Basic Med above 18,000MSL?

DFH65 said:
Not everyone on Basic Med goes that route because they have a medical issue that prevents them from getting a class 3. Many could get a class three but don't want to put up with the cost and time related to proving to the FAA they are worthy.

The FAA medical system is a mess.
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Why an individual chooses not to get a medical is irrelevant. The fact that they choose not to subject themselves to the time and expense of proving even the minimal health criteria of a third class medical simply means they’re an unknown, and the FAA has chosen to not allow unknowns to act as PIC in the chunk of airspace that is more restrictive than most any other and airplanes that fall under more stringent rules for certification.
 
Brad W said:
the only thing I can think of is that the doc doing a class 3 should presumably have some focused aeronautical knowledge/training
where the basic med doc may not..... you'd think all docs would have a pretty solid understanding of the physiology, but sadly I think there's lots "they" don't know.....
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But what do they do to test anything to do with breathing? If there was an issue, then the FAA would add a pulmonary function test. There are small simple devices to do a basic FVC and FEV1. My PCP does for every physical. So he has a better idea of my capability to deal with altitude that any AME I would see.
 
Common causes of sudden incapacitation include heart disease & diabetes, so testing for that seems appropriate. And checking medical history. But no test is perfect, the best any test can do is detect obvious indicators or correlating factors.

If they really care about high altitude function, they'd do the whole treadmill protocol. But even that is only a rough guide. Climbing mountains, I've seen fit endurance athletes get altitude sickness where some couch potatoes do fine. Being fit with high cardio function is correlated with good high altitude function but there are plenty of exceptions.
 
OneCharlieTango said:
How does undiagnosed diabetes lead to sudden incapacitation?
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Ever heard of ketoacidosis? Not to mention just blood sugar management. A relative's diabetes that I grew up around could have put that relative in a state within less than 20 minutes that you wouldn't have wanted them to be your pilot.
 
With Diabetes, a major different is whether the person is taking insulin or not. Hopefully obvious, everybody with Type 1 Diabetes has to use insulin. Some people with Type 2 Diabetes require insulin. If sugar is showing up in a urine sample then it is pretty bad meaning either known and very badly controlled or previously undiagnosed and pretty bad. Either way, sugar unexpectedly present in urine typically means the person needs to go see a doctor ASAP and passing a FAA medical is no longer their top concern.
People with Type 1 Diabetes are now allowed to get a medical now. It is not a trivial process but it is possible. Many conditionals, among them (but not limited to), it has to be well controlled and (last time I checked) there are in-flight blood testing requirements.

It is not uncommon for people to be in ketoacidosis during initial diagnosis of Type 1 Diabetes.
 
Honestly. What are the odds that an adult with no prior symptoms or diagnosis of diabetes is going to suddenly go into DKA while piloting an airplane?
 
OneCharlieTango said:
What are the odds that an adult with no prior symptoms or diagnosis of diabetes is going to suddenly go into DKA while piloting an airplane?
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Low.

There are many medical issues that can pop up with no advance warning. I have no idea what medical issues are more likely than others to suddenly incapacitate a person. Note that for many conditions (including Diabetes) symptoms which are obvious for a Doctor or which are obvious in hindsight to a "regular" person may not be seen for what they are prior to a diagnosis. So, there very well could be prior symptoms of diabetes which simply are not seen for what they are. After diagnosis they would be obvious in hindsight.

I do appreciate having a second person with me who is capable of taking over in the unlikely event that I suffer a sudden and incapacitating medical emergency. Which does not necessarily mean a certificated pilot. And which also does not mean that I do not fly solo.
 
I think the big difference is that a class III if done correctly identifies high risk medical problems for pilot incapacitation, or degraded performance. Some examples include but are not limited to insulin requiring diabetes, seizure disorders, heart failure, coronary artery disease, suicidal depression, severe neuromuscular disease, disqualifying medications like prescription narcotics etc. You can have all those conditions and if your doc says you are stable, he can sign off on your DL, and can sign off on your basic med if he/eh feels you are OK, especially if they have no real knowledge of the demands of flying and flight physiology. Depending on case, those medical problems might not be compatible with the pilot that you want flying your family. The fact that flying is as safe as it is from a medical incapacitation standpoint is as much about the people that are never allowed to be pilots, as it is people that are pilots that are heavily monitored.
 
Rockymountain said:
... The fact that flying is as safe as it is from a medical incapacitation standpoint is as much about the people that are never allowed to be pilots, as it is people that are pilots that are heavily monitored.
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^^^ BINGO ^^^
 
Not necessarily, since anyone on BasicMed had to have a 3rd class medical at some point.
 
MRC01 said:
Not necessarily, since anyone on BasicMed had to have a 3rd class medical at some point.
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Yeah, but "at some point" might be 15+ years ago. And people using Basic Med may have developed any number of new maladies since that last class 3, even while on Basic Med, that the FAA knows nothing about. Yet Basic has as good a record as 3rd class.
 
Rockymountain said:
The fact that flying is as safe as it is from a medical incapacitation standpoint is as much about the people that are never allowed to be pilots,...
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The FAA boasts that over 99.5% of applicants are (eventually) issued medicals. If even 10% of those rejects would have crashed a plane if allowed to fly (a dubiously high number), then we're expending an awful lot of resources to weed out 0.05%.
 
Pinecone said:
But what do they do to test anything to do with breathing? If there was an issue, then the FAA would add a pulmonary function test. There are small simple devices to do a basic FVC and FEV1. My PCP does for every physical. So he has a better idea of my capability to deal with altitude that any AME I would see.
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Wouldn't anemia have implications for the altitude at which supplemental oxygen would be needed?
 
Palmpilot said:
Wouldn't anemia have implications for the altitude at which supplemental oxygen would be needed?
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Do they test for that for a Class 3? Nope. Not even for a Class 2. I never did a Class 1 FAA one.
 
MRC01 said:
Not necessarily, since anyone on BasicMed had to have a 3rd class medical at some point.
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And then they had a reason to go BasicMed rather than renew Class 3. That means people with health problems should be over represented in the BasicMed group. It’s certainly true that people requiring Special Issuance are over represented in the BasicMed group, suggesting that not only is Class 3 worthless, but Special Issuances are particularly worthless.
 
Pinecone said:
Do they test for that for a Class 3? Nope. Not even for a Class 2. I never did a Class 1 FAA one.
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During a period when I was anemic, I was told by two or three AMEs that it would be a problem for renewing my medical. It comes out in response to questions 18x and 19.
 
Half Fast said:
The FAA boasts that over 99.5% of applicants are (eventually) issued medicals. If even 10% of those rejects would have crashed a plane if allowed to fly (a dubiously high number), then we're expending an awful lot of resources to weed out 0.05%.
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At what cost to the applicants I wonder.
 
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