Medical Reform

[wrench]

I was at an aviation safety conference Saturday and two AME physicians spoke during one session on the new rules for a Basic Medical. What I took away from what they were saying is that our general family physicians wont have much interest in performing the required paperwork and assuming any possible liability that might be associated with it. I'm curious on what our general pilot community's take on it is and if they have heard the same reports or concerns from those in the AME/Medical community.

[TTaylor]

I think it is going to be a mess and not sure it is going to save much money.  We could have gotten the same thing by just extending the Class 3 medical for those over 40 to four years rather than the current two.   I would guess that the office visit if you can get your doctor to fill out the forms will cost as much or more than the current Medical Examiners charge.

[mooniac15u]

For some I suppose cost is an important factor. However, this may seem more like a win for those who face constant delays in getting special issuance medicals approved each time, often with expensive, unnecessary tests.

[tony]

I think the two AME's are spot on.  Time will tell.  

[Marauder]

4 hours ago, wrench said:

I was at an aviation safety conference Saturday and two AME physicians spoke during one session on the new rules for a Basic Medical. What I took away from what they were saying is that our general family physicians wont have much interest in performing the required paperwork and assuming any possible liability that might be associated with it. I'm curious on what our general pilot community's take on it is and if they have heard the same reports or concerns from those in the AME/Medical community.

I agree. There may be some doctors who will participate but I know firsthand many won't. A few years ago I had a medical issue that required an SI. My primary was asked to provide a letter indicating my condition was stable. He wouldn't provide it until I sent him a letter indicating the FAA and my AME would be responsible for approving my return to flight status. They missed the boat on this one.

I'm still not happy that the 3rd class medical can't be used for the 4 year period. I just got my unrestricted 3rd class and I thought I would be good for 4 years. Nope. I would need to do the conversion to BasicMed in 2 years. 

[thinwing]

The two AMEs gave a very different take away from the similar seminar given last Saturday from our very own Mooney Bravo driving AME Dr Bob Achtel here in Sacramento.I wonder if the two AMES who suggusted liability concerns are miss stating the obvious.Under the rules ,a licensed physician is NOT certifying the pilot as fit to fly.That is not the intent of basic med...the Pilot himself is...All the physicians role ( other than a physical with in 4 years)is that he DISCUSSED the 10 or so factors that could preclude safe flight.Note I say 10 items...I don't know yet .,because the FAA has  not yet released those items...The main requirement...the one that certifys the pilot is a STATE DRIVERS LICENSE.Also the completed medical factors course AOPA will have online.So any perceived liability by a state licensed physician (no mention of type as in primary care)will resolve itself once the physicians realize exactly what their function is.Some will balk..but I predict very little refusal from physicians.In this case ..the physicians are acting as counselors....they will in fact incurr less liability than certifying your child as healthily enough for school sports.Again the form itself can be as simple as checked off medical history...I agree time will tell and as DR Achtel pointed out....you don't have to do basic med...you can still go to your AME just like before...that's what I'm doing because of two restrictions...18000 ft and flight to Canada and Mexico Maybe prohibited by being non icao.

[Jerry 5TJ]

I'm planning to keep getting 3rd class medical for a while yet.  Perhaps in 2 years the new rules will lead to a smooth process  

Another factor: It is cheaper to see my AME than to pay my primary care physician for an office visit. 

 

 

[thinwing]

He doesn't have to be primary care and you should have a basic comprehensive physical every 4 years anyway..you never got that from your AME..i.e. Worst physical since the one eyed retired Md vouching for scout camp

[Ron McBride]

I talked to my primary care giver Tuesday at Kaiser.  She told me that Kaiser will not do drivers license medicals.  She "may" be able to help and call it a general purpose medical and fill out the paper work.  She does sign yearly a letter to the FAA for my SI.  She is also not a fan of flying, and I have offered many times to take her for a ride.

Last week, I found a draft of the medical form on line and can not find it again.  Do you have a copy that could be shared/??   My SI expires the end of May.  Hopefully with the form she will understand more and help.    I may have to continue with the SI or try something else.   I am also going to call me AME and get his input.

Thanks Ron

[DonMuncy]

1 hour ago, thinwing said:

The two AMEs gave a very different take away from the similar seminar given last Saturday from our very own Mooney Bravo driving AME Dr Bob Achtel here in Sacramento.I wonder if the two AMES who suggusted liability concerns are miss stating the obvious.Under the rules ,a licensed physician is NOT certifying the pilot as fit to fly.That is not the intent of basic med...the Pilot himself is...All the physicians role ( other than a physical with in 4 years)is that he DISCUSSED the 10 or so factors that could preclude safe flight.Note I say 10 items...I don't know yet .,because the FAA has  not yet released those items...The main requirement...the one that certifys the pilot is a STATE DRIVERS LICENSE.Also the completed medical factors course AOPA will have online.So any perceived liability by a state licensed physician (no mention of type as in primary care)will resolve itself once the physicians realize exactly what their function is.Some will balk..but I predict very little refusal from physicians.In this case ..the physicians are acting as counselors....they will in fact incurr less liability than certifying your child as healthily enough for school sports.Again the form itself can be as simple as checked off medical history...I agree time will tell and as DR Achtel pointed out....you don't have to do basic med...you can still go to your AME just like before...that's what I'm doing because of two restrictions...18000 ft and flight to Canada and Mexico Maybe prohibited by being non icao.

Unfortunately, the question is not really what the doctor is certifying to, but (1) what the doctor "believes" he is certifying to, and (2) what a plaintiff's lawyer can later convince a jury he was certifying to. If the doctor thinks he may get sued if the pilot harms someone, he is likely going to be reluctant to sign off on most anything. A disclaimer in the regulation might help.

 

[Cruiser]

Lots of assumptions here and on all the other aviation message boards. The bottom line is we all will have to wait and see. As in almost everything these days, there are extreme views on both sides.

I have heard pilots say the BasicMed is going to be their way of getting around the FAA's no fly list of meds and conditions.........  NOT!

I have heard AMEs (mostly) say no physician will touch the exam form with a signature if they value their practice............. NOT!

There will be some unintended consequences for sure, but overall BasicMed just needs to get implemented so it can start being used.

[larryb]

Why not just visit the regular AME, pay their fee, and ask for the "basic med" version?

[tony]

All I know is when I asked my personal physician to write a letter stating my BP was stable, they freaked out when they heard pilot, flying and AME.  They refuse to author the letter.  That was 2 years ago.  So I get it, they were ignorant, but it is what it is.  I can just imagine whats going to happen when I ask them to sign a form.  I can hear the questions now. why do I have to sign the form?  Whats it for?  who are you sending it to?   Where is it going? etc ......

The medical profession practices defensive medicine.  They are so afraid of litigation.  

Cruser is right, we just need to wait and see.

Edited January 28, 2017 by tony

[Hank]

The way I understand it, we don't "send the form" to anyone, it just goes into our logbook and stays there, to be produced on request (just like our flight and aircraft logbooks, in a reasonable timeframe). I'm guessing the online class we will take has a completion certificate of some kind, that will also get stashed away; that part hasn't been released, finished or discussed much yet.

[Cruiser]

the online course includes a questionaire much like the MedExpress form we currently fill out. The form including a one time release for the FAA to check your drivers license for DUIs gets sent to the FAA. The FAA has 60 (maybe 90) days to review and/or deny approval just like they do now on 3rd class medicals.

3rd class by AME                                 BasicMed by your doctor

fill out MedEx and take code to AME         fill out check list and take to doctor exam

AME performs exam                                  doctor performs exam

if passed AME enters code                         if passed doctor signs form

downloads MedEx and signs

pilot keep medical, copy to FAA                   pilot keeps medical form

                                                                      pilot takes on line course every two years sends copy to FAA

[Danb]

Oh it's going to be so interesting, Larryb may be on to something 

[thinwing]

4 hours ago, larryb said:

Why not just visit the regular AME, pay their fee, and ask for the "basic med" version?

That's a really good idea!

[thinwing]

3 minutes ago, thinwing said:

That's a really good idea!

I know I am quoting my self,but it's a win win...for everybody...the AME are concerned about loss of revenue to their practices...they know no AME has ever been sued or held liable for death or injuries caused by a pilot they approved ,they are state licensed md and understand what basic med is...I cannot think of a reason that would not work.

qouting

[Tom]

On 1/28/2017 at 1:36 AM, thinwing said:

Under the rules ,a licensed physician is NOT certifying the pilot as fit to fly.That is not the intent of basic med...the Pilot himself is...All the physicians role ( other than a physical with in 4 years)is that he DISCUSSED the 10 or so factors that could preclude safe flight.

This is not correct, see:  AC 68-1.  https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC_68-1.pdf

 

 

Edited April 24, 2017 by Tom

[Cruiser]

Time will tell. Some GP doctors state they take more liability risk when they release high school students injured in sports. Others will avoid aviation altogether. 

The AMEs position is a bit biased, they will loose customers. Also, for years they have been told to hold strict limits on what they are allowed to accept, with BasicMed the FAA is telling them to use your own judgement on things they were never allowed to accept before. Gotta be a bit unnerving to do this.

Look at it from their perspective, a pilot comes in for a 3rd class exam with a medical condition that requires them to defer to the FAA and not approve. The next pilot he examines has the exact same condition and under BasicMed the doctor can approve him to fly.

[bradp]

I'd look to occupational health subspecialty physicians to provide the certification for the basic med. many are AMEs, understand return to work certifications, and are available in most major metro areas. I got my last 3rd class renewal with one and it was a totally streamlined process.

Remember you want a physician that is thorough but that doesn't know everything about you and your health history. For that reason I'd probably steer shy of ones personal primary physician.

Personally, I'm just going to ask my wife to sign the form. ;-). Or I'm on my way to a second class and it's a moot point anyway.

Sent from my iPhone using Tapatalk

[1964-M20E]

Suspending new federal rules maybe a good thing. 

What we got with the 3rd class reform was something but by no means the intent.   The intent was to get the feds out of the 3rd class physical business.  Go to your doctor and if you are good for normal activity you are good period no questionnaires, no forms nothing but a normal doctor visit. 

 

Maybe the new rules will be held up indefinitely all we need to do is what the law itself states.  Go see a doctor every 4 years at a minimum.

 

[DXB]

On 1/27/2017 at 7:49 PM, larryb said:

Why not just visit the regular AME, pay their fee, and ask for the "basic med" version?

This is a TERRIFIC idea.  I'm renewing my 3rd class in April the regular way but will ask at the same time if he would be cool with doing that in the future.  He makes the same (rather modest) amount of money, but with less work for him and his office staff.  Any other primary doctor will think it is a total PITA and naturally be nervous about liability in an unfamiliar area to them.

[tony]

15 hours ago, Tom said:

 

 

 

 

Well isn't that an "up yours" from the FAA. Any physician who reads the form isn't going to sign that.  It's requiring the physician to make a judgement about something they probably know nothing about.  Guess I'll be seeing my AME for a long time.  

[mooniac15u]

The conversations on MS around this issue have gone something like this:

"Congress will never pass it..."

"The president will never sign it..."

"The FAA will never meet their deadline..."

"The doctors will never sign the form..."

I think I will wait and see how the doctors actually react.