Status of FAA Third Class Medical Exemption

[aviatingfool]

Yep, sure don't want to waste money on those negative biopsies, might save a few lives......

There is less and less "public policy" to believe in every day. But then someone whose star is hitched to the bureaucracy would never admit it. Just listen.....

 

[bbchien]

Like everything else in this increasingly third world county, it's about resouces. PSA is expensive. DHS uses about 1 Million as the value of a life saved or loss prevented, so the yield on doing annual PSAs is scored against that scale. 1M is what it was 25 years ago as well, so it has become effectively $300,000. As we descend into being a third world country, we score detection and cure rates against vaccinations, CABG, etc.

When Dr. Jerry Chodak "sold" PSA to the urological community circa 1985, it was a time when we saw a lot of advanced cancer and we were in the shadow of the debacle of Jackie Gleason, whose internist never offered to stick his finger up the U-know-what.

So Dr. Chodak's recommendation was made in the face of the docs seeing severe, advanced disease. Now since we operate on any prostate cancer and biopsy agressively, and most of what we see is contained. But the cost effectiveness isn't good, and MRI is available (didn't exist in 1985).

90% of what we see is very slow growing, indolent disease. That doesn't cut if for some, like David. And I get that. That is like when the enemy's round are coming at you, it's personal. YES IT IS. But we're talking NATIONAL POLICY here, so they are going to do the "million Dollar Calculation". And that's life in America.

If a person wants to actually pay personal resources, for an annual PSA, more power to them. But in fact none of us do that. David didn't do that. It's all insured. That is why, the joint task force came out and dissed annual PSA. The numbers don't add up.

In an ideal world I'd be doing MRI for everything....

David, try to stay sober....and try to "give it up". I mean this was 11/17/2011 for heaven's sakes when you last personally abused me.

 

[RJM62]

Thanks, doc.

-Rich

 

[steingar]

Yep, sure don't want to waste money on those negative biopsies, might save a few lives......

There is less and less "public policy" to believe in every day. But then someone whose star is hitched to the bureaucracy would never admit it. Just listen.....

What David doesn't understand is ALL men develop prostate cancer. In most it manifests as a benign and mild enlargement. Unfortunately it is far worse in some, which is why us old guys have to have someone stick their finger up our you-know-what on a regular basis.

I ran with a lady doc for awhile thinking just like Rich. She was way worse than the guy I got now. And he at least laughs at my jokes. "One last thing doc, I need a letter to my wife...

...yes, I was hoping for a letter explaining that indeed, my head is not in there.

 

[Old Geek]

The best piece of prostate advice I've heard is "use it or lose it"

 

[Marauder]

The best piece of prostate advice I've heard is "use it or lose it"

Too funny! Is one form better than another?

 

[Unregistered]

This has been perhaps the most informed discussion of the topic that I have read. I found it using a Google search. I hope that Doctor Chien is wrong about the proposal's chances but I suspect he's right. I've had a couple of issues through the years and have always self grounded and worked through the problem with FAA. Not hard, though I had to get on a commercial flight once to go and talk to a regional AME administrator. It was worth it and I got an attaboy from that particular doc. I'm flying LSA now but may go after a 3rd class with the docs help later. If the new proposal goes through I will buy something larger and continue to self certify as I always have.

 

[Unregistered]

@ "Rich" aka "Noveau Hillbilly"

Very well written observations on the role of bureaucracy and politics vs. science and logic !
I think there is a general drift, where we are regulated (i.e., governed) by fiat from independent (i.e., unaccountable) agencies. Politicians set up these agencies (FAA, Dotransportation, DoEducation, DoEnergy, EPA, FCC, CDC, etc.) which are all buffered from direct legislative intervention. The same with executive orders. The regulations They issue do not necessarily have the "consent of the governed" and little recourse is avaiable when they don't. In the present case, despite the overwhelming majority of pilots favoring the petition, the pilots have no real power or say in the outcome of this FAA decision. We must await, powerless, for their fiat decision. No consent of the governed.

John

 

[N918KT]

http://www.aopa.org/sunnfun/2013/13...-for-third-class-medical-e.html?CMP=News:S1RM

Update on the 3rd class medical exemption petition. Dr. Chien, you may be right all along of this may not get passed. Seems that the FAA is going to let this one go into a cliff hanger not knowing whether or not this would get passed. It may be dead on arrival.

 

[Warrior]

I like the expansion of the Light Sport to include planes such as the Piper Warrior or the use of the driver's license instead of doing the third class but I predict that this won't happen.

 

[X3 Skier]

I like the expansion of the Light Sport to include planes such as the Piper Warrior or the use of the driver's license instead of doing the third class but I predict that this won't happen.

I suspect the reason that will not happen is the manufacturers of LSA airplanes will suffer from the many old Warriors, etc in the market. They are suffering enough by their estimation to withstand such as assault of the market.

It again is logical but we are talking about the FAA.

Cheers

 

[Warrior]

I suspect the reason that will not happen is the manufacturers of LSA airplanes will suffer from the many old Warriors, etc in the market. They are suffering enough by their estimation to withstand such as assault of the market.

It again is logical but we are talking about the FAA.

Cheers

Isn't the light sport market suffering from the 150k price tag of their airplanes! I don't think that market has taken off like some had hoped.

 

[X3 Skier]

Isn't the light sport market suffering from the 150k price tag of their airplanes! I don't think that market has taken off like some had hoped.

It is as bad as it is now with just their LSA competitors. If they had to also to compete with $25K - $40K Warriors and 172's they probably wouldn't sell another plane.

Cheers

 

[bbchien]

I would remind those reading this, that the Board of Aviation Medical Advisors of AOPA counterproposed that instead of the current "hard to see how it is possible to win this one", recommended back in September 2011, that we go for what our Aussie buddies did- GP signoff (it's more comprehensive as they have a National Health System) for 3,200 lbs and under, 2 persons up, fixed gear, fixed prop, Day VFR. They won that in summer 2012.

We could have been there. In the states, that would be a State CDL signoff medical, done by your family doc. This was even supported by legal.

But instead, we are noplace. I could be wrong. But I have been watching since 1979 and haven't been wrong yet (There SERIOUSLY could be a first time on "policy" - but "I don't think so.... ").

Oh well. Didn't look "glamorous" or "sweeping" enough I guess, for current leadership.

 

[somorris]

for current leadership.

Which will soon be changing .

 

[Unregistered]

Doc C: always appreciate your intelligent insights. So much naive cheerleading or useless ranting on other websites.

I believe there will be blowback from a lot of angry pilots whose hopes were raised by self-serving BS from AOPA/EAA leaders. Maybe the latter will find new careers on Wall Street.

 

[steingar]

Might become a priority for the FAA if a few Senators got involved...

 

[bbchien]

Doc C: always appreciate your intelligent insights. So much naive cheerleading or useless ranting on other websites.

I believe there will be blowback from a lot of angry pilots whose hopes were raised by self-serving BS from AOPA/EAA leaders. Maybe the latter will find new careers on Wall Street.

No. Actually this one came to us from "K" Street, in DC. Lobbyist row.

 

[dibaf]

I believe EAA has recently said that they do not expect the petition to go anywhere.

 

[KeithASanford]

Dr. Bruce,
Do you think the recent development of the Special Issuance rules could be interpreted as a partial response/compromise to the 3rd class medical petition or were those changes in the works independent of the petition? It does involve a more leniency in the medical requirements.

 

[Jim Logajan]

Dr. Bruce,
Do you think the recent development of the Special Issuance rules could be interpreted as a partial response/compromise to the 3rd class medical petition or were those changes in the works independent of the petition? It does involve a more leniency in the medical requirements.

Unsolicited opinion: Seems likely to have simply been part of a periodic update. The Pilots Bill of Rights has a section on "new" statutory requirements that medical certification must now meet, but hard to say whether it has any influence yet, or ever will.

 

[bbchien]

Unsolicited opinion: Seems likely to have simply been part of a periodic update....

Has no clue.

Dr. Bruce,
Do you think the recent development of the Special Issuance rules could be interpreted as a partial response/compromise to the 3rd class medical petition or were those changes in the works independent of the petition? It does involve a more leniency in the medical requirements.

No. It is a direct response to a meeting last May 13 with the Federal Air Surgeon, in a ballroom in Atlanta, in which the 100 busiest AMEs met to say, Dr. Tilton, "your system is broken and you need to let us help you". These 100 guys - can't ignore and simultaneously hope the system will survive.

Those 100 guys do a SIGNIFICANT percentage of the whole of medical certification. If their cases simply got dumped into the system, the camel's back would break.

I know this because....well I was present.

******

I need to give credit to a couple of the Examiners on the 3rd floor of the CAMI building in OKC. They pushed it and wrote the protocols. They can read handwriting, too.

There are a few more cooking.

 

[Jim Logajan]

Unsolicited opinion: Seems likely to have simply been part of a periodic update.

Has no clue.

Can't argue with your assessment since I labeled it as an opinion. In my defense, I was relying on the simple fact that the following 55 page document covering changes to the guide showed them occurring several times a year over the last 6 years. Naturally it didn't mention the back story (which is much appreciated; thanks) to the latest changes.

http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/archives.pdf

 

[airheadpenguin]

We could have been there. In the states, that would be a State CDL signoff medical, done by your family doc. This was even supported by legal.

I was talking with one of my CDL buddies and it sounds like the DOT is going to an AME type system there as well since the states DMVs are now also being required to hold onto a copy of your CDL medical.

We shall see since the state compliance deadline is January 2014 and mine expired in December, so I'll get to see this new system first hand ... soon

 

[denverpilot]

I believe EAA has recently said that they do not expect the petition to go anywhere.

Probably more objective than the supposedly pilot membership organization selling medical "assistance" add-ons to their membership dues.

Just sayin'.

AOPA has created their own fiscal disincentive to move to a simplified medical certification path, with their enhanced medical services plan. Right?

If they work to fix the problem, it now hurts their bottom line. Doing both is quite odd.

 

[KeithASanford]

Probably more objective than the supposedly pilot membership organization selling medical "assistance" add-ons to their membership dues.

Just sayin'.

AOPA has created their own fiscal disincentive to move to a simplified medical certification path, with their enhanced medical services plan. Right?

If they work to fix the problem, it now hurts their bottom line. Doing both is quite odd.

 

[RV10flyer]

http://www.eaa.org/en/airventure/ea...edical-certificate-reform-its-a-high-priority

 

[nddons]

Go to the AOPA tent at OSH. You can sign a big chart that I'm sure will be sent to DC ASAP.

 

[denverpilot]

Go to the AOPA tent at OSH. You can sign a big chart that I'm sure will be sent to DC ASAP.

Ooh. Be still my beating heart.

 

[RJM62]

Go to the AOPA tent at OSH. You can sign a big chart that I'm sure will be sent to DC ASAP.

I hope it's perforated every six inches to make it more useful to Members of Congress.

-Rich

 

[EdLarkin]

I sat thru the Administrator's briefing at Osh on July 31st. What a pile of crap. Excuses for everything (medical, 100LL, part 23, etc.) . A smirking politician that won't do anything until forced.

It was obvious that both Pelton and Baker (EAA and AOPA) were doing nothing to push for GA, merely toadying up to him.

Unfortunately, I couldn't stay for Senator Inhofe's session this AM. It promised to be interesting.

 

[CTLSi]

Watching Democrat Party voters suddenly expect their version of the Federal Government to actually serve the people is a laugh to watch. The FAA, IRS, EPA, HHS, VA, all of it are now fully formed in the image of Obama and the liberals.

See why it matters now? You won't see anything out of the FAA for years now.

 

[Jay Honeck]

Watching Democrat Party voters suddenly expect their version of the Federal Government to actually serve the people is a laugh to watch. The FAA, IRS, EPA, HHS, VA, all of it are now fully formed in the image of Obama and the liberals.

See why it matters now? You won't see anything out of the FAA for years now.

Post of the Decade, here. Sadly.

 

[Palmpilot]

Watching Democrat Party voters suddenly expect their version of the Federal Government to actually serve the people is a laugh to watch. The FAA, IRS, EPA, HHS, VA, all of it are now fully formed in the image of Obama and the liberals.

See why it matters now? You won't see anything out of the FAA for years now.

Neither party has clean hands when it comes to serving the people.

 

[ClimbnSink]

Neither party has clean hands when it comes to serving the people.

Yup. Big gov't is a bipartisan boner. They both love it, one side just denies it sometimes.

 

[Henning]

Post of the Decade, here. Sadly.

When did Republicans stand up for GA? You think there's a difference?

 

[Capt. Geoffrey Thorpe]

Watching Democrat Party voters suddenly expect their version of the Federal Government to actually serve the people is a laugh to watch. The FAA, IRS, EPA, HHS, VA, all of it are now fully formed in the image of Obama and the liberals.

See why it matters now? You won't see anything out of the FAA for years now.

Something changed?

Really?

 

[cowman]

You'd think Democrats would love GA... what with their efforts to get wealth away from the rich and all....

 

[N918KT]

I am beginning to wonder if Republicans are more Pro-Aviation or Pro-GA than Democrats and if Democrats are more against issues relating to aviation and GA? Since we have so few Democratic cosponsors in both the House and Senate supporting GAPPA, is this usually the case?

 

[dans2992]

My impression is that maybe 90% of non-professional pilots are Republicans, and that Democrats generally hate GA more than the Republicans. Although neither party really likes it.