Basic Med and AME

Ventucky Red

Ventucky Red

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Getting to be that time and I am considering going to basic med due to the sleep apenea thing I have going on... Had no problem getting a Special Issuance last year and I don't foresee it being a problem this year either if I go with a Third Class. I was just starting the therapy at the time of my medical and have been averaging 7 hours a night for about 85% of the time... well beyond the requirement.

My question is are AMEs doing the physicals for Basic Med or are they referring you-back to your primary care physician if going to basic med is a work around for the special issuance? I feel a little weird contact the guy I have been using forever.... and I don't how that community feels about this as it is taking money away from them...

Thanks
 
Ventucky Red said:
Getting to be that time and I am considering going to basic med due to the sleep apenea thing I have going on... Had no problem getting a Special Issuance last year and I don't foresee it being a problem this year either if I go with a Third Class. I was just starting the therapy at the time of my medical and have been averaging 7 hours a night for about 85% of the time... well beyond the requirement.

My question is are AMEs doing the physicals for Basic Med or are they referring you-back to your primary care physician if going to basic med is a work around for the special issuance? I feel a little weird contact the guy I have been using forever.... and I don't how that community feels about this as it is taking money away from them...

Thanks
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When my primary care physician saw the FAA's recommended reading list in the BasicMed instructions, he decided that he didn't have time to learn what he needed to learn about aeromedical issues. When I asked my AME if he was doing them he said yes, but that it was preferable (or something like that) to do it with my primary care physician. When I told him that my PCP had declined and why, he agreed to do it.
 
I went to a local urgent care clinic well known for providing physicals for DOT, schools, sports, camp, and other activities.

Brought all required medical history items, the forms, and the info AOPA had created for the benefit of the doctors. As I was the first for this doc to request the BasicMed exam, he had some questions about the process. Once he had his answers, he administered the exam (including checking my lower exhaust port) and signed the papers.

Many others have reported BasicMed success with these clinics versus visiting their PCP’s or AME’s. So that might be the best route for you.
 
Yes, I used clinic that does DOT physicals, faster than my GP, and more knowledgeable about BasicMed criteria.
 
I asked my AME if he would be willing to do my BasicMed exam because I knew that my PCP did not have the equipment to do color vision and ocular alignment testing. My AME had been encouraging me to apply for a 3rd class, but I decided it would be safer to go BasicMed (no jeopardy), and my AME was quite willing. It varies widely: some will do it, others will not or are forbidden to by their clinic.
 
Ventucky Red said:
Getting to be that time and I am considering going to basic med due to the sleep apenea thing I have going on... Had no problem getting a Special Issuance last year and I don't foresee it being a problem this year either if I go with a Third Class. I was just starting the therapy at the time of my medical and have been averaging 7 hours a night for about 85% of the time... well beyond the requirement.

My question is are AMEs doing the physicals for Basic Med or are they referring you-back to your primary care physician if going to basic med is a work around for the special issuance? I feel a little weird contact the guy I have been using forever.... and I don't how that community feels about this as it is taking money away from them...

Thanks
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Just curious, if it's no problem, why not just stay with the 3rd class? I have SA and get a SI myself and get a 2nd class with no problem.
 
At least with my SI for sleep apnea it was a yearly issue. Now with basic med it's a physical every 4 years and internet class every 2 years. I think it's worth it. I did my basic med exam when I got my DOT medical exam, worked out great.
 
I let my III Class expire, then went to my PCP a day or so later, to be clear of the FAA clutches; never looked back, and no reason to see an AME ever again. Keep in mind, the AME works for the FAA - you just get to pay the fee.

I had dodged the bullet on the sleep apnea nonsense, which was always a pointless, artificial road block; no data ever supported that bizarre decision. No SI, etc., but decided I'd not give the FAA another shot at me.
 
Said like a guy who doesn't want to get better....
I'd feel better if you ordered up your home sleep study (home) on your own and you knew.....

If you have it and are untreated, you die younger, perform more poorly, get right heart failure, pulmonary hypertension....."which was always...pointless". Being left on your own recognizance is great, but you need to be responsible for your self.
 
bbchien said:
Said like a guy who doesn't want to get better....
I'd feel better if you ordered up your home sleep study (home) on your own and you knew.....

If you have it and are untreated, you die younger, perform more poorly, get right heart failure, pulmonary hypertension....."which was always...pointless". Being left on your own recognizance is great, but you need to be responsible for your self.
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My CPAP machine literally saved my life. If nothing else, from being a hwy casualty from falling asleep at the wheel. I can’t imagine not having the machine any more.
 
So Bruce, since you chimed in and because you are my absolute favorite AME, will/can you do BasicMed? Apologies if you've already weighed in on that issue.

Greg
 
iflyvfr said:
So Bruce, since you chimed in and because you are my absolute favorite AME, will/can you do BasicMed? Apologies if you've already weighed in on that issue.

Greg
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Sigh.
The insurance co. wants $24,000 to do them. I can't make that work. :(
 
bbchien said:
Said like a guy who doesn't want to get better....
I'd feel better if you ordered up your home sleep study (home) on your own and you knew.....

If you have it and are untreated, you die younger, perform more poorly, get right heart failure, pulmonary hypertension....."which was always...pointless". Being left on your own recognizance is great, but you need to be responsible for your self.
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Said like a guy who doesn't/didn't have sleep apnea; and having a competent personal physcian, and overwhelming evidence to support that conclusion; more to the point, it isn't, or shouldn't be, the FAA's place to play big brother and make such calls about personal health, when it's also overwhelming clear that it was/is of near zero impact to aviation safety for III Class medical holders.
 
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I looked in to going to an outfit that does DOT physicals, but what I have found is that most of them do not have a state licensed physician on staff, but rather "licensed examiners." Some of the chiropractors do them as well, but I have not been able to nail down if a chiropractor constitutes a state licensed physician in California.
 
Sac Arrow said:
I looked in to going to an outfit that does DOT physicals, but what I have found is that most of them do not have a state licensed physician on staff, but rather "licensed examiners." Some of the chiropractors do them as well, but I have not been able to nail down if a chiropractor constitutes a state licensed physician in California.
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I had mine done at a DOT place only to find out the same thing. The guy who did the evaluation was apparently not an MD, which I didn't know. When it was time to sign the form he excused himself and came back 5 minutes later saying he couldn't sign it but a doc would be in later and I could pick it up in the afternoon, which I did. Guess I got lucky?
 
BrianNC said:
My CPAP machine literally saved my life. If nothing else, from being a hwy casualty from falling asleep at the wheel. I can’t imagine not having the machine any more.
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I never had a problem with any form of daytime sleepyness. My problem was just the opposite - I started having problems falling asleep. I was snoring myself awake just as I was drifting off, and it was taking me upwards of two hours just to fall asleep. I went and had a sleep study and it showed I had OSA.

As soon as I got the CPAP machine, I immediately took to it, and in the four years I've been on it, I recall only two nights I didn't use it, and that was only because I pulled all-nighters packing up a house for a move. CPAP therapy has been the single best medical and quality-of-life decision I ever made.

If anybody out there has similar problems falling asleep, or if you sleep with somebody and they observe you snoring/choking/gasping - PLEASE go do a sleep study and get checked out!
 
Sundancer said:
Said like a guy who doesn't/didn't have sleep apnea; and having a competent personal physcian, and overwhelming evidence to support that conclusion; more to the point, it isn't, or shouldn't be, the FAA's place to play big brother and make such calls about personal health, when it's also overwhelming clear that it was/is of near zero impact to aviation safety for III Class medical holders.
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Not true. 90% of accidents are due to PP pilot performance, and there is literally no way to know for sure without at least a home study. And we already have three sentinel events in system.

I'm just sayin.....without some sort of observational, he can't tell.
And, my office is full of guys who will never let go of their CPAP.

"Being a wall" frequently (I'm not saying you) reflects distrust that you might really have it. This is the only part I don't like about basic med. I had a PCP write that his airman has no signs/symptom of SA, but then the guy fell asleep in my office. Um huh. When he awakened he insisted he was "just fine". He is now one with not only the home CPAP, but one at the Cottage, and a travel machine.

You can't know....what you don't know.
 
bbchien said:
Not true. 90% of accidents are due to PP pilot performance, and there is literally no way to know for sure without at least a home study. And we already have three sentinel events in system.

I'm just sayin.....without some sort of observational, he can't tell.
And, my office is full of guys who will never let go of their CPAP.

"Being a wall" frequently (I'm not saying you) reflects distrust that you might really have it. This is the only part I don't like about basic med. I had a PCP write that his airman has no signs/symptom of SA, but then the guy fell asleep in my office. Um huh. When he awakened he insisted he was "just fine". He is now one with not only the home CPAP, but one at the Cottage, and a travel machine.

You can't know....what you don't know.
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Doc, in all sincerity, you are missing the point - and maybe have a dog in the fight, and that colors your eval, as your concern is pilot's health. But pilot incapacitation, to the point that a fatal accident results, is as rare as hen's teeth, and even rarer that an event that sleep apnea would predict occurs. Is sleep apnea serious? Sure is! Is it a causal element, statistically significant in GA accidents. No, it is not, so the FAA is way, way over stepping, and intruding, in personal health management they have no legitimate stake in.

It's great you helped these guys, and that they were willing patients, but it's bogus to say they were a significant risk to aviation safety, due to SA.

Heck Doc, 99% of all accidents should be due to pilot performance - else we'd be dying from mechanical failures, bird strikes, meteor impacts, and/or loss of atomic union. Putting a lot of pilots through an intrusive, expensive, bureaucratically bungled process, because some of them might/might have apnea? FAA is not/not a health service provider, and certainly not equipped or competent to mandate treatment. Or to enforce life style choices - a fat, overweight, smoker pilot will probably, eventually, flunk a physical. His/her choice, not Uncle Sam's.
 
Why on earth would you use a AME for basic Med, kinda defeats the point lol

Heck, based off the "mandatory retirement" in the professional pilot world, it proves the medical is a joke anyways and should be done away with, you want to improve safety just have a IQ test to become a pilot, but that doesn't mesh with the new no kid left behind nonsense.
 
James331 said:
Why on earth would you use a AME for basic Med, kinda defeats the point lol
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Not at all. The standards for BasicMed are different than for 3rd class. What difference does it make if they are applied by an AME vs. any other physician? It makes no less sense for an AME to do both a 3rd class exam and a BasicMed exam than for an AME to do both 1st class and 3rd class exams.

And there may be reasons to go to an AME vs a PCP, such as that your PCP balks because of various reasons. In my case it would have been lack of equipment to test color vision and ocular alignment, as he later admitted, even though he was initially willing to do the exam. I would have had to go to an ophthalmologist and pay out of pocket (several hundred dollars), since those tests (at least ocular alignment) are not part of a regular eye exam and aren't medically necessary. With the AME, it was a cinch, and cost no more than a regular 3rd class exam.

The main reason I went BasicMed is to avoid the costs of maintaining an SI, not to keep away from the AME.
 
azure said:
Not at all. The standards for BasicMed are different than for 3rd class. What difference does it make if they are applied by an AME vs. any other physician? It makes no less sense for an AME to do both a 3rd class exam and a BasicMed exam than for an AME to do both 1st class and 3rd class exams.

And there may be reasons to go to an AME vs a PCP, such as that your PCP balks because of various reasons. In my case it would have been lack of equipment to test color vision and ocular alignment, as he later admitted, even though he was initially willing to do the exam. I would have had to go to an ophthalmologist and pay out of pocket (several hundred dollars), since those tests (at least ocular alignment) are not part of a regular eye exam and aren't medically necessary. With the AME, it was a cinch, and cost no more than a regular 3rd class exam.

The main reason I went BasicMed is to avoid the costs of maintaining an SI, not to keep away from the AME.
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If I didn't fly for a living I'd go basic Med and do it with a PCP, if the PCP couldn't/wouldn't do it, I'd find a new PCP.

One of the things with basic med is its one more step away from government types, and historically the further away from them the better off you often are.
 
Glen R said:
I had mine done at a DOT place only to find out the same thing. The guy who did the evaluation was apparently not an MD, which I didn't know. When it was time to sign the form he excused himself and came back 5 minutes later saying he couldn't sign it but a doc would be in later and I could pick it up in the afternoon, which I did. Guess I got lucky?
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Actually, you're not not BasicMed compliant. The state-licensed physician actually has to conduct the clinical examination. A PA or NP can't phone it in for the physician to sign. Sure, the physician can have assistance with the exam such as collecting medical history, vitals, etc., but the state-licensed physician actually has to see you.
 
Sundancer said:
Doc, in all sincerity, you are missing the point - and maybe have a dog in the fight, and that colors your eval, as your concern is pilot's health. But pilot incapacitation, to the point that a fatal accident results, is as rare as hen's teeth, and even rarer that an event that sleep apnea would predict occurs. Is sleep apnea serious? Sure is! Is it a causal element, statistically significant in GA accidents. No, it is not, so the FAA is way, way over stepping, and intruding, in personal health management they have no legitimate stake in.

It's great you helped these guys, and that they were willing patients, but it's bogus to say they were a significant risk to aviation safety, due to SA.
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It's also bogus to say, "there are no statitistics for aviation deaths from SA". Why? There are no findings a postmortem to identify it.
Heck Doc, 99% of all accidents should be due to pilot performance - else we'd be dying from mechanical failures, bird strikes, meteor impacts, and/or loss of atomic union. Putting a lot of pilots through an intrusive, expensive, bureaucratically bungled process, because some of them might/might have apnea? FAA is not/not a health service provider, and certainly not equipped or competent to mandate treatment. Or to enforce life style choices - a fat, overweight, smoker pilot will probably, eventually, flunk a physical. His/her choice, not Uncle Sam's.
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No dog here at all. I'm turning some pilots away I'm so busy.

But the outline for certification in the face of SA is totally taken from the American Assoc. of Sleep Physician's 2009 consensus paper. It is so totally aligned with how "you should be diagnosed and treated". No more.

I've got literally ten of guys (not quite 100) who got stented and didn't report that (discovered after a non-CV incident involving the aircraft). Self policing only works to a point. If your doc is a sleep doc and he thinks you don't have it that's one thing.....but there is a lot of self deception. And if you argue, "well the medical doesn't prevent coronary deaths" this conversation is over. It was intended to reduce same and it clearly does- see Webster, et. al, 2012 in the CAMI library.

And I'm basically libertarian! I detest that the Basic Med signoff was changed in the Senate such that the trial lawyer can access the doc's malpractice policy, that it's impossible to do your taxes by yourself any longer, and I generally think you should be able to insurance regulate your risk.

But then there will be guys who decide, "I'm judgement proof and I'm gonna do this...". You can't win.
 
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Actually, I meant "your dog in the fight" was your concern for aviator's health - did not mean to imply it was your wallet. Leaving out SA as a cause (or not a cause) there just aren't many accidents caused by pilot incapacitation - certainly not enough to justify such an intrusive boondoggle. What I'm arguing is that the FAA is out of line in this - not arguing that pilots (or anyone else) should ignore health danger signs. But am arguing the FAA doesn't have a a legitimate interest, not one supported by facts. High cholesterol? Gonna test for that? Hey, we can't know if your coronary arteries are calcified without a cardiac CT for calcium so, so do we send everybody out for one of those? For guys who average 100 hours per year (about 0.114% of the time), it's not rational, or effective. There are risks we share just being alive, and there needs to be a common sense acceptance of when the mitigation becomes extremism.

Granted, some accidents may have been the result of incapaciation, and we may miss those just because we can't know - but a spin out of the base-to-final turn probably wasn't, or continued VFR into IFR, etc. are usually clearly obvious as the cause. But we stil make airplanes with rudders, and without autopilots.

Anyway, rational people can disagree. . .
 
Sundancer said:
...might/might...

...not/not...
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Pardon me for going off topic for a moment, but I have been wondering what it signifies when you repeat a word with a slash in between. I see that a lot, and it's been puzzling me. :confused2:
 
Palmpilot said:
Pardon me for going off topic for a moment, but I have been wondering what it signifies when you repeat a word with a slash in between. I see that a lot, and it's been puzzling me. :confused2:
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Well the first one should’ve been might/might not, So that will make more sense to you. The second one I think is just a mistake. It should’ve just read not once without a slash. But generally speaking you’re putting the slash between two alternatives to the sentence like the might/might not.
 
BrianNC said:
Well the first one should’ve been might/might not, So that will make more sense to you. The second one I think is just a mistake. It should’ve just read not once without a slash. But generally speaking you’re putting the slash between two alternatives to the sentence like the might/might not.
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I keep seeing it with nothing to differentiate what comes before the slash from what comes after. (I never see this on other forums.)
 
Palmpilot said:
I keep seeing it with nothing to differentiate what comes before the slash from what comes after. (I never see this on other forums.)
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Yeah, that must be a mistake. What's on the other side of the slash should be different than what came before the slash. That's why I assume it's a mistake on the not/not. I just looked again. You are right, the might/might' is wrong to. Should have been 'might/might not'. I have no idea what the 'not/not' should have been. lol.
 
gdwindowpane said:
He was probably sleepy when he posted...
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Sorry, beginning to realize it's not a convention that's commonly recognized; someone asked on another post I made, as well - it's meant to indicate emphasis, certainty, but without the "shouting" implied by using all caps. Picked it up within my work community, but clearly it's not universal, so I'll abstain, or go with italics, etc.
 
Sundancer said:
Sorry, beginning to realize it's not a convention that's commonly recognized; someone asked on another post I made, as well - it's meant to indicate emphasis, certainty, but without the "shouting" implied by using all caps. Picked it up within my work community, but clearly it's not universal, so I'll abstain, or go with italics, etc.
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Mystery solved!
 
Sundancer said:
it's meant to indicate emphasis, certainty, but without the "shouting" implied by using all caps.
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Makes sense. I tend to use this technique for *emphasis* like that.

It’s a bleed over for me from email that bolds the text in between the *s with certain formats.
 
In a poorly written request for proposal I've seen the criteria listed as "and/or". You better believe the contractor will deliver the "or" choice.
 
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