More Change at FAA medical

[jbarrass]

I agree. Just keep the class 3 for those guys.

I see your logic, but the problem is that if it becomes something like ICAO Only and remains in existence, it will grow back. It needs to be "CFR Part 67.301 is deleted in it's entirety".

I don't think there are enough pilots who fly internationally that meet CL3 but not CL2 to justify keeping an entire regulation. There are not many differences,

 

[bbchien]

Hey Dr. Chien,

I wanted your opinion or feedback if you are able to offer any. I worked with a HIMS AME over the course of almost a year gearing up to submit for a 1st class medical. I had chiari decompression surgery October 23', past adhd diagnosis and a GAD diagnosis from talk therapy. A few other things came up in my medical record that had to be addressed (mild asthma, heart murmur). My HIMS AME and I essentially gathered every medical record possible (he then went through it all), we worked on getting updated imaging for neuro, updated visits with all of my doctors/past therapist, full heart work up, pft test, I did a preemptive HIMS Neuropsych Eval/cogscreen. If it was something that needed to be addressed or would flag a response from the FAA for "more information" we worked on getting it done prior to submitting. We also made sure everything got the 90 day window. If he felt it would need to be addressed he had me do whatever he felt the FAA would ask for.

We did the exam in mid July and since then I've sat under "Transmitted" in Medxpress. Several calls to the FAA with being told it's under review, it's on the physicians desk and the latest from the RFS, is my file is on several physicians desk (due to the different things needing review) and the reason for not updating in the system is since no correspondence has been made to me. Also RFS said the backlog is very high right now. I knew this going in that I would be waiting awhile.

I lost my AME recently due to retiring. Found a new one, but they aren't going to show as my new AME until a new exam is done. The RFS said do not do a new exam until a decision is made as it will throw out any work I've currently done.

1. If it reaches the 1 year mark, does everything I did go out the window and need to be redone? The neuropsych eval and cogscreen/battery tests alone cost me over $8k. I did very well on the eval and the report was very favorable and addressed all neuro and psych related history.

2. Is it possible no correspondence has been made since I preemptively provided basically all documentation under the sun the FAA may have needed. Granted I know they can always ask for more.

3. Should I contact you directly and pay for a consult to give you a better understanding about my case?

Oh. Jays_s. Did you get the letter saying the file has gone to DC?

If it goes over a year, well, the worst they can do is deny you, and the in the "for further consideration" letter, demand an updated Neuropsych, neurologist and local psychiatrist commentary as to your GAD. But That would not be a factor of your issuance Not Valid Any Class after 07/31/2025 certificate.

I have many memos from the HIMS DC office saying that if I want my man's application to "go" upload the the less than 90 days prior to one year (after 05/01/2025) updated data so that when your file comes up, the Medical officer has "not outdated data".

Engage your congress critter as soon as after 183 days to prevent this from happening. If you go to the congresscritter pirot to 183 days you just get an "extreme backlog" note back. If after 186 days, you get the same note back but about 2 weeks latter miraculously you get something official.

B
(It's become pretty clear to me that the aerospacemedical docs system works for the federal attorneys and not the other way around.)

 

[bbchien]

IMO this was not a color vision accident. It was a crew exhaustion and slop accident. None of the three crewmembers even recalled seeing the VASI.

 

[SACsky]

Oh. Jays_s. Did you get the letter saying the file has gone to DC?

If it goes over a year, well, the worst they can do is deny you, and the in the "for further consideration" letter, demand an updated Neuropsych, neurologist and local psychiatrist commentary as to your GAD. But That would not be a factor of your issuance Not Valid Any Class after 07/31/2025 certificate.

I have many memos from the HIMS DC office saying that if I want my man's application to "go" upload the the less than 90 days prior to one year (after 05/01/2025) updated data so that when your file comes up, the Medical officer has "not outdated data".

Engage your congress critter as soon as after 183 days to prevent this from happening. If you go to the congresscritter pirot to 183 days you just get an "extreme backlog" note back. If after 186 days, you get the same note back but about 2 weeks latter miraculously you get something official.

B
(It's become pretty clear to me that the aerospacemedical docs system works for the federal attorneys and not the other way around.)

Thanks so much for the response! Unfortunately I have not gotten anything from the FAA, no letters or anything correspondence wise. I was calling every other week and just get told it's "under review, no decision's been made". Come next month I'll be at 183 days. The AME exam was done on July 15th. All supporting docs sent in that day, minus the neuropsych's report which was submitted in September after it was finished. I will definitely reach out to my congress person come next month. Maybe that will get me some sort of response. Thank you again for getting back to me, I appreciate it!

 

[MikeNY]

Just keep the class 3 for those guys.

Agreed, and where eliminating class 3 would have adverse consequences.

 

[Tools]

A different point of view for consideration…

I don’t remember a 3/c being such a big deal. Could it be how the faa is administrating that now rather than the 3/c itself being the problem?

Basic med isn’t “easier”, it’s just sans faa…

EVERYTHING runs its course. The faa has run theirs, now we get to figure out how to endrun their disfunction.

 

[TCABM]

A different point of view for consideration…

I don’t remember a 3/c being such a big deal. Could it be how the faa is administrating that now rather than the 3/c itself being the problem?

Basic med isn’t “easier”, it’s just sans faa…

EVERYTHING runs its course. The faa has run theirs, now we get to figure out how to endrun their disfunction.

Third class isn’t a big deal. I flew on a DOD medical for 20+ years. Getting an FAA third class in office took lots of documentation from my .mil medical records because I had a hx of melanoma, hypothyroidism, LASIK, and some other stuff.

Then, 30 days later, the FAA wanted a cardio work up from something from my original FAA medical in 1990, I think (that was also issued in-office but got a similar letter). DOD never cared one whit about that condition.

So I went and did a couple of specialty cardio exams and got a cardiology note stating this issue was a nothing burger. The condition isn’t (and has never been) recognized as disease, yet the FAA treats it as such.

If I ever do another FAA medical, I’m going to do this stuff up front, out of pocket, along with the dermatology and thyroid current stuff and I’m going to find the right AME who can issue in office just like Bruce did for me given all the documentation I’ve got.

But honestly it sounds like the latest guidance is effectively in-office issuance, to include CACIs, or denial with instructions to follow if you decide to apply again.

If that’s the case, I think the FAA is trying to discourage those who will require HIMS follow up by denying them up front. Maybe I’m misunderstanding the policy or maybe there’s data that supports a low percentage of those types of applicants actually do what’s needed for the issuance. Sadly, if that’s the case, I can understand flicking the booger to file 13 a bunch of stuff currently in the queue to hopefully speed the stuff up for those who will do the work.

 

[Chip Sylverne]

Elimination of the third-class medical would have ICAO implications for anyone wishing to fly outside of the USA. Even a close friend and ally like Canada doesn't recognize BasicMed, despite efforts at getting that approved. It's never as simple as it seems.

In fairness, Canada's close friend and ally the US doesn't recognize their Class 4, which is Basic Med without the previous class 3 requirement, valid only outside controlled airspace. Maybe if we give a little we might get a little.

 

[Lindberg]

In fairness, Canada's close friend and ally the US doesn't recognize their Class 4, which is Basic Med without the previous class 3 requirement, valid only outside controlled airspace. Maybe if we give a little we might get a little.

Where would you fly an airplane in the US only outside of controlled airspace?

 

[Chip Sylverne]

Where would you fly an airplane in the US only outside of controlled airspace?

Class G.

 

[Capt. Geoffrey Thorpe]

I don’t remember a 3/c being such a big deal.

For many it's not. For the rest of us it's somewhere between stupid expensive and time consuming and absofalutly impossible.
For me, not even close to being worth trying and potentially losing my Sport Pilot privileges.

 

[Randomskylane]

Thanks so much for the response! Unfortunately I have not gotten anything from the FAA, no letters or anything correspondence wise. I was calling every other week and just get told it's "under review, no decision's been made". Come next month I'll be at 183 days. The AME exam was done on July 15th. All supporting docs sent in that day, minus the neuropsych's report which was submitted in September after it was finished. I will definitely reach out to my congress person come next month. Maybe that will get me some sort of response. Thank you again for getting back to me, I appreciate it!

I hate to be a Debbie downer but… I waited about a year for approval on a very simple test result (they needed two doctors to read the negative kidney stone test)

This was several years ago but every aviation board seems to have the same general theme; backlog is miles long.

Iirc if you are in AOPA they will add you to their list of people to nag the FAA about

Good luck!

 

[Anthem]

It's clear the intention is to make bold decisions that cut about 1/3 of the spending while increasing personal liberty.

It's not about doing more with less, it's about doing less with less.

Eliminating the 3rd class entirely is a good start with very very minimal risk. Even the FAA has concluded the accident rate due to medical incapacitation using Drivers licenses, BasicMed, or none at all is not statistically significant. Define it as a drivers license medical. (ICAO pilots can make arrangements and should not block the rest of us). There would be an immediate and significant improvement in wait time for the remaining pilots since CAMI now has many less cases to deal with. .

Another goal is to reduce duplication. The rest of DOT has a medical already, replace the 2nd class with a DOT physical. Duplication is not value added.

The 1st class medical has legs and given the public reliance on air transport makes some sense. But they should be required to use the rulemaking process to come up with a transparent list of disqualifying conditions. No tax dollars should be spent doing SI on Prostate cancer etc.

Change is hard, but it's time.....

I disagree. If you want to have the same as 3rd class privileges then get the 3rd class. If you want to make BasicMed 3rd class - then abide by the ICAO restrictions of it - and see where you get. Getting rid of it just cripples the many more 3rd class holders at the benefit of BM. You arent working for more privileges for BM - you're crippling the other one. Unless the rest of the world accepts our watered down BM - then it'll essentially be crippling 3rd class holders over the much smaller group of BM.

I see your logic, but the problem is that if it becomes something like ICAO Only and remains in existence, it will grow back. It needs to be "CFR Part 67.301 is deleted in it's entirety".

I don't think there are enough pilots who fly internationally that meet CL3 but not CL2 to justify keeping an entire regulation. There are not many differences,

There are significant differences. BM is much more limited. Either raise the BM specs to class 3 to be accepted universally or accept them as a separate but not equal reality. I for one dont want to lose privileges to fly to various countries or some of the other limited options that BM has.

A different point of view for consideration…

I don’t remember a 3/c being such a big deal. Could it be how the faa is administrating that now rather than the 3/c itself being the problem?

Basic med isn’t “easier”, it’s just sans faa…

3rd class isnt a big deal, except for those that it is. Then they cant pass it, or costs too much to pass it - and then its a big deal. BM is absolutely easier. Much much easier. If it wasnt, every one of thsoe BM holders would rather have the class 3 medical than BM. Which is exactly what they are arguing for here. People get BM for various reasons, easier is one of them, disqualifying conditions and cost to overcome is another (which is again easier), less hassle ( again, easier).

Keep in mind - these people arent actually asking for the 3rd class to be removed. They are asking to be placed in the 3rd class with BM without the current 3rd class requirements - which no other country supports. They want all the privileges of 3rd class with BM. If you just removed 3rd class completely and had class 1, class 2 and BM - guess what - they still wouldnt be happy.

 

[SACsky]

I hate to be a Debbie downer but… I waited about a year for approval on a very simple test result (they needed two doctors to read the negative kidney stone test)

This was several years ago but every aviation board seems to have the same general theme; backlog is miles long.

Iirc if you are in AOPA they will add you to their list of people to nag the FAA about

Good luck!

I was an AOPA member, but I didn't renew my membership this year. How would joining again help my case? Would someone there call on my behalf.

Unfortunately I had a really bad experience with their medical division about two years ago when I first started to get things in gear to try and get an SI. One of the medical consultants gave me very bad information and said I shouldn't even try to get a medical. Based off of them not understanding what chiari malformation is, despite my knowing there are several chiari pilots out there with 1st class medicals. I almost listened to them and gave up. It's always left a really bad taste in my mouth. I cancelled my membership ultimately because of this experience.

 

[bbchien]

Unfortunately I had a really bad experience with their medical division about two years ago when I first started to get things in gear to try and get an SI. One of the medical consultants gave me very bad information and said I shouldn't even try to get a medical. Based off of them not understanding what chiari malformation is, despite my knowing there are several chiari pilots out there with 1st class medicals. I almost listened to them and gave up. It's always left a really bad taste in my mouth. I cancelled my membership ultimately because of this experience.

And that is why, ultimately, I left the AOPA Board of Aviation Medical Advisors.

 

[Anthem]

keep in mind - AOPA is a political organization. That is their primary and main focus. Everything else is just "fluff" and "advertising" for so and so services to get you to join the group to be counted as one of them and to financially support them. Their medical division are not manned by docs to help you, their legal division are not manned by lawyers to help you. Yeah, there are token players, but they arent going to give you the best individual decision for your situation. If you need a lawyer, hire an aviation lawyer. If you need real medical advice - go to a good aviation doc (like Dr Bruce, and others on here).

 

[jbarrass]

I disagree. If you want to have the same as 3rd class privileges then get the 3rd class. If you want to make BasicMed 3rd class - then abide by the ICAO restrictions of it - and see where you get. Getting rid of it just cripples the many more 3rd class holders at the benefit of BM. You arent working for more privileges for BM - you're crippling the other one. Unless the rest of the world accepts our watered down BM - then it'll essentially be crippling 3rd class holders over the much smaller group of BM.



There are significant differences. BM is much more limited. Either raise the BM specs to class 3 to be accepted universally or accept them as a separate but not equal reality. I for one dont want to lose privileges to fly to various countries or some of the other limited options that BM has.



3rd class isnt a big deal, except for those that it is. Then they cant pass it, or costs too much to pass it - and then its a big deal. BM is absolutely easier. Much much easier. If it wasnt, every one of thsoe BM holders would rather have the class 3 medical than BM. Which is exactly what they are arguing for here. People get BM for various reasons, easier is one of them, disqualifying conditions and cost to overcome is another (which is again easier), less hassle ( again, easier).

Keep in mind - these people arent actually asking for the 3rd class to be removed. They are asking to be placed in the 3rd class with BM without the current 3rd class requirements - which no other country supports. They want all the privileges of 3rd class with BM. If you just removed 3rd class completely and had class 1, class 2 and BM - guess what - they still wouldnt be happy.

Couple thoughts. Just my $0.02

First, to be clear, Yes there are many of us proposing eliminating the 3rd class root and branch. Replaced by a drivers license (like SP) for all PP operations. It is sufficient and is proven to work. BM goes away too.

There is no evidence at all that documents it helps reduce accidents from medical incapacitation and at least one CAMI study that it's irrelevant.

There would also be a big downstream benefit with the significant reduction in volume of cases for those that remain in the Class 1 pool. Not to mention the cost/time savings to all the non-commercial pilots.

As to the ICAO tangent, we pay for a major portion of ICAO's operation (20% in dues and a majority of the "voluntary" contributions). Our representative, Anthony Clare, nor his predecessor Charlie Christ has even put BM on the agenda or made any public statements. We're not trying vey hard to fix it. We have the leverage to fix it if we want to. There is no justification to make 100% of pilots go through this process to benefit a very few.

The safety benefits of CL3 medicals (none documented) is far, is not at all justified by the burden of the system. There is a search for very major improvements in efficiency and cost savings. This is low hanging fruit.

 

[Anthem]

When you quote statistics - you need to compare apples to apples. And there isn’t a statistical category with enough data to actually do it.

You are using a category that has previous history against a future that doesn’t. Namely EVERYONE who is on basic med has previously had a class 1/2/3 medical and has somewhat proven themselves to fit that class standard at some point in time. What you are asking in the future - is drivers license only without filling that standard. Just the previous 1/2/3 medical has eliminated a crap ton of non-eligible people. Just the failure of a medical and eliminating sport pilots has also eliminated a crap ton of people that shouldn’t be pilots. Your new “standard” of just a drivers license opens things up to drunks, mental health issues, drug addicts, and every other person that previously couldn’t hold a medical to be flying. And everyone knows you can get any doctor to sign something without oversight. Look at the online paid telemedicine. Look at all the mj medical cards. All of those people are docs of some accrediation that can sign off on a new lower standard basic med without any oversight.


So no - I am against that. I kind of like that basic med has to pass a certain threshold and eliminate pilots that arent qualified before going down that route. You should as well to maintain the BM standard so that it stays statistically safer and irrelevant. . Yes - continuing with BM and no longer the class system that the standard there no longer applies but they at least passed the standard at one time or another - vs never having been able to pass to begin with. If you wanted to open it up - then essentially you should look at expanding sport - and even that has the previous medical failure that eliminates.

As for ICAO - that is not run by us. Even if we provide a lot of the funding, its a global accepted standard. Congress passed BM for our country. They didnt (and probably wouldnt dare go down that path) or enforcing its acceptance for every other country. The point being is that the entire rest of the world accepts a current standard - and thats the way it should be. And your usage of the term "fix it" implies its broken. It isnt. Every other country is ok with it, and apparently hasnt opened up their own versions of basicMed - which means - they generally like it where its at. You are proposing to fix a problem that isnt there - just because it fits your narrative.

But no, I oppose on many fronts. I have no issue with Basic Med - I dont even mind its current expansion that is rolling out now. But I oppose when the BM proponents propose to eliminate class 3's or assimilate in to it where the current lose their privileges because a vocal less stringent group of people want to.

 

[UTLonghorn_1979]

When you quote statistics - you need to compare apples to apples. And there isn’t a statistical category with enough data to actually do it.

You are using a category that has previous history against a future that doesn’t. Namely EVERYONE who is on basic med has previously had a class 1/2/3 medical and has somewhat proven themselves to fit that class standard at some point in time. What you are asking in the future - is drivers license only without filling that standard. Just the previous 1/2/3 medical has eliminated a crap ton of non-eligible people. Just the failure of a medical and eliminating sport pilots has also eliminated a crap ton of people that shouldn’t be pilots. Your new “standard” of just a drivers license opens things up to drunks, mental health issues, drug addicts, and every other person that previously couldn’t hold a medical to be flying. And everyone knows you can get any doctor to sign something without oversight. Look at the online paid telemedicine. Look at all the mj medical cards. All of those people are docs of some accrediation that can sign off on a new lower standard basic med without any oversight.


So no - I am against that. I kind of like that basic med has to pass a certain threshold and eliminate pilots that arent qualified before going down that route. You should as well to maintain the BM standard so that it stays statistically safer and irrelevant. . Yes - continuing with BM and no longer the class system that the standard there no longer applies but they at least passed the standard at one time or another - vs never having been able to pass to begin with. If you wanted to open it up - then essentially you should look at expanding sport - and even that has the previous medical failure that eliminates.

As for ICAO - that is not run by us. Even if we provide a lot of the funding, its a global accepted standard. Congress passed BM for our country. They didnt (and probably wouldnt dare go down that path) or enforcing its acceptance for every other country. The point being is that the entire rest of the world accepts a current standard - and thats the way it should be. And your usage of the term "fix it" implies its broken. It isnt. Every other country is ok with it, and apparently hasnt opened up their own versions of basicMed - which means - they generally like it where its at. You are proposing to fix a problem that isnt there - just because it fits your narrative.

But no, I oppose on many fronts. I have no issue with Basic Med - I dont even mind its current expansion that is rolling out now. But I oppose when the BM proponents propose to eliminate class 3's or assimilate in to it where the current lose their privileges because a vocal less stringent group of people want to.

The existing process has made it infeasibe for many people that would ultimately be issued SI for Class 3 due to the timing and costs to run through the FAA HIMS hoops. It will be interesting to see where the 0.1% of denied applicants goes with this new rule, since it’s no longer in “deferred” status but now “denied.” I bet it jumps substantially.

Also, and here’s a shocker, there are already many people flying with class 1, 2 and 3 medicals that are drunks, drug addicts or have mental health issues,they just aren’t being honest at the application onset and/or haven’t been cought.

With the implementation of MOSAIC, we’ll have probably 8K+ pilots operating under sports pilot able to operate at the same speeds and compexity of aircraft of most class 3 pilots, and with using a DL ONLY as their physical/mental fitness qualification. I’d be curious the accidents per 100 operating under SP vs. PP as all I read about are PP accidents.

Lastly, everyone of these pilots has to be certifed to operate under each certificate - get instruction and get checked out. They don’t just get a medical, or show a DL, then hop in an airplane and do what they want…assuming they aren’t outright breaking the law. This is the more critical aspect of flight “worthiness” for me. Just because you’re medically fit to fly, doesn't mean you’re capable…and there sure are a ton of people flying that should not be. 99.9% of the accidents I read about are pilot error/loss of control/flying into IMC/bad weather…not resulting from physical or mental malidies or events.

If you get the HIMS/deferral process to under 6 months from start to finish, my bet is you make the bulk of the complaints go away. Or at least mine...

 

[Anthem]

Also, and here’s a shocker, there are already many people flying with class 1, 2 and 3 medicals that are drunks, drug addicts or have mental health issues,they just aren’t being honest at the application onset and/or haven’t been cought.

There are. And those should all be disqualifed and/or permanently barred. If your dishonest here, you're credibility is nothing. So hours, certs, etc are all worth nothing.

With the implementation of MOSAIC, we’ll have probably 8K+ pilots operating under sports pilot able to operate at the same speeds and compexity of aircraft of most class 3 pilots, and with using a DL ONLY as their physical/mental fitness qualification. I’d be curious the accidents per 100 operating under SP vs. PP as all I read about are PP accidents.

Technically no. Because there is a large group of people who attempt class 1/2/3 medical and are denied and therefore eliminated from operating within sport. I actually have no issue with the less than transparent situation of people knowing they get eliminated from sport if they fail an actual medical. It catches people who probably shouldnt be flying.

I would argue there are more people eliminated from Sport because of a failed medical, than there are actually sport pilots.

Lastly, everyone of these pilots has to be certifed to operate under each certificate - get instruction and get checked out. They don’t just get a medical, or show a DL, then hop in an airplane and do what they want…assuming they aren’t outright breaking the law. This is the more critical aspect of flight “worthiness” for me. Just because you’re medically fit to fly, doesn't mean you’re capable…and there sure are a ton of people flying that should not be. 99.9% of the accidents I read about are pilot error/loss of control/flying into IMC/bad weather…not resulting from physical or mental malidies or events.

Agreed on most. However if you have a history of something, whether its cardiac, mental or whatever - it can easily be suppressed during training to get ratings. Afterward - that could rear its head at any moment.

If you get the HIMS/deferral process to under 6 months from start to finish, my bet is you make the bulk of the complaints go away. Or at least mine...

And this I seriously doubt. If that was the case - then sure. But I doubt the bulk of the complaints will disappear with this alone. Im almost positive that they will want the timeline reduced to 6months (or less), they want less stringent controls, they want to be allowed to take "allowed" and "disallowed" meds (because their interpretation of a prescription is that you are "ok" by taking them, and lastly they'll want to eliminate the costs associated with the screening (generally 5-8K). the last one particularly. Because I hear more about the costs related to the screening than the actual time. the actual time component doesnt come in to play until AFTER they've paid the screening cost.

 

[MauleSkinner]

Class G.

So would you be encouraging people to fly primarily at 600 AGL?

 

[SACsky]

And that is why, ultimately, I left the AOPA Board of Aviation Medical Advisors.

Btw Dr. Bruce you were a big reason why I didn't initially give up after speaking with AOPA. I had reached out to you via your website and you wrote me a very helpful, straightforward and informative email that stated what I was up against and how I could go about things. So I want to say thank you because without that email I don't know if I would have carried on and got everything figured out regarding my case (at least on my end, minus the whole waiting on a response from the FAA part). I can't thank you enough.

 

[Chip Sylverne]

So would you be encouraging people to fly primarily at 600 AGL?

Not a matter of encouraging, it's a matter of legal reciprocity, or at least basis for negotiation. We continually point fingers at them without assessing our own position. Are you suggesting Canadian holders of Class 4's aren't capable of deciding what risks they wish to accept?

As far as where Class G exists above 700 ft, there's plenty of those already here on POA.

 

[MauleSkinner]

Not a matter of encouraging, it's a matter of legal reciprocity, or at least basis for negotiation. We continually point fingers at them without assessing our own position. Are you suggesting Canadian holders of Class 4's aren't capable of deciding what risks they wish to accept?

No, I’m saying Canadian holders of Class 4s have a lot less risk to mitigate than they would in he U.S.

 

[UTLonghorn_1979]

Why is there this “God complex” or pilot superiority complex amongst many pilots regarding a “need” for FAA Drs and specific medical certification for pilots that don’t intend to carry for hire? Any family/GP Dr can come to a reasonable conclusion on whether a patient should be flying as PIC or not. On a day to day basis, and in between every medical exam required for class 3, it’s ultimately up to the PIC to determine their fitness to fly.

Any yokel can get a drivers license and get on a highway or highly congested public road with all the other yokels driving on that same road/highway with a far higher likelihood of causing bodily injury or physical damage. Whether that be accidental or intentional. I personally find it far more stressful driving under certain conditions vs flying, assuming I adhere to my personal minimums.

Again, how many accidents, whether intentional or accidental, are caused by pilots operating under part 91 in general and due to mental or physical health?

 

[Chip Sylverne]

No, I’m saying Canadian holders of Class 4s have a lot less risk to mitigate than they would in he U.S.

Fair enough. But that's a judgement issue, not medical qualification.

 

[AvNavCom]

Any family/GP Dr can come to a reasonable conclusion on whether a patient should be flying as PIC or not.

Disagree. I'm trained and boarded in Aerospace Medicine. My Family Medicine and Internal Medicine colleagues ordinarily have absolutely no idea about altitude medicine, the effects of G-loading, and flight physiology in general. Most of them also have no understanding of aerospace medical regulations, nor any desire to add that to their already prodigiously overloaded schedules. There have been many instances in which I've had to change or remove medication from patients who have been breezily handed medication with the potential for both subtle and even overt incapacitation or attentional deficits. Driving at 1G when you can pull over at any time if you start to feel bad is an entirely different proposal than flying at 100+ knots over people's houses and no way to put it down if dizziness or chest pain starts.

Like it or not, the general public (the ones constantly trying to shut down airports) feel safer knowing that pilots are held to a higher level of scrutiny, both medically and in training. It's the same reason that truckers have to get a DOT physical, even though the biggest danger is the dumbass in a sedan brake-checking them. I suspect you would find near-zero support at any level of authority to allow aviation to become the medical free-for-all that driving is.

 

[Half Fast]

I suspect you would find near-zero support at any level of authority to allow aviation to become the medical free-for-all that driving is.

You mean like Sport Pilot?

 

[bbchien]

Disagree. I'm trained and boarded in Aerospace Medicine

My favorite is the Cardiologist who "clears" the airman for flight (EF 35%). I ask the doc, "how much medicine do you practice at 0.5 BAR?"

If the discussion continues, I get to ask, "Do you know how the heart responds to the need for oxygen below .08 BAR?" The pilot is so torqued off by FAA's refusal: "But my doctor sez I'm fine".

Then he issues an addendum, "final decision of course is by the FAA".
Sigh.

Btw Dr. Bruce you were a big reason why I didn't initially give up after speaking with AOPA. I had reached out to you via your website and you wrote me a very helpful, straightforward and informative email that stated what I was up against and how I could go about things. So I want to say thank you because without that email I don't know if I would have carried on and got everything figured out regarding my case (at least on my end, minus the whole waiting on a response from the FAA part). I can't thank you enough.

SACsky, if you would indulge me with an email...even via the website. I can never tell who's who and I'd love to look that that....

 

[robin ardoin]

^^^That's pretty scary! No reserve left there.

 

[Tools]

I still think this would all be better if docs didn’t determine ability to fly but rather just fitness…

Leave the ability part to an instructor or examiner. I don’t blame docs for being conservative about being “responsible” for a guy’s ability to go fly. Many, if not most, aren’t pilots.

A doc can conservatively decide if an observed ride of some sort ought to be conducted.

 

[SACsky]

My favorite is the Cardiologist who "clears" the airman for flight (EF 35%). I ask the doc, "how much medicine do you practice at 0.5 BAR?"

If the discussion continues, I get to ask, "Do you know how the heart responds to the need for oxygen below .08 BAR?" The pilot is so torqued off by FAA's refusal: "But my doctor sez I'm fine".

Then he issues an addendum, "final decision of course is by the FAA".
Sigh.

SACsky, if you would indulge me with an email...even via the website. I can never tell who's who and I'd love to look that that....

Sure thing I can send you an email back!

 

[UTLonghorn_1979]

You mean like Sport Pilot?

Exactly…

 

[AvNavCom]

I still think this would all be better if docs didn’t determine ability to fly but rather just fitness…

Not sure what you're referring to here. We determine medical suitability, not ability (outside of specialized military aptitude testing, as you doubtless recall). I'm not aware of any AMEs determining anything other than fitness to fly. Have you seen examples otherwise?

 

[Tools]

When a doc issues a medical a pilot then has the ability to fly which he did not before the issuance. Not only has he been found suitable, but has the ability.

Yes, I have seen docs NOT ISSUE because of the fear of that pilot being (in their mind or whatever goes on up there) not ABLE to fly, although they meet regulatory requirements.

In other words, they are suitable IAW regulation, but a doc takes away their ability to go fly. They tend to use their “discretion” (contrary to regulation) to justify this.

This happens ALL THE TIME at the federal level.

 

[UTLonghorn_1979]

Disagree. I'm trained and boarded in Aerospace Medicine. My Family Medicine and Internal Medicine colleagues ordinarily have absolutely no idea about altitude medicine, the effects of G-loading, and flight physiology in general. Most of them also have no understanding of aerospace medical regulations, nor any desire to add that to their already prodigiously overloaded schedules. There have been many instances in which I've had to change or remove medication from patients who have been breezily handed medication with the potential for both subtle and even overt incapacitation or attentional deficits. Driving at 1G when you can pull over at any time if you start to feel bad is an entirely different proposal than flying at 100+ knots over people's houses and no way to put it down if dizziness or chest pain starts.

Like it or not, the general public (the ones constantly trying to shut down airports) feel safer knowing that pilots are held to a higher level of scrutiny, both medically and in training. It's the same reason that truckers have to get a DOT physical, even though the biggest danger is the dumbass in a sedan brake-checking them. I suspect you would find near-zero support at any level of authority to allow aviation to become the medical free-for-all that driving is.

I’m talking vanilla, GA, piston flying population. You have people that have been flying for ~ 8 years on basic med, way past last AME exam, and people on SP without ever taking an AME exam. They seem to be doing just fine.

 

[Jim_R]

Again, how many accidents, whether intentional or accidental, are caused by pilots operating under part 91 in general and due to mental or physical health?

For better or worse, we'll never know how many accidents that would have been caused by mental or physical health were prevented because the would-be pilots were screened out via the FAA medical cert process.

 

[AvNavCom]

I’m talking vanilla, GA, piston flying population. You have people that have been flying for ~ 8 years on basic med, way past last AME exam, and people on SP without ever taking an AME exam. They seem to be doing just fine.

I agree that BasicMed has been very encouraging regarding safety, although that population (as was noted by Anthem above) has been pre-screened. Sport pilots are interesting, in that they are (I think) a good example of trying to find the right balance between freedom and safety. The training and medical screening bars are significantly lower, but the pilots in turn are limited in their privileges. Post-MOSAIC, I think we'll see the closest thing we can realistically expect to what you're advocating: sport pilots being able to fly most light GA aircraft with just a driver's license. That said, BasicMed or a FAA physical will be needed for night flight, with the latter for any international flight.

Third-class medicals let you fly literally any aircraft, up to multi-engine turbines (just not for pay). I cannot imagine any scenario in which a person would be given such privileges with just a driver's license or a form from their family doc. The only path I can see would be the removal of the prior FAA physical requirement from BasicMed, but that would be a very hard sell. Third-class physicals aren't going anywhere, for sure.

 

[Anthem]

I’m talking vanilla, GA, piston flying population. You have people that have been flying for ~ 8 years on basic med, way past last AME exam, and people on SP without ever taking an AME exam. They seem to be doing just fine.

Uhh, but BM doesnt limit it to vanilla GA flying pistons. Many Turboprops - single and multi now fall under BM. And if the argument is to conflate 3rd and BM - then essentially they can fly ANYTHING (just not for hire). So the arguments being made are not vanilla, GA, pistons. Or maybe instead of the class 3 that BM is arguing, with Mosaic coming along, lets get rid of BM and just merge Sport/Mosaic/BM together. No previous medical required.

As for your BM - If you dont like it, then sure - lets make the BM people pass a class medical every four years instead of the much easier renewal. . I dont think that would fly real well. The point being - is that you've eliminated a crap ton of ineligible people by that initial clause - whether they were capable of passing, or not - they have been eliminated. Same for Sport - a large group that could have flown under Sport - have tried to get a class medical and failed and was eliminated from the group.

For better or worse, we'll never know how many accidents that would have been caused by mental or physical health were prevented because the would-be pilots were screened out via the FAA medical cert process.

Exactly. The numbers they are using have potential failures screened out already. The Sport class is closer, but it is also screened out. Your potential troubling numbers are statistically very probable in that group.

Third-class medicals let you fly literally any aircraft, up to multi-engine turbines (just not for pay). I cannot imagine any scenario in which a person would be given such privileges with just a driver's license or a form from their family doc. The only path I can see would be the removal of the prior FAA physical requirement from BasicMed, but that would be a very hard sell. Third-class physicals aren't going anywhere, for sure.

Exactly. Third class can take you all the way up to anything, even pass type ratings. You dont need a 2nd class to fly a Gulfstream/Global either - just a type rating. However, the single pilot exemption for most are at the twin turboprop level, and some citations with SPE, Pilatus 12/24 etc.

The argument to get rid of class 3 is really about expansion of BM privileges to class 3 and at the same time, encapsulating Sport type of licensing (but Im sure they also want to remove the disqualification with previous medical clause). If you purely got rid of class 3 - and kept BM in place exactly - they wouldnt be any happier. Actually it would be worse - now they have to pass a class 2 medical (which still is nearly identical to a 3rd but with slightly stricter vision requirements) before being eligible for BM. Im sure that wouldnt go over well either. . .

And it is ridiculously easy to get a doc to sign off on BM. I have hear of people paying $100 for an online consult with a doc. They sign the BM form and off they go without any real examination. Its the same type of "docs" that are signing off on medical 420 cards, and what not.

 

[Half Fast]

Third-class medicals let you fly literally any aircraft, up to multi-engine turbines (just not for pay).

Right. And what is so magical about a 3rd class compared to a BM that the 3rd should allow this? Especially considering the number and types of SIs given for a 3rd. A 3rd class isn't typically preventing people from flying due to medical conditions; it's merely (?) causing them to spend lots of money and have unneccesary tests for the privilege.

I cannot imagine any scenario in which a person would be given such privileges with just a driver's license or a form from their family doc.

That's one of the big problems with OKC: lack of imagination. Try stretching yours a bit. Look at the data we have from BM and SP and use it to draw meaningful, fact-based conclusions, rather than simply defaulting to "I cannot imagine..."

The only path I can see would be the removal of the prior FAA physical requirement from BasicMed, but that would be a very hard sell.

The only reason we have that in the first place is due to the insistence of one now-deceased senator. I think her body is cold enough now that we can eliminate her silly pre-req.