PBOR2 passes Senate Committee

Last minute amendment from Diane Feinstein (D-Umbass)

The amendment modifies the physicians statement from
(iv) to sign the checklist, stating: “I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist.”; and

...

(iv) a certification by the individual that the checklist described in subsection (b) was followed in the comprehensive medical examination required in subsection (a)(7); and
to
(iv) to sign the checklist, stating: “I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual’s ability to safely operate an aircraft.”; and

...

(iv) a certification by the individual that the checklist described in subsection (b) was followed and signed by the physician in the comprehensive medical examination required in subsection (a)(7); and
and adds this:
(l) Authority To Require Additional Information.— (1) IN GENERAL.—If the Administrator receives credible or urgent information, including from the National Driver Register or the Administrator’s Safety Hotline, that reflects on an individual’s ability to safely operate a covered aircraft under the third-class medical certificate exemption in subsection (a), the Administrator may require the individual to provide additional information or history so that the Administrator may determine whether the individual is safe to continue operating a covered aircraft. (2) USE OF INFORMATION.—The Administrator may use credible or urgent information received under paragraph (1) to request an individual to provide additional information or to take actions under section 44709(b) of title 49, United States Code.

I'm wondering if she proposed that amendment at the request of the White House. If so, it might reduce the chances of a veto.
 
Does anyone know if Board Certified Nurse Practitioners will be able to give the sign-off?

The bill specifies that the exam must be done by a "state-licensed physician," and that the form has to be signed by the physician.
 
It doesn't sound like much of a reform if you still must see doctors and have forms signed.

I have my reservations because anything the government touches turns to shiste.
 
It doesn't sound like much of a reform if you still must see doctors and have forms signed.

I have my reservations because anything the government touches turns to shiste.

Although the form requirement is potentially troublesome, it does, at least, greatly reduce the number of issues that require FAA involvement/delays, and it also appears to avoid putting sport pilot privileges in jeopardy.
 
My daughter is a veterinarian. I'll have her sign my form right after she's done preg-checking a cow.

"Better to remain silent and be thought a fool than to speak out and remove all doubt." - Abraham Lincoln

In many states Stan, NPs can provide Primary Care services just like physicians. That's your "I learned something today".
 
They'll always be some doc willing to sign you off, if you have a pulse, I would guess.
 
They'll always be some doc willing to sign you off, if you have a pulse, I would guess.


Yep. Aren't there Docs who have devoted their entire career to scratching their signature on medical marijuana prescriptions?
 
Yep. Aren't there Docs who have devoted their entire career to scratching their signature on medical marijuana prescriptions?


Yes. Basically, medical marijuana = legalized marijuana.

Here in AZ we have "sign flippers" on every street order advertising "medical" marijuana. Prescriptions written on the spot....
 
How about AMEs that fought so hard to screw us into keeping the 3rd class. Maybe they will see it as a way to keep the cash cow and provide the sign-offs?

As a relatively new AME i can promise you that doing these exams is no cash cow! Your comment is simply wrong. I do it a service to the flying community not to get rich!

I see both sides but if I wasn't a pilot and someone brought something saying i just need this filled out so i can fly i would probably be pretty cautious about it.

Physicians are very much concerned and rightly so about taking on any additional liabilities. This will just pose another risk. As of a little over a year ago anyone who did DOT physicals had to take a minimum 8 hour online course then travel to a testing center to demonstrate they had the knowledge of who could safely operate a vehicle for hire. Now it seems odd that physicians who have no clue about flying can simply do exam and allow someone the right to fly.

Just playing the devils advocate, this coming from someone who has paid thousands to get my medical back after a short self limited atrial fib. rhythm issue

I hope it works out for everyone. I had to send nice guy out last month for terrible lung disease to get everything in order with lung tests, specialist letter notes from his provider when in the big picture I could care less if he is flying his RV up in the unpopulated area of Colorado.
 
How about AMEs that fought so hard to screw us into keeping the 3rd class. Maybe they will see it as a way to keep the cash cow and provide the sign-offs?

???

Cash cow???

If I was a successful Doc, no way in hell would I sign a paper exposing myself/my practice/my family to liability in exchange for a measly $100. I don't see any upside to that equation for a physician.
 
???

Cash cow???

If I was a successful Doc, no way in hell would I sign a paper exposing myself/my practice/my family to liability in exchange for a measly $100. I don't see any upside to that equation for a physician.

Must be a reason AMEs were among the only ones fighting this bill, right?
 
Must be a reason AMEs were among the only ones fighting this bill, right?

Can't speak to that, I only know what I'd do. I guarantee Docs without AME training are going to pass on this.
 
After all these years when your primary care,couldn't certify you to fly,they may be reluctant to take on the responsibility. If you have a good primary care doc. there should be no problem.
 
Once the House passes the legislation, and the President signs, the FAA will have a year to write the proper regulations. So, we have at least a year before this goes into effect, probably more.

Since my third class is due in March 2016, looks like I will have another medical exam to go through. Sigh.
 
???

Cash cow???

If I was a successful Doc, no way in hell would I sign a paper exposing myself/my practice/my family to liability in exchange for a measly $100. I don't see any upside to that equation for a physician.

Not so much the AMEs who fought this, but the AMA certainly came out against it. My belief is some political pressure from them is what stalled the FAA's revision of the regulation at the DOT level.
 
Not so much the AMEs who fought this, but the AMA certainly came out against it. My belief is some political pressure from them is what stalled the FAA's revision of the regulation at the DOT level.
The AMA is a lobbying organization for....whom.....Pilots??? No!!!....Physician's interests.
 
The AMA is a lobbying organization for....whom.....Pilots??? No!!!....Physician's interests.

What we don't know is what was the AMA's beef? Concerned that incapable pilots will be falling out of the sky? Concerned that a few Docs might miss that extra couple of hundred a month? Concerned about the potential liability Docs may take on?

I know they release a position paper or memo, but I'm not going to go and find it.
 
???

Cash cow???

If I was a successful Doc, no way in hell would I sign a paper exposing myself/my practice/my family to liability in exchange for a measly $100. I don't see any upside to that equation for a physician.
But doesn't your physician basically "sign you off" in the paperwork you take to your AME after some medical condition is over or stable?
 
What we don't know is what was the AMA's beef? Concerned that incapable pilots will be falling out of the sky? Concerned that a few Docs might miss that extra couple of hundred a month? Concerned about the potential liability Docs may take on?

I know they release a position paper or memo, but I'm not going to go and find it.
The AMA only had a dog in the fight because the Docs have a dog in the fight. And what would the docs want to protect???? Safer skies???? Not their job, that's the FAA's job....so deductive reasoning....???

I didn't want to believe it either but as Spock quoted Arthur C Doyle, "Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth."
 
The AMA only had a dog in the fight because the Docs have a dog in the fight. And what would the docs want to protect???? Safer skies???? Not their job, that's the FAA's job....so deductive reasoning....???

I didn't want to believe it either but as Spock quoted Arthur C Doyle, "Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth."

Yep. I'm sure that the docs actually believed that there was some sort of danger in the legislation from a safety perspective, but it was fabricated out of their need to retain business. The "few hundred per month" is but a small part of the pie - they fear the slippery slope of eliminating medicals.

Just a guess, but what else could they possibly have objected to?
 
Oh, and BTW - the AMA is also the reason why there has been a fight in various states that give NPs (Nurse Practitioners) full autonomy of practice. The medical community has been seeing many patients preferring the care of an NP over a physician, with the physician losing significant business.

I have a very close acquaintance that works in a practice of all NPs who have taken a big chunk (I estimate about 1mill/yr) out of physician's pockets with the Veteran's Administration. Hence my question about NPs in the PBOR2.
 
"Better to remain silent and be thought a fool than to speak out and remove all doubt." - Abraham Lincoln



In many states Stan, NPs can provide Primary Care services just like physicians. That's your "I learned something today".


Your humor node in your brain appears to have abscessed, and is turning you into an anus. You'd better get that checked out by your NP.
 
But doesn't your physician basically "sign you off" in the paperwork you take to your AME after some medical condition is over or stable?


It's one thing for your primary care physician to write a letter saying that your blood pressure is well controlled with meds, and you have no heart disease. It's another to "sign off" on that entire list.
 
It's one thing for your primary care physician to write a letter saying that your blood pressure is well controlled with meds, and you have no heart disease. It's another to "sign off" on that entire list.
Doctors need to "sign off" on far more serious conditions as well. We haven't heard of people having problems with that on a large scale.
 
Your humor node in your brain appears to have abscessed, and is turning you into an anus. You'd better get that checked out by your NP.
If you were intending to be funny, then I apologize. I thought it was your turn to be the ass three days ago and you were monopolizing the time.
 
Doctors need to "sign off" on far more serious conditions as well. We haven't heard of people having problems with that on a large scale.

Yes, but most of those people, if they have issues, won't cause metal to rain down on poor unsuspecting ground dwellers. Liability is the issue.
 
I didn't want to believe it either but as Spock quoted Arthur C Doyle, "Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth."

Bear in mind that the quote comes from a work of fiction. In reality, possibilities are often unknown or overlooked.
 
Is it feasible that the bill could include "hold harmless" language for the signing physician?

Technically yes, but that would defeat the point of the bill. Duh! Cant hold a dead guy responsible, and if there is a hold harmless where would the finger pointing end up?
 
Is it feasible that the bill could include "hold harmless" language for the signing physician?

I think that's an excellent idea. Now that the ball is in the House's court, they could add that as an amendment.
 
Technically yes, but that would defeat the point of the bill. Duh! Cant hold a dead guy responsible, and if there is a hold harmless where would the finger pointing end up?

I thought he was talking about a provision relieving the certifying physician from liability.
 
Yes, but most of those people, if they have issues, won't cause metal to rain down on poor unsuspecting ground dwellers. Liability is the issue.
I don't see how liability would be any different than it is now, although I guess some people don't tell their doctors that they are pilots. I have always confessed, though, and when I had a medical condition that needed a doctor's statement, it didn't seem to me that they were reluctant to provide one. Of course that is only my experience.
 
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I'm a pilot and a licensed physician. I wonder if I can sign my own form?
 
I wonder if you can add a hold harmless clause to the form and have it still be valid.
 
Yes, but the pilot is dead the physician is the next person to point the finger at.

Congress has the power to prevent that. As an example, they used that power in passing the 18-year statute of repose in the 1990s, which is what convinced Cessna to start making piston singles again.

Are AMEs getting sued? Historically, the manufacturer of the airplane seems to be the most frequent target of lawsuits.
 
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I wonder if you can add a hold harmless clause to the form and have it still be valid.

I don't see how the pilot could prevent others from suing the physician.
 
Must be a reason AMEs were among the only ones fighting this bill, right?

Just where in the hell do you come up with this crap? Sorry to say my friend you are clueless!

Step up to the plate and show me the info to support what your spewing!

Chew on this, i collect $125 an exam no matter what class. I could easily double my monies or prob. triple it by seeing regular patients in place of these. Instead i do these at the end of the day so they don't interfere with my regular schedule. This places me getting home 30-45 minutes later to spend with my family just to help a pilot. The cost comes nowhere close to compensate your for your time to review documents on certain physicals.
 
Congress has the power to prevent that. As an example, they used that power in passing the 18-year statute of repose in the 1990s, which is what convinced Cessna to start making piston singles again.

Are AMEs getting sued? Historically, the manufacturer of the airplane seems to be the most frequent target of lawsuits.

The FAA makes it explicitly clear that they will in no way or manner become involved in a lawsuit if your are sued. Instead it all falls on your own malpractice. Another positive for doing exams.

Except for meeting some fine people and sharing stories regarding flying doing physicals for the financial rewards for the most part not realistic!
 
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