Basic med problem

[jaylw314]

10 minutes ago, N803RM said:

My basic med was completed by me personal Doctor.  We went through the form, line by line.  I was told that they did not have the color test, so She got creative, pointed to a poster and asked what colors I could see.  I did the vision test in the hallway with the normal charts.   When we had this completed, Her comment was, Is that all, "this was much easier than the Special Issuance crap that we were doing yearly. "

I like your doctor, I should see if we can hire her

 

18 hours ago, DonMuncy said:

The saga continues. Today my usual family doctor's office called and said she would not be able to do the exam, due to liability concerns of their group. This really does not surprise me too much. It doesn't take a rocket scientist to surmise that the doctor signing off on basic med is some sort of statement that the pilot is capable. And thus, if the pilot ever kills or maims someone, guess who a sharp plaintiff's lawyer is going to add to the list of people to sue.

There's a saying in medical school--

"Those who practice to not get sued are probably practicing bad medicine

Those who practice to not get sued successfully are probably practicing good medicine"

Whenever I see the former in doctors, I always make sure I question their decisions that much more carefully, because their decisions might not be in my best interest. 

[midlifeflyer]

3 hours ago, jaylw314 said:

There's a saying in medical school--

"Those who practice to not get sued are probably practicing bad medicine

Those who practice to not get sued successfully are probably practicing good medicine"

Whenever I see the former in doctors, I always make sure I question their decisions that much more carefully, because their decisions might not be in my best interest. 

Agreed. The actual liability in this situation is probably minimal. But fear is fear, reasonable or not. And it's not just physicians.

I sort of agree with @DonMuncy's comment the " It doesn't take a rocket scientist to surmise that the doctor signing off on basic med is some sort of statement that the pilot is capable. "  It takes a stretch of the  imagination, helped by a wee bit of paranoia.

Edited March 8, 2018 by midlifeflyer

[Dream to fly]

21 hours ago, Yetti said:

which is the one that make me laugh.   CDL and Aviation are under the same US Department of Transportation.  SMH

 

Since you went there...  So in order to drive commercial or fly you have to be in really good physical shape and pass a medical every couple of years.  But,  be able to pass a driving test 50 years ago and fog a mirror when you exhale and we will be happy to sell you a 40K pound rolling house that is 45 plus feet long pulling a car and a boat and have the softest air ride suspension.  Gotta love it.  Makes sense to me

[L. Trotter]

I have been providing basic Med (as a physician) since it's inception. I have spoken to the legal folks and believe I have this figured out (if that is even possible).

-There is no more liability doing basic med than any other medical assessment.

-A physician providing basic med is not in any way "certifying" the pilots ability (medical or otherwise) to fly a plane. The responsibility rests on the pilot to know if they are healthy enough (free of perhaps minor and certainly major illnesses) to competently and reliably pilot an aircraft. For example, a pilot can have a major "health event" 1 hour after being issued a basic med exam. There is no way a physician can determine the future. The same holds true for a CDL as well.

-The issue with many Docs is that they don't understand their possible "new" role serving pilots in a way that has traditionally been an FAA responsibility. Unfortunately, perception, right or wrong, is currently the guiding force. Give it time, things will improve as Docs learn and become more familiar with what is been asked of them.

-Many retired AME's do not carry malpractice insurance and therefore will not act as a practicing physician (ie. no basic med). As an AME, they are acting as a type of consultant for the FAA and are making a recommendation to the FAA as to wether the pilot meets FAA flight standards-a different medical-legal arrangement.

-As far as the eye exam....any Snell chart will work (the chart that has all the letters that 10 feet down the hallway). I actually use one on my computer that is adjusted for std reading distance. The basic med form only asks for vision (20/20 ect) corrected or not. There is no need for an eye specialist exam unless there is something unique and you would need to see a specialist....regardless as to the need for basic med. The same hold true for any medical specialist need.

-If you have a significant health issue (heart, psychiatric, diabetes ect) and have never been granted a FAA special issuance (waver) for that particular issue, you will need to re-visit the AME as the basic med will not apply. You are no longer a basic medical candidate. Once you receive the special issuance you now re-qualify for basic med. If you have never had an AME evaluation (new pilot), you will need one first, then you qualify for subsequent basic med exams.

I hope this helps.

[DonMuncy]

L Trotter, I think you are exactly right. It is unfortunate that a lot of doctors (like probably most of the general population) has a skewed perception of aviation and the risks and liabilities involved. I hope you are right about the situation improving over time.

[wburger1]

I went to CareOne in Richmond, TX right before school started and got the pre-school physical special.  Only paid $18.00 and passed in a half hour.  Now good for 4 years.

[steingar]

Funny, both AMEs that have done my 3rd class are DO's.  One was really pretty, but she sucked as an AME.

I never thought the MD thing would be so bad with Basic Med.  MD's sign stuff all the time.  I would think the law suit would be just as bad if the Doc signs Timmy off to play football and he gets killed.  Happens too.

[DonMuncy]

3 hours ago, steingar said:

Funny, both AMEs that have done my 3rd class are DO's.  One was really pretty, but she sucked as an AME.

I never thought the MD thing would be so bad with Basic Med.  MD's sign stuff all the time.  I would think the law suit would be just as bad if the Doc signs Timmy off to play football and he gets killed.  Happens too.

I agree with you, but the "airplanes are dangerous" bias comes into play when some people start assessing risk, liability, etc.

[MyNameIsNobody]

Having trouble finding a Basic Med Doc.  Liked the idea of asking my 3rd class doc to sign.  He wouldn’t.  I want not because of cost so much, but the hassle of every two years vs. four years on Basic Med.  The pilot is “self certifying” with every flight so buck literally and figuratively stops there, but fear of the unknown is a powerful thing and they can STILL GET SUED.  Need some case law out there to show them it is “safe” to certify basic med.  I wish AOPA would provide a list of docs by larger City that will do Basic Med.  Is there such a thing?  Not happy that my 3rd class doc won’t do it.  Kind of bullshit in my opinion.  I think I am going in to have a face to face on that decision vs. hearing from a nurse his position.  I will pass on the “why” of it when I have more information...

[jaylw314]

On 3/8/2018 at 5:31 PM, L. Trotter said:

I have been providing basic Med (as a physician) since it's inception. I have spoken to the legal folks and believe I have this figured out (if that is even possible).

-There is no more liability doing basic med than any other medical assessment..

Nice to hear it from a treating doc's side.  I worry that people will go to doc's other than their PCP since it violates the spirit of BasicMed.  I worry if the FAA sees a lot of MDs doing it who clearly have nothing to do with pilots' ongoing treatment, they may decide to yank it in the future.

[jaylw314]

On 3/9/2018 at 5:52 AM, steingar said:

Funny, both AMEs that have done my 3rd class are DO's.  One was really pretty, but she sucked as an AME.

I never thought the MD thing would be so bad with Basic Med.  MD's sign stuff all the time.  I would think the law suit would be just as bad if the Doc signs Timmy off to play football and he gets killed.  Happens too.

DO's go through exactly he same training and curricula, and are functionally identical to MDs.  I trained some DO students, and my impression is that the only difference is that they include an osteopathic manipulation course that is now optional

[HRM]

On 2/28/2018 at 12:07 PM, yvesg said:

OK folks, lets try this... how many fingers?

None...that's a Playboy Bunny logo.

[HRM]

2 hours ago, jaylw314 said:

DO's go through exactly he same training and curricula, and are functionally identical to MDs.  I trained some DO students, and my impression is that the only difference is that they include an osteopathic manipulation course that is now optional

Well known fact...can't get into US med school? Go DO, after that it's dentistry, podiatry and lastly chiropractic. Did I miss any?

[jaylw314]

6 hours ago, HRM said:

Well known fact...can't get into US med school? Go DO, after that it's dentistry, podiatry and lastly chiropractic. Did I miss any?

Not really true anymore.  And from professional experience I can say the quality of students is equally crappy

[DonMuncy]

Back when I went to veterinary medical school, it was reputedly harder to get into than medical school. I have no knowledge whether that was true, and zero information currently.

[Hank]

7 hours ago, HRM said:

Well known fact...can't get into US med school? Go DO, after that it's dentistry, podiatry and lastly chiropractic. Did I miss any?

I thought those who couldn't get into U.S. med schools went to the Caribbean, Grenada especially.

[HRM]

1 hour ago, Hank said:

I thought those who couldn't get into U.S. med schools went to the Caribbean, Grenada especially.

Well. I meant the ones who didn't want to leave the US.

As for vets, Don, all those different species? Much, much harder.

BTW, all my data is anecdotal.

[DonMuncy]

12 minutes ago, HRM said:

 

As for vets, Don, all those different species? Much, much harder.

 

I usually told people I was licensed to practice medicine on every species on earth, but one.

[L. Trotter]

11 hours ago, jaylw314 said:

Nice to hear it from a treating doc's side.  I worry that people will go to doc's other than their PCP since it violates the spirit of BasicMed.  I worry if the FAA sees a lot of MDs doing it who clearly have nothing to do with pilots' ongoing treatment, they may decide to yank it in the future.

I agree with your comment.

Unfortunately, 100% of the basic meds I've performed are not on my patients. All of these patient's primary care providers refused to perform this service. As a result, I typically spend a minimum of 1 hour sometimes 2 hours getting the patient's entire medical/surgical history. This may not be the spirit of what was intended, but it's the best I can do at this point. Someone (docs like me) has to get the ball rolling on the medical side. I believe once things get rolling personal primary care providers will jump on board and the program will run as intended.

[DonMuncy]

1 minute ago, L. Trotter said:

I agree with your comment.

Unfortunately, 100% of the basic meds I've performed are not on my patients. All of these patient's primary care providers refused to perform this service. As a result, I typically spend a minimum of 1 hour sometimes 2 hours getting the patient's entire medical/surgical history. This may not be the spirit of what was intended, but it's the best I can do at this point. Someone (docs like me) has to get the ball rolling on the medical side. I believe once things get rolling personal primary care providers will jump on board and the program will run as intended.

I think you are right. I (and I'm sure the pilots you have done) appreciate that people like you exist.

[L. Trotter]

9 hours ago, HRM said:

Well known fact...can't get into US med school? Go DO, after that it's dentistry, podiatry and lastly chiropractic. Did I miss any?

I'm sorry, I know this is off topic. I can't let this go and have others believe this inaccurate opinion.

Be careful with your "facts". Hope you were just kidding.

I am a DO. I was excepted to both MD and DO schools.I chose a DO school intentionally because I believed in spinal manipulation. My father was a chiropractor, out of choice, and never had any interest (nor applied) to any other profession. If you compare medical school curriculums, both MD and DO are identical with one exception, the DO's have an extra class on spinal manipulation. In reality, medical school is just a warm-up (MD or DO) to learning the art of medicine. A physicians skill set is really developed in residency (training after med school) which in many cases (like mine) is longer than medical school.

If I missed the humor or sarcasm of your comment i apologize.

[carusoam]

Nothing like working so hard to get a license to learn...  

Some of the coolest things in life start out this way.

Best regards,

-a-

[Tommy]

Here in Australia, Pilot's medical are done differently. The AME doesn't sign up on your medical, rather it's the chief medical officer of CASA (our FAA). The process begins with the pilot filling out an online questionnaire with questions probing every organ system plus mental health / drug&alcohol. Once it's completed, you front up to an AME and have every orifices probed. The AME then completes the rest of the online questionnaire with the physical findings and some personal comment like "this guy is my best fishing buddy." The computer then analyses all the data and if you are unlucky, it will ask the AME to arrange a few additional tests for you. Once those tests are done, your AME will upload the test results. For a lot of AMEs, the process of renewal stops here. 2-month extension is all they can hand out at this point in time if the computer says okay.

One of the medical officers of CASA will then take over. If everything looks legit, your application will be approved and signed off by the chief medical officer. If not, then begins the painful process of more tests and specialist's opinions. The back and forth can take months and makes you regretting buying your AME all those free beer.

But since the individual AME doesn't sign off the medical plus the fact that one is supposed to answer the questionnaire truthfully, it does alleviate almost all legal responsibility on AME's part. So it's not difficult to find an AME around in Australia but be prepared to fight government bureaucracy that is much more resourceful than you. 

 

[DonMuncy]

Not that it should be of much interest; I finally got my Basic Med exam done today. 

For anyone in Dallas, Martin McElya DO, did mine with no glitches. He is a pilot, and a nice guy.

[HRM]

On 3/11/2018 at 11:09 PM, L. Trotter said:

Hope you were just kidding.

Sort of. Anyway, see my profile: Interests--flying, diving and aggravating people.