I agree with dbahn, Basic Med is a good start. And it might be getting a little better (see
here). The FAA reauthorization bill might not survive the sausage factory but it did
pass out of committee unanimously so it has strong bipartisan support.
Any improvements will have to come legislatively, the "doctors" in OKC will not heal themselves.
I also agree with Jon Wilder. The FAA medical branch is a self-dealing mess. They are far more beholden to the bureaucracy than to any notion of safety. The AME on this board are great about pushing "Health First, FAA later" But the bureaucrats have created significant disincentives for doing so.
To a great degree, this could be solved (or at least greatly mitigated) by raising the Sport limits to 12,500 pounds, 6 PAX, and 250 IAS. No legislation required. The big winners would be the the revenue airman who would not have nearly as long a wait for SI with the Class 3 cleared out of the queue.
Relevant portions from link:
BasicMed: The legislation would expand BasicMed privileges by increasing the number of allowable passengers from five to six and increasing the allowable number of seats in an aircraft from six to seven. In addition, the maximum certificated takeoff weight of the aircraft would be increased from 6,000 pounds to 12,500 pounds. Language would also require the FAA to help facilitate the recognition of BasicMed in Canada and other countries and would allow designated pilot examiners (DPEs) to administer a practical test or proficiency check while flying under BasicMed.
Improving FAA medical processes: The bill would also establish an aviation medical working group to work with the FAA in reviewing and improving medical processes and policies to ensure timely and efficient certification of pilots. The working group would also address the special issuance process and the appropriateness of expanding the list of medical conditions an aviation medical examiner can issue; evaluate certain medications and treatments approved for use by pilots; address ADHD, ADD, and mental health processes and policies; and review technologies to help red-green color blindness and their possible application for pilots.