bbchien
Touchdown! Greaser!
Well, heck, Sec'y Pena's commentary was "We will tolerate no accidents".
More Change at FAA medical
- Thread starter bbchien
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bbchien
Touchdown! Greaser!
The postponement notice cited that they hadn't effectively gotten the word out to the AMEs......
ateamer
Pattern Altitude
Keep in mind that DOGE - if it actually comes into existence- will only be an advisory board. It will only make recommendations, without the authority for compel compliance. Many government functions and departments are set by statute.
Kenny Phillips
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Kenny Phillips
Too bad they don't.
True.
Bear in mind, though, that the two primary advisers have tremendous resources and influence, and since they’re not USG employees and have no “official” government role, they’re not constrained by regulations that restrain government staff. If they decide some Congress critter is a problem, they can hand $50M to a primary opponent and unleash all sorts of media hell with as much freedom as any other private citizen.
It’s already started. Watch the progress or death of the present CR bill.
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UTLonghorn_1979
That’s exactly right. You have to threaten their jobs and livelihood in order for them to respond.
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Bob Noel
not exactly a good justification
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UTLonghorn_1979
How so? If they aren’t doing their jobs, you run someone against them that will. That’s what a democratic republic does.
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Bob Noel
"threaten" has very different connotations
better to encourage them to do the right thing.
but we are definitely in a very adversarial world now...
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UTLonghorn_1979
Only if easily “triggered.” Please don’t read anything “threatening” into that word either.
Threatening only has the connotation literally ascribed to it…in my use, their job as a tax payer funded employee, senator, representative, etc will be at threat/risk if they continue to defy the will of the people/keep doing a bad job. Just like we saw this past November.
If holding the elected officials accountable is adversarial, we’ll just need to disagree.
Jon Wilder
Pre-takeoff checklist
Well...it appears my assessment of the FAA's interpretation of the 2024 Reauthorization Act Section 801 was spot on.
Sam Graves, House Representative of the 6th District of Missouri, is the House Transportation and Infrastructure Committee Chairman. He leads the House Committee that oversees the FAA. He took issue with the FAA's interpretation—recently cited by Federal Air Surgeon Dr. Susan Northrup in a webinar for aviation medical examiners—that the policy change was enabled by the agency's 2024 reauthorization, specifically Section 801.
And wouldn't you know it, the FAA recanted its previous claim that the 2024 Reauthorization enabled the policy change -
A link to the AOPA article from where these excerpts were taken can be found here.
FAA delays medical denial policy
The FAA on December 18 announced a two-month delay implementing a controversial new policy to deny rather than defer medical certificate applications deemed incomplete.
www.aopa.org
It appears Congress is on it.
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I swear, the FAA could “interpret” the sky to be green and the ocean to be dry.
Let’s ask them to interpret 8/2(2+2). Maybe they’ll stay busy and out of our hair for a while.
Let’s ask them to interpret 8/2(2+2). Maybe they’ll stay busy and out of our hair for a while.
There, it's fixed. LOL Encourage them by threat of losing their elected position. What else motivates most congress critters?
Hookers and blow?
Cap'n Jack
Final Approach
Money. Lots of it.
Statutes authorizing authorities are different than statutes requiring specific actions. Stopping the bureaucracy from doing something required will require legislation and that will be harder to do. But in Med, very little is specifically required by statute. It is required by rules/regulations and policy which are functions of the executive branch which appears on-board with DOGE.
To change rules/regulations is not necessarily hard or easy as it requires the admin to follow the administrative procedures act. Not necessarily hard, but can be slowed down by bureaucrats. For example, there are 15 specific disqualifying conditions in the FAR. It would take time to change these (add, delete, or change). But could easily be done in 2 years.
Policy decisions are relatively easy to change. Just update the policy without violating existing statutes or regulations. Looking at the "guide to the AME", a policy that effectively adds hundreds of disqualifying conditions and getting rid of the stupid stuff could be done very quickly. I expect places like this would be where the initial focus is.
To change rules/regulations is not necessarily hard or easy as it requires the admin to follow the administrative procedures act. Not necessarily hard, but can be slowed down by bureaucrats. For example, there are 15 specific disqualifying conditions in the FAR. It would take time to change these (add, delete, or change). But could easily be done in 2 years.
Policy decisions are relatively easy to change. Just update the policy without violating existing statutes or regulations. Looking at the "guide to the AME", a policy that effectively adds hundreds of disqualifying conditions and getting rid of the stupid stuff could be done very quickly. I expect places like this would be where the initial focus is.
...while sailing on a boat named Monkey Business!
traumamed
Pre-Flight
Money for...
Here's the rub: please define "stupid stuff."
I have been doing aeromedical consulting work on the side for years. I'm not an AME (and have no desire to be), but I know more than the average AME about navigating the FAA bureaucracy for deferrals and successfully obtaining special issuances after denials. In doing this work, I have learned how a lot of that "stupid stuff" made it onto the FAA's radar. As with most of the FARs, there is quite a bit written in blood.
The simple fact is that what the medically uninitiated consider "stupid stuff" often isn't so stupid. None of my clients have ever thought their condition(s) should ground them. If they did, they wouldn't have hired my firm. A big part of my job has been to educate them about the specific risks their condition(s) could pose to their safety of flight, to get them to take ownership of their conditions, and to take management of them seriously.
Most of the common conditions of concern to the FAA are fairly easy to overcome within several months for people who get them under appropriate control. For "disabling" conditions, getting a SODA/LoE via a MFT is often achievable. The people who don't take their conditions seriously and take the attitude that it's "stupid stuff" never get their medical -- and often don't take too long to become my "client" in my main gig over at the hospital.
OK, I'll try. I define "Stupid Stuff" as medical conditions that don't significantly risk the non-participating public in a significant enough manner to justify intrusive federal government intervention.
For example, in my case, prostate cancer. I have never once met a doctor in real life that thought prostate cancer caused any risk of sudden incapacitation in flight. It's not a measurable risk at all, and certainly does not justify an intrusive government bureaucracy. Or the successful 40 year old who took Adderall in 4th grade to get their grades up. Or doctors in OKC who overrule the diagnoses of a doctor who actually examines a patient without an examination. There are many more.
this is the best line….. and so true. Lol
Somebody with prostate cancer thought it should ground them?
No. Somebody with prostate cancer doesn’t believe it should ground them. Exactly what the other poster said. You don’t believe it should - just like everyone else. I mean the bipolar people don’t believe they should be grounded either. Nor a bunch of others.
Cancer in general is a grounding event until it’s proven that it’s clear. It doesn’t seem to matter if it’s skin cancer or prostate cancer. They seem to ground until they find out it’s not an end of life type of thing.
traumamed
Pre-Flight
So who is supposed to define what constitutes conditions that pose significant risk? The public has entrusted physicians to make those calls. Pilots have an inherent conflict of interest that impacts their ability to be impartial when it comes to making self-assessments of their medical fitness. I say that as both a physician and a pilot.
Your prostate cancer is not a great example, both because it does pose a risk if it is unmanaged, and it is not inherently disqualifying. Although prostate mets to the brain are rare, they can still happen. If someone takes a cavalier attitude about managing their prostate cancer, develops an unrecognized brain met, and seizes while acting as PIC, everyone on the plane and at the crash site is going to have a very bad day. Or what if you have mets to your vertebrae (very common) and suffer a pathologic fracture with neurologic involvement mid-flight? With that said, AMEs can issue to prostate cancer patients if certain conditions are met and proper monitoring is occurring. Barring that, special issuances are issued all the time for many cancers, including prostate. Manage it and you're good to go.
With regard to ADD/ADHD, issuance has improved significantly in the last few years. Regardless, you may want to look in the medical literature about these conditions and also about the sympathomimetic effects of the drugs used to treat them. There are lifelong cognitive differences in ADD/ADHD patients compared to unaffected individuals. Do I think those differences are really an issue? Not in most cases. In a few, yes. Also, for patients remaining on active treatment (which is many adults nowadays), would you feel okay with your airline pilot being hopped up on cocaine as long as it was being prescribed by a physician? Didn't think so. Ritalin is basically the pharmacologic equivalent, and Adderall - aka amphetamine - is actually more potent than cocaine due to its ability to not only block dopamine reuptake but also trigger its release.
I'm generally a live and let live kind of guy, but pilots can and do kill innocent people on the ground with some degree of frequency due to ADM errors. I consider medical arrogance an ADM error.
EDITED FOR: mostly unsuccessful attempt at brevity. Lol.
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Kenny Phillips
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I propose a time limit (which exists for certain other things in gov't) beyond which you get provisional flying privileges if you have supplied all that is asked of you.
That doesn't mean you fly forever, or even until the next medical, but it puts the onus where it belongs once the applicant has done his due diligence.
That doesn't mean you fly forever, or even until the next medical, but it puts the onus where it belongs once the applicant has done his due diligence.
traumamed
Pre-Flight
I agree with this 100%. The biggest source of frustration for pilots impacted is that their wings are clipped for months at a time. The overwhelming majority I know do take both their health and their responsibility as a pilot seriously. They want to stay in compliance. The FAA could easily allow provisional issuance by an aeromedically-qualified MD. Then the time burden of the internal FAA review becomes much less onerous. If the FAA has supplemental concerns, those could be addressed within an allotted timeframe as well. The important thing is having a patient being monitored and on appropriate treatment. No MD is going to take on the liability risk of clearing a pilot they don't fully believe is good to go. Their med mal would get slaughtered if there were an accident.
Tools
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Tools
Better question… why do we ask NON PILOTS, who are NON PRACTICING doctors, to make a fitness to fly determination at all? Especially when their hands are tied by dark age aeromedical mythology.
Why don’t we ask a CURRENT PRACTICING doctor to determine medical normalcy, and a flight instructor or examiner determine if they can fly?
Leave the administrating to the AMEs.
Why don’t we ask a CURRENT PRACTICING doctor to determine medical normalcy, and a flight instructor or examiner determine if they can fly?
Leave the administrating to the AMEs.
I’m
Because - even previous doctors have said - they don’t handle any of the aviation related complications with said medical conditions. They sign off on general ability to function in society. Not at flying, scuba or whatever other activities.
even better question - why are pilots who aren’t doctors and have never practiced being a doctor, trying to determine fitness to fly - and when it poses a conflict of interest. There is a path with your pcp - use it if you want. It just requires a first time initial clearance of a medical.
Because - even previous doctors have said - they don’t handle any of the aviation related complications with said medical conditions. They sign off on general ability to function in society. Not at flying, scuba or whatever other activities.
even better question - why are pilots who aren’t doctors and have never practiced being a doctor, trying to determine fitness to fly - and when it poses a conflict of interest. There is a path with your pcp - use it if you want. It just requires a first time initial clearance of a medical.
AchillesLastStand
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AchillesLastStand
I spoke to a doc that consults with the FAA and helps create policy. That doc said that clinical docs are sought out by the FAA for their opinions, but then turn around and don’t listen to that opinion. It’s the DMV of medicine.
Kent Wien
Pre-takeoff checklist
With regard to the color vision iPad test being used now, I got to experience it yesterday while getting my medical. Something I hadn’t seen mentioned is that you get about 4 seconds per ‘plate’ to see the number before it disappears. That didn’t seem to be the case with the paper version. My AME had already had a failure that morning and that was before 9am on the first day they were using it.
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UTLonghorn_1979
PREFACE - MY GOAL AND ADVOCACY IS FOR CLASS 3 REFORM, NOT CLASS 1 OR 2 OR PILOTS IN THE BUSINESS OF TRANSPORTING PEOPLE OR ITEMS FOR HIRE.
Since it seems like this forum is being used for advocating change at the FAA vs. actual changes at the FAA, I think it’s pretty safe to say there is room for improvement at the front line level (AMEs/HIMS AMEs) and at the administrative level at the FAA.
There seems to be a lot of animus towards viewpoints like mine, and the push back that I give on this forum, including to Drs., but pardon my skepticism given the number of self interests involved here and the “a$$ covering,” fear of legal ramifications being a huge driver of the existing practices. Yes, we want safe pilots in the air. BUT, it’s hard to say that the manner the FAA is using to measure or ensure this is less that ideal.
As “traumamed” stated, the main frustration, at least on my part, is the amount of time pilots are stuck in the system for certain medical conditions and how there are loopholes that allow other pilots get around the FAA’s overburdensome medical approval process. This creates the reality that pilots will not be honest in order to not be subject to the bureacracy of the FAA and we will have unfit pilots flying for leisure or with passengers.
Examples:
1. It will take the applicant 30-90 days to supply the FAA with requested items, including the required specialists recommendation to approve medical. However, FAA will take another 8-12 months to respond with approved, denied, or need more info.
2. New pilots, or ones with expired medicals after 2006, but with conditions that would otherwise not pass a Class 3 medical can go Basic Med or just operate under SP with their driver’s license. With MOSAIC, that’s basically the same as Class 3 without IFR rating.
a. So you could have someone develop a condition, or just not report it to the FAA, wait until their medical certificate expires and move to operate under BM or MOSAIC.
3. So you have GP’s evaluating and approving fitness for flight under Basic Med and soon MOSAIC, no FAA medical involvement. The same liability for Drs. exists here, so what’s the difference between this and Class 3?
Since it seems like this forum is being used for advocating change at the FAA vs. actual changes at the FAA, I think it’s pretty safe to say there is room for improvement at the front line level (AMEs/HIMS AMEs) and at the administrative level at the FAA.
There seems to be a lot of animus towards viewpoints like mine, and the push back that I give on this forum, including to Drs., but pardon my skepticism given the number of self interests involved here and the “a$$ covering,” fear of legal ramifications being a huge driver of the existing practices. Yes, we want safe pilots in the air. BUT, it’s hard to say that the manner the FAA is using to measure or ensure this is less that ideal.
As “traumamed” stated, the main frustration, at least on my part, is the amount of time pilots are stuck in the system for certain medical conditions and how there are loopholes that allow other pilots get around the FAA’s overburdensome medical approval process. This creates the reality that pilots will not be honest in order to not be subject to the bureacracy of the FAA and we will have unfit pilots flying for leisure or with passengers.
Examples:
1. It will take the applicant 30-90 days to supply the FAA with requested items, including the required specialists recommendation to approve medical. However, FAA will take another 8-12 months to respond with approved, denied, or need more info.
2. New pilots, or ones with expired medicals after 2006, but with conditions that would otherwise not pass a Class 3 medical can go Basic Med or just operate under SP with their driver’s license. With MOSAIC, that’s basically the same as Class 3 without IFR rating.
a. So you could have someone develop a condition, or just not report it to the FAA, wait until their medical certificate expires and move to operate under BM or MOSAIC.
3. So you have GP’s evaluating and approving fitness for flight under Basic Med and soon MOSAIC, no FAA medical involvement. The same liability for Drs. exists here, so what’s the difference between this and Class 3?
Tools
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Tools
I think that everyone who is stuck in some limbo always points out - but there could be drunks/drug/mental health etc etc who aren’t caught that have a medical. And it’s like - oh so not fair. The faa’s goal is to be a front line block and then gradually work on weeding out the rest. There is no justification for the others to be there and complaining about it to justify a position is just that - immature complaining.
You have a legit gripe about timeline and responses. As for your continued barking up that there could be people who are holding medical because they lied, or subsequently got whatever condition that the FAA doesn’t know about - nah. That’s something that needs to be fixed as well. But you aren’t arguing for that to be fixed (which by extension means prosecuted fully as well) - but merely to try and strengthen your case that there are already problematic people in there and therefore you should also be allowed to go in because others have fraudulently passed.
And no, I have zero tolerance for people who lie anywhere. If you are willing to lie here - you’re willing to lie on your actual achievements, hours etc. and that makes said person a fraud as well.
Great. So you want to use the fars. Ok. Let’s do that then. The medical stuff is also coded in the data and by extension all their decisions trees and what they and us can and can’t do. So we are back at square one - and you accept what has been codified already
Jameskerr3
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James
mental health conditions like adhd track and anti depressant cases are taking 12-15 months. id rather wait longer for approval and have them be careful thats just me. and guys please be nice to each other- b real but nice. we need to be there for each other- disagree too but stay nice.
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Llewtrah
This was my concern with BasicMed in general. If that was a reliable process, there wouldn’t be DUIs and we wouldn’t see so many “got a DUI - am I screwed?” posts by anonymous posters here: if people can’t consistently and honestly determine fitness to drive, what makes us think they’ll do so for flying? And that’s just drinking and driving. There are people out there driving with medical and cognitive issues that I think most of us would agree should not be doing so. And, debatably, driving in such situations is riskier to others than most bug-smasher GA flying.
I’m not advocating for lower standards for flying; I’m observing that self-determining fitness is not 100% reliable by any means.
And yet, with BasicMed at least, it works very well. FAA Citation here.
Shouldn't we continue in that direction since the results and evidence show it's working?
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UTLonghorn_1979
Well, yeah, it’s an obvious issue and valid critique that people playing by the rules are going to point out that those who aren’t have an easier time than people in my position who were honest from the start. The justification is that the FAA’s handling of this is creating an incentive to lie. That’s not immature complaining, that’s human nature and motivation and a fact. Or I guess you’ve never told a lie in your life? Please….
And you can change your comment from “but there could be drunks/drug/mental health etc etc who aren’t caught that have a medical” to "but there ARE drunks/drug/mental health etc etc who aren’t caught that have a medical.”
You can’t “fix” dishonesty. There are already penalties for that. What are you suggesting? What’s your point? You’re not promoting or suggesting any fix. I, on the other hand, have suggested creating a more transparent and steamlined approach for CLASS 3 applicants which is no different than that being used for BM and SP/MOSIAC. I’m not outlining that again here.
That’s great you can stand on your moral high ground, so can I. I was honest on my application, so I don’t understand the relevance of your comment. People are going to lie, people lie. As long as there is an incentive to do so, nothing changes.
Rcmutz
Cleared for Takeoff
UTLonghorn… I’m a 79 grad of OSU. Great game last night. Knew it would be a 4 qrt. battle. Next fall at the Shoe will be epic!
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Great game! Ohio definitely wanted it more and deserved it. Good luck vs. ND!
Bucket list to make it up for a game at the Shoe as well as, dare I say, the Big House!