Out of state alternative Basic Med?

O

Outofstate

Guest
Thinking of pursuing Basic Med next time my 3rd class medical is due. My doctor doesn’t do them, and I haven’t been able to find a local doc who will. A google search revealed a number of doctors who advertise FAA Basic Med, but none of them are in my state. I’ve also noticed that many if not most are alternative practitioners and chiropractors, not MDs or DOs. There’s no shortage of snake oil online, so I want to know for certain these places are legit before putting myself through the trouble of traveling. Also want to confirm there’s no kind of rule anywhere specifying that the basic med exam needs to be within state of residence. Thanks for any advice.
 
Outofstate said:
Thinking of pursuing Basic Med next time my 3rd class medical is due. My doctor doesn’t do them, and I haven’t been able to find a local doc who will. A google search revealed a number of doctors who advertise FAA Basic Med, but none of them are in my state. I’ve also noticed that many if not most are alternative practitioners and chiropractors, not MDs or DOs. There’s no shortage of snake oil online, so I want to know for certain these places are legit before putting myself through the trouble of traveling. Also want to confirm there’s no kind of rule anywhere specifying that the basic med exam needs to be within state of residence. Thanks for any advice.
Click to expand...
Going out of state for medical exams, FAA or BasicMed, has never been an issue. That being said, what state do you live in that you cannot find a doctor?
 
Have you read Part 68? I have and saw no requirement that the state licensed physician be licensed in the state of the pilot’s residency. Why would there be such a requirement?
 
I live in NC. My PCP would not do basic med. I drove one hour to SC.
 
Outofstate said:
I’ve also noticed that many if not most are alternative practitioners and chiropractors, not MDs or DOs. There’s no shortage of snake oil online, so I want to know for certain these places are legit before putting myself through the trouble of traveling.
Click to expand...

they must be state licensed physicians. Some states consider Chiropractors physicians, but I doubt an “alternative practitioner” is considered a physician by a state medical licensing board.
 
I know at least one practitioner of alternative medicine who is a state licensed MD.

As far as going out of state, where I live it is very common.
 
I assume a chiro who advertises basic med is doing so in a state that licenses them as physicians, but I understand OP's caution with that bunch :D
 
schmookeeg said:
I assume a chiro who advertises basic med is doing so in a state that licenses them as physicians, but I understand OP's caution with that bunch :D
Click to expand...
It seems many state boards of chiropractic medicine have made a statement concerning whether the ability to conduct BasicMed examinations is within their scope of practice. A google search may turn something up on their respective websites.
 
Brad Z said:
It seems many state boards of chiropractic medicine have made a statement concerning whether the ability to conduct BasicMed examinations is within their scope of practice. A google search may turn something up on their respective websites.
Click to expand...


Which states, and what do they say about it?

Chiros have been doing DOT exams for a long time. Not much difference.
 
Half Fast said:
Which states, and what do they say about it?

Chiros have been doing DOT exams for a long time. Not much difference.
Click to expand...
I honestly haven't googled all 50 states + DC and territories. Obviously there's no difference between a doctor of chiropractic (DC) in a state that considers them a physician and a state that does not, but the statute that created BasicMed said "state licensed physician". I suspect that Congress probably didn't intend for DCs to be included in that definition, but that's what the law says and that's how the FAA interpreted and enforced it.
 
The exam is so simple a CNA could do it, so I don’t see why a chiro shouldn’t if he’s licensed as a “physician.” When I use AOPA’s Basic Med doc finder for my area, 3 out of the 5 docs listed are chiropractors.

I’m due for my exam in Sep. I received a card in the mail recently from an AME in Lakeland advertising flight physicals so I called and asked if he did Basic Med. Nope, only class 1, 2, or 3. No explanation.

Is the FAA discouraging its AMEs from doing Basic Med exams?
 
Half Fast said:
Is the FAA discouraging its AMEs from doing Basic Med exams?
Click to expand...
No, but when conducting a BasicMed examination, they're doing so as a state licensed physician, not as a designee of the FAA. Apparently that has some not insignificant liability ramifications.
 
Brad Z said:
No, but when conducting a BasicMed examination, they're doing so as a state licensed physician, not as a designee of the FAA. Apparently that has some not insignificant liability ramifications.
Click to expand...


Yes, but I doubt it’s any worse than they face doing a DOT exam or a sports physical. The doc I called is not a full-time AME; he has a regular medical practice so he must be insured.
 
Half Fast said:
Yes, but I doubt it’s any worse than they face doing a DOT exam or a sports physical. The doc I called is not a full-time AME; he has a regular medical practice so he must be insured.
Click to expand...
I'm not an AME and I'm not an attorney. I'd ask the individual AMEs why they don't do them.
 
Half Fast said:
Yes, but I doubt it’s any worse than they face doing a DOT exam or a sports physical. The doc I called is not a full-time AME; he has a regular medical practice so he must be insured.
Click to expand...

Local Doc here stopped doing Basic Med because his insuror threatened to drop him if he continued.
 
JScarry said:
Have you tried the places that do the Commercial Driver physicals? The ones attached to my primary care physician will do them for just a little more than my AME charges.

https://nationalregistry.fmcsa.dot.gov/home
Click to expand...
This - just call a few or walk in with the Basic Med form and ask if they'll do it. 90% of the time they will. Make sure they can also do an eye test - which consists of an eye chart at the end of the hallway and you read some letters.
 
Brad Z said:
No, but when conducting a BasicMed examination, they're doing so as a state licensed physician, not as a designee of the FAA. Apparently that has some not insignificant liability ramifications.
Click to expand...

From what I've heard/read, the issue is more insurance. I'm not sure there are any real liability differences, though that doesn't mean there aren't perceived ones. I'm fairly sure the AME guidance is clear that AME's are not FAA employees and have no "cover" from the FAA in connection with exams they perform.
 
bradg33 said:
From what I've heard/read, the issue is more insurance. I'm not sure there are any real liability differences, though that doesn't mean there aren't perceived ones. I'm fairly sure the AME guidance is clear that AME's are not FAA employees and have no "cover" from the FAA in connection with exams they perform.
Click to expand...
insurance and liability go hand and hand. I suspect insurers see much less liability risk acting under the aegis of an FAA designee than as a stand-alone doc.

AMEs are not FAA employees, but they are applying part 67 standards and FAA guidance in their decision making. They are not making an assessment of whether the applicant has a medical condition that would prevent the applicant from flying safely, they are assessing whether the applicant met a standard set by the FAA.

When conducting a BasicMed exam, the doc is applying his or her clinical judgement rather than established standards. But if an accident occurred later, that doc might have to sit on the stand in court and defend whatever standard they did apply for that exam.

I suppose an AME could apply part 67 standards to BasicMed exams, and refuse to sign off on anything that would otherwise require a deferral, but I suspect that would result in customer dissatisfaction and would create unnecessary issues.
 
I'm wondering if these insurance companies are actually seeing claims related to BascMed exams, or if it's just a case of not having an objective basis to evaluate the claims risk and therefore wanting to play it safe by not getting involved.
 
Palmpilot said:
I'm wondering if these insurance companies are actually seeing claims related to BascMed exams, or if it's just a case of not having an objective basis to evaluate the claims risk and therefore wanting to play it safe by not getting involved.
Click to expand...

This report from last year from the FAA indicates no statistical difference in accident or fatality rates between Basic Med and 3rd Class Medical pilots:
https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2020s/media/202118.pdf
 
Jeff Oslick said:
This report from last year from the FAA indicates no statistical difference in accident or fatality rates between Basic Med and 3rd Class Medical pilots:
https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2020s/media/202118.pdf
Click to expand...

The accident rate of BasicMed is somewhat unrelated to the medical malpractice exposure of a physician conducting BasicMed examinations. As we all know, when there is a fatal accident, anyone who is in any way responsible for facilitating that flight could be the subject of civil litigation. The last doctor who signed off a pilot could be an easy target. For an AME, their defense is a simple "the pilot met the FAA standard when I conducted his exam". For BasicMed, the Doc now has to defend the rationale they used to sign the CMEC, which may include making judgements on conditions that would otherwise be made in OKC under a special issuance. I think insurance companies see this and the uncertainty from a litigation perspective, and either don't provide coverage or price it to compensate for the unknowns. I have no idea whether any BasicMed docs have been sued, or what the outcome is, but these types of things generally play out over several years, so there's not much experience over the past five years for anyone to assess the liability factor.
 
Brad Z said:
but these types of things generally play out over several years, so there's not much experience over the past five years for anyone to assess the liability factor.
Click to expand...

I understand your point, but I suspect if there was an accident/lawsuit along these lines, the interwebs would have spread word of it.
 
Outofstate said:
Thinking of pursuing Basic Med next time my 3rd class medical is due. My doctor doesn’t do them, and I haven’t been able to find a local doc who will. A google search revealed a number of doctors who advertise FAA Basic Med, but none of them are in my state. I’ve also noticed that many if not most are alternative practitioners and chiropractors, not MDs or DOs. There’s no shortage of snake oil online, so I want to know for certain these places are legit before putting myself through the trouble of traveling. Also want to confirm there’s no kind of rule anywhere specifying that the basic med exam needs to be within state of residence. Thanks for any advice.
Click to expand...

You said your "doctor" doesn't do them, by which I assume you mean your "regular" doctor. Have you asked your AME? Or just searched the FAA database for AMEs in your area? If they can do a 3rd class, they can do a Basic Med. They may or may not be willing to, but that's where I'd start.
 
Jeff Oslick said:
I understand your point, but I suspect if there was an accident/lawsuit along these lines, the interwebs would have spread word of it.
Click to expand...
Even if the number of cases turns out to be zero, I think there may be some validity to the view that five years may not be a long enough period for insurance companies to come to a statistically-valid conclusion about what the claims risk is.
 
My good friend just turned 80, flies a Comanche. His aviation insuror has forced him off Basic Med, and is requiring a 3rd class annually.

If he sells it and buys a 172, he can go back to a Basic Med.
 
Chip Sylverne said:
My good friend just turned 80, flies a Comanche. His aviation insuror has forced him off Basic Med, and is requiring a 3rd class annually.

If he sells it and buys a 172, he can go back to a Basic Med.
Click to expand...
Sounds like he needs a better insurance company.
 
Old Thread: Hello . There have been no replies in this thread for 365 days.
Content in this thread may no longer be relevant.
Perhaps it would be better to start a new thread instead.
Back
Top