIs are not always sent to HIMS. Crank up that BAC to a high enough level and you’ll get your wish. It’s not only alcohol, though. Drug possession convictions often require very similar evaluations and expensive follow up. ADD/ADHD, bipolar disorder, schizophrenia, etc., some have “no chance, ever!” But alcohol, that should be allowed to slide? Why? Or why not? Should we just have the FAA bag it all and hand out licenses to everyone who feels they deserve to fly? What’s the worst that could happen?

 

[Half Fast]

Should we just have the FAA bag it all and hand out licenses to everyone who feels they deserve to fly? What’s the worst that could happen?

The answer would be “Sport Pilot.”

And so far I haven’t seen that category overwhelmed with crashing drunks.

 

[Lindberg]

My hypothesis is that most people won’t agree with lessening alcohol standards for pilots.

But, best of luck.

I have several family members fearful of flying, even commercial. They have a long list of concerns, some justified, some not. The pilots having at one time been really, really drunk in their free time wouldn't crack the top 20.

 

[pilot445]

DUIs are not always sent to HIMS. Crank up that BAC to a high enough level and you’ll get your wish. It’s not only alcohol, though. Drug possession convictions often require very similar evaluations and expensive follow up. ADD/ADHD, bipolar disorder, schizophrenia, etc., some have “no chance, ever!” But alcohol, that should be allowed to slide? Why? Or why not? Should we just have the FAA bag it all and hand out licenses to everyone who feels they deserve to fly? What’s the worst that could happen?

What’s interesting is that’s exactly what the FAA is forced to do with Sport Pilot as far as medical standards go with just a Drivers License required. ADD/ADHD and Bipolar are good to go.

 

[Jeff Oslick]

BUT,..

It isn’t the job of the FAA to “diagnose and treat” and they don’t.

If ordering someone into AA isn't diagnose and treatment, then I don't know what is.

 

[Half Fast]

What’s interesting is that’s exactly what the FAA is forced to do with Sport Pilot as far as medical standards go with just a Drivers License required. ADD/ADHD and Bipolar are good to go.

It’s also where Basic Med has forced them, after the one-time medical. Rather than a lifetime of HIMS, a pilot can let his 3rd class expire and go Basic.

 

[bflynn]

The answer would be “Sport Pilot.”

And so far I haven’t seen that category overwhelmed with crashing drunks.

No category is overwhelmed with them. The best study I can find is between 2000-2007, there were 12 cases over 8 years of pilots with prior alcohol offenses having accidents. 1 of those was in a Pitts S-1, 9 in certificated aircraft and 2 not mentioned. At 1.5 cases per year across all of aviation, certainly not overwhelming. https://libraryonline.erau.edu/online-full-text/faa-aviation-medicine-reports/AM08-22.pdf

That's only covering 3 years at the beginning of sport pilot, but my takeaway is that we're dealing with such a small group that drawing conclusions from it must be unreliable. Even just getting down to how many sport hours are flown in the US is very difficult. I did see...in the most recent Nall report?...that sport pilot makes up 15% of fatal accidents, but there were no probable causes associated with them. I think we would be hard pressed to say sport makes up 15% of flying, but I don't think alcohol is a significant factor in the count of any category of crashes.

A not very useful link, but a reminder to me that the FAA is looking at everything. This is a report from the FAA forensic team on the findings of fatal accident autopsies. There is some discussion of alcohol in here, but I didn't see any concrete numbers tied back to flight rules. https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2020s/media/202013.pdf

 

[pilot445]

If ordering someone into AA isn't diagnose and treatment, then I don't know what is.The diagnosis however would have been made

No category is overwhelmed with them. The best study I can find is between 2000-2007, there were 12 cases over 8 years of pilots with prior alcohol offenses having accidents. 1 of those was in a Pitts S-1, 9 in certificated aircraft and 2 not mentioned. At 1.5 cases per year across all of aviation, certainly not overwhelming. https://libraryonline.erau.edu/online-full-text/faa-aviation-medicine-reports/AM08-22.pdf

That's only covering 3 years at the beginning of sport pilot, but my takeaway is that we're dealing with such a small group that drawing conclusions from it must be unreliable. Even just getting down to how many sport hours are flown in the US is very difficult. I did see...in the most recent Nall report?...that sport pilot makes up 15% of fatal accidents, but there were no probable causes associated with them. I think we would be hard pressed to say sport makes up 15% of flying, but I don't think alcohol is a significant factor in the count of any category of crashes.

A not very useful link, but a reminder to me that the FAA is looking at everything. This is a report from the FAA forensic team on the findings of fatal accident autopsies. There is some discussion of alcohol in here, but I didn't see any concrete numbers tied back to flight rules. https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2020s/media/202013.pdf

The real question is, what proportion of accidents can be attributed to lack of experience vs uncertifiable medical issues. Those are the two factors that make sport pilot unique.

 

[bflynn]

The real question is, what proportion of accidents can be attributed to lack of experience vs uncertifiable medical issues. Those are the two factors that make sport pilot unique.

That is the question. But the FAA almost never assigns a probable cause to a medical deficiency, so we don't know. For example, if the pilot had a heart attack, it's likely to say LOC, especially if a post crash fire burns everything up.

 

[forks]

I did see...in the most recent Nall report?...that sport pilot makes up 15% of fatal accidents

That's not the case. The report states that 15% of accidents in which a sport pilot was involved were lethal (3 out of 20 accidents). The overall lethality of all non-commercial fixed-wing accidents was 18.1%


Sport pilots accounted for 2% of all accidents (20 out of 988 accidents).


Ron @wanttaja published his research in Kitplanes Magazine under the title "Homebuilt Accidents: The Pilot’s Condition" and concluded that the introduction of the Sport Pilot certificate "didn’t lead to a large increase in the number of incapacitation accidents."

 

[Daleandee]

The real question is, what proportion of accidents can be attributed to lack of experience vs uncertifiable medical issues. Those are the two factors that make sport pilot unique.

This is quite accurate. Light Sport planes are light and can catch a GA pilot unawares by the need for quicker control input, faster reaction times, much lighter control forces, and sometimes how fast they slow down during landings because of lack of weight/energy.

We are currently replacing a gear leg on an ELSA that a GA pilot let get too slow on landing and flared it a little too high. Damaged the gear and his ego but other than that it was all good.

Paul B. has a good video on this:

 

[BladeSlap]

I disagree. Having a standard tougher than the medical norm for detecting alcohol abuse means using the medical norm would result in some pilots not being identified.

We don’t have to guess. How many alcoholics don’t get identified under the normal medical standards and kill someone in a car crash? How many pilots under the FAA system?

That’s called not following standards.

There is a reason we make a standard, if you move it forward OR backward you’re no longer following the standard.

In a normal auto rotation I shoot for 70kts, the DPE isn’t just looking that I don’t go under 70, and he also not happy if I go over 70kts, the number is 70 and he wants to see 70

Agreed upon modern medical standards, you ether following them or you're not

 

[bflynn]

That's not the case. The report states that 15% of accidents in which a sport pilot was involved were lethal (3 out of 20 accidents)

Thank you for the correction - reading late at night, it's possible to misread.

But I think we're still talking about small numbers and therefore statistics becomes much less useful for evaluation.

 

[bflynn]

That’s called not following standards.

There is a reason we make a standard, if you move it forward OR backward you’re no longer following the standard.

Half Fast said above - the task is different and so there should be a different standard. The FAA is not medically diagnosing people, that isn't what occupational medicine does. They are identifying people to monitor.

My own case with them - my doctor was interested in a sound he heard listening to my heart, referred me to a cardiologist, who had me do an echo. The sound was identified and it's not a problem. BUT.....FAA medical comes along and sees that an echo was done and wants to look at it more closely. So I'm required to have additional monitoring and a stress test. Why? Because what I reported on my medical identified me as potentially having a disqualifying condition. The FAA wanted to know if I did. My doctor also said that it was ridiculous and I agreed. But it was also true that I wasn't getting a medical until I complied, so we did the additional testing.

The same thing happens with alcohol. A pilot who has been counseled not to drink excessively reports on his medical that he was mugged and stabbed waiting on an uber. The FAA looks at his discharge paperwork, notes the BAC reading, combines that with history, and questions if the pilot has a drinking problem. So the pilot must enter the FAA's program for monitoring to know if he has a problem. This is the FAA process at work. It's isn't special for alcohol, it's just the way it works.

The only difference between what I described for the alcohol situation and my own is a matter of degree. My testing cost less and took less time, but I was otherwise treated the same. That's what occupational medicine does.

 

[BladeSlap]

Half Fast said above - the task is different and so there should be a different standard. The FAA is not medically diagnosing people, that isn't what occupational medicine does. They are identifying people to monitor.

My own case with them - my doctor was interested in a sound he heard listening to my heart, referred me to a cardiologist, who had me do an echo. The sound was identified and it's not a problem. BUT.....FAA medical comes along and sees that an echo was done and wants to look at it more closely. So I'm required to have additional monitoring and a stress test. Why? Because what I reported on my medical identified me as potentially having a disqualifying condition. The FAA wanted to know if I did. My doctor also said that it was ridiculous and I agreed. But it was also true that I wasn't getting a medical until I complied, so we did the additional testing.

The same thing happens with alcohol. A pilot who has been counseled not to drink excessively reports on his medical that he was mugged and stabbed waiting on an uber. The FAA looks at his discharge paperwork, notes the BAC reading, combines that with history, and questions if the pilot has a drinking problem. So the pilot must enter the FAA's program for monitoring to know if he has a problem. This is the FAA process at work. It's isn't special for alcohol, it's just the way it works.

The only difference between what I described for the alcohol situation and my own is a matter of degree. My testing cost less and took less time, but I was otherwise treated the same. That's what occupational medicine does.

I disagree.

I also trust modern medicines opinion of health over some doctor in OKC.

Did some research, a lot of those doctors make under 200k a year, based on a public records, you don’t get the best and brightest doctors for that price.

I don’t have many names, but I also wonder how many of the doctors in OKC were full time pilots, feels like we are taking the word of less than qualified people on our health, vs following very researched and proven modern medicine.
If you’re fit enough to be a judge with your mind, or logger with your body, I think you’re fit enough to sit in a seat and move flight controls.

The argument for NOT using modern medical standards, is a argument I think a logical mind would not want to press.