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Basic med problem


DonMuncy

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On 3/11/2018 at 8:47 PM, DonMuncy said:

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.

Veterinary school should be more difficult to get into, there are far fewer of them than medical schools.  When I applied I got the impression that their applicant pool wasn't as robust as the one for the medical schools.  That was a long time ago.

Speak of a long time ago, when I made my application women were a distinct minority in Veterinary schools and practices.  Now men are a distinct minority.  Last time Mrs. Steingar was in hospital all the MDs were woman and all the nurses were men.

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I am now having some success.  I contacted my “normal” physician (not FAA) and nurse of course lectured me on how I should be going regularly as I am (old) now. :)

She talked with Dr. and he is willing to do.  I was kind of a goober and didn’t understand that AOPA NOT FAA are gatekeeper, (for lack of a better word) on BasicMed.  I printed the new doctor question/info sheets and the questions that are taken to physician.  I filled out my info online (typed) and signed.  I got an eye exam in January (good until 2019) so hoping that will satisfy vision (along with acknowledgement that I am limited to day flight due to red/green issue).  Exam scheduled for 4/9.

Following the Dr. visit I will have his completed exam and information (that I maintain in plane).  I will then go online and do the online certification and will be “good to go” for four years.

Fingers crossed...

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Nice BasicMed info is on AOPA Home page at top with tab that reads: BasicMed.

All info on “how to proceed” is there.  I phoned AOPA and received a call back with questions answered.  Paid for membership right there with savings on flight physical every two years.

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For anyone who plans on, but has not yet done Basic Med, don't bother trying to do the on-line medical course until you have your medical exam done. You must list the doctor who did the exam on the form to get your certificate.

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3 hours ago, DonMuncy said:

For anyone who plans on, but has not yet done Basic Med, don't bother trying to do the on-line medical course until you have your medical exam done. You must list the doctor who did the exam on the form to get your certificate.

...and OK City apparently looks at them to check for such things as denied medicals and the like.

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Yeah the MD / DO thing... they are equivalent.  In fact I am an MD, my wife is a DO. DO schools seem to attract a bit more of a student population for better or worse that want to do primary care but even that stereotype is fading.  DO schools do be willing to take (in general) students who have had other life experiences / careers and want to come back to learn medicine and this is (in general) a good thing.  Some of the best sub specialists at one of the biggest super sub specialized Children’s hospitals I knew were DOs.  There are some biases, mostly political/historic in nature (my wife tells me that the licensing process for DOs in LA either or MS is arduous compared to MDs).  During the clinical part of medical school where you go to various hospitals we spent about half our time with DOs side by side literally learning the same things at the same places from the same people. There is a palpable bias toward MDs over DOs in the Harvard training programs for no good reason... but I’m sure that will fade when the older generations of medical educators do the same and DOs rise to leadership positions through those big hospital systems.   There seem to be a lot of DO schools schools in the Midwest and DOs seem to be most engrained there.   Hope this helps.  

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  • 2 months later...
Here's my recent BasicMed experience.  Possibly my information has been expressed in previous MS threads [my disclaimer].  :P
 
3 out of 4 AME's I queried in our local area [Santa Maria, San Luis Obispo, Santa Barbara will NOT do BasicMed exam.  Why not?  One AME said he could not do BasicMed because he is an AME!  WOW!  It has been stated to me, that the FAA is discouraging AME's from performing the BasicMed!  Another WOW!  Counterproductive that seems.  And, I do understand the FAA was ordered to implement BasicMed by Congress............obviously begrudgingly. 
 
One local AME said he would perform the BasicMed, stating that it was the same exam either way.  Sounds logical to me.  With that said, why not an AME perform BasicMed?  It's the same exam, with less paperwork for the doctors/office.   Hence, same exam, less paperwork equals more profit for doctor.  It's also been stated that AME's are angry over the BasicMed.  Why?  Again, same exam, less paperwork effort equals more profit. 
 
In addition, previously my medical care was from a state licensed physician.  A few years ago [for whatever reason], I was passed along to a Nurse Practitioner.  I've continued to receive quality care from the NP.  As we know, a NP is not acceptable to sign off on BasicMed.  In my opinion, my NP is quite medically qualified for such.  I understand not allowing an NP to sign off on the exam was a last minute compromise in order to get the bill passed.  How unfortunate.  Possibly with enough effort from AOPA and others, there could be a change to that rule allowing an NP to sign off on the exam.
 
My other findings...........trying to find a local state licensed physician to perform BasicMed is next to impossible, unless one is currently under the care of such.  It seems doctors are NOT accepting new patients here.  This is a burdensome situation.  Possibly others have experienced a similar situation.
 
The good news!.........my former physician [a nice acquaintance], who no longer sees patients on a regular basis, did agree to perform BasicMed for me.   Yippee!!
 
We have a local FAAST meeting scheduled soon and one of our guest speakers is a newly appointed AME who declined to perform BasicMed.  At the meeting, I will inquire "why not" and provide his answer on this thread. 
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9 minutes ago, MooneyMitch said:
Here's my recent BasicMed experience.  Possibly my information has been expressed in previous MS threads [my disclaimer].  :P
 
3 out of 4 AME's I queried in our local area [Santa Maria, San Luis Obispo, Santa Barbara will NOT do BasicMed exam.  Why not?  One AME said he could not do BasicMed because he is an AME!  WOW!  It has been stated to me, that the FAA is discouraging AME's from performing the BasicMed!  Another WOW!  Counterproductive that seems.  And, I do understand the FAA was ordered to implement BasicMed by Congress............obviously begrudgingly.  . 

My understanding is that the intent and spirit of BasicMed was to have primary care physicians who have a previous working relationship with the pilot be the one to do the exam.  An existing primary physician would be expected to have the advantage of knowing the pilot's medical history and already be involved in managing any treatment.  The idea of using "hired gun" physicians, including AME's, goes against the intention of BasicMed, even if technically not disallowed.

So yes, if you do not have a primary physician that you have a good working relationship with, then BasicMed wasn't really intended for you in the first place.  The whole Nurse Practitioner/Physician's Assistant thing throws another curveball into that too, although both NP and PA's are supposed to have MD's and DO's on site for consultation and supervision (in theory).

Knowing that, anything you can do ahead of time to prepare would increase the chances of success--talking about it with your physician the visit before actually showing up for the exam, asking your NP or PA if they can arrange an examination with their on-site physician, talking to the front office to set aside the time for an examination, etc.  Just showing up for a 15 minute appointment at the clinic with the form without doing any prepwork is almost guaranteed to be unsuccessful.

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"One local AME said he would perform the BasicMed, stating that it was the same exam either way.  Sounds logical to me.  With that said, why not an AME perform BasicMed?  It's the same exam, with less paperwork for the doctors/office.   Hence, same exam, less paperwork equals more profit for doctor.  It's also been stated that AME's are angry over the BasicMed.  Why?  Again, same exam, less paperwork effort equals more profit." 

Again, this sounds logical to me.........................it's the same exam, new patient or existing patient for the AME.  So why not?  Why is the FAA discouraging the BasicMed for AME's?  Interesting!

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10 minutes ago, MooneyMitch said:
Here's my recent BasicMed experience.  Possibly my information has been expressed in previous MS threads [my disclaimer].  :P
 
3 out of 4 AME's I queried in our local area [Santa Maria, San Luis Obispo, Santa Barbara will NOT do BasicMed exam.  Why not?  One AME said he could not do BasicMed because he is an AME!  WOW!  It has been stated to me, that the FAA is discouraging AME's from performing the BasicMed!  Another WOW!  Counterproductive that seems.  And, I do understand the FAA was ordered to implement BasicMed by Congress............obviously begrudgingly. 
 
One local AME said he would perform the BasicMed, stating that it was the same exam either way.  Sounds logical to me.  With that said, why not an AME perform BasicMed?  It's the same exam, with less paperwork for the doctors/office.   Hence, same exam, less paperwork equals more profit for doctor.  It's also been stated that AME's are angry over the BasicMed.  Why?  Again, same exam, less paperwork effort equals more profit. 
 
In addition, previously my medical care was from a state licensed physician.  A few years ago [for whatever reason], I was passed along to a Nurse Practitioner.  I've continued to receive quality care from the NP.  As we know, a NP is not acceptable to sign off on BasicMed.  In my opinion, my NP is quite medically qualified for such.  I understand not allowing an NP to sign off on the exam was a last minute compromise in order to get the bill passed.  How unfortunate.  Possibly with enough effort from AOPA and others, there could be a change to that rule allowing an NP to sign off on the exam.
 
My other findings...........trying to find a local state licensed physician to perform BasicMed is next to impossible, unless one is currently under the care of such.  It seems doctors are NOT accepting new patients here.  This is a burdensome situation.  Possibly others have experienced a similar situation.
 
The good news!.........my former physician [a nice acquaintance], who no longer sees patients on a regular basis, did agree to perform BasicMed for me.   Yippee!!
 
We have a local FAAST meeting scheduled soon and one of our guest speakers is a newly appointed AME who declined to perform BasicMed.  At the meeting, I will inquire "why not" and provide his answer on this thread. 

Your observation and experience are unfortunate and not unique. I am a physician well versed in this area. I've done all the AME stuff except take the required 1 week course in Oklahoma (Ive been signed up twice-some work thing always gets in the way). This is what I believe to be happening:

-AME's are FAA consultants and are acting as such. They are NOT practicing physicians when performing their "duty" for the FAA. Legally, as a consultant they have no need to carry malpractice insurance as they only recommend whether you qualify for a certain flight medical or not. 

-Basic Med does have a negative financial impact on AME's (less exams being given). They no longer have a monopoly on flight physicals.  I have a 20 year history with an AME Colleague who wont even answer a simple AME question for me. An overt and blatant act to not support Basic Med-sad.

-AME's are telling other non-AME physicians they are a high risk if they perform Basic Med exams (false and very misleading).

-Primary care physicians don't understand what Basic Med is and what they are signing.

-Basic Med is a congressional program, the result of a lobbying group (AOPA), not an FAA program.

-Now just a personal thought......The FAA does not want to give up any control and has no interest in supporting a program that was essentially crammed down their throat by congress. Government agencies at their core seek for more control and power, not less. They can't help it. 

Like any change it will take some time. Personally, I believe the core concept of Basic Med make a lot of sense and is an improvement in care and pilot qualification at a much more reasonable price. A pilots physician should be more qualified to render an opinion as to the health of their patient. This program is also consistent with the DOT CDL medical certificate for commercial truck drivers.

If it is of help to anyone, I am willing to provide Basic Med exams at Oshkosh is year. I will be there all week, hopefully camping close to the Mooney Caravan site. PM me if you have interest.   

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L.Trotter................thank you for your input.  As I read this entire thread, I'm discovering ideas and thoughts regarding my question of "why not".

I will post answers from our new AME as to his declining to do BasicMed.

 

 

 

 

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44 minutes ago, MooneyMitch said:

"One local AME said he would perform the BasicMed, stating that it was the same exam either way.  Sounds logical to me.  With that said, why not an AME perform BasicMed?  It's the same exam, with less paperwork for the doctors/office.   Hence, same exam, less paperwork equals more profit for doctor.  It's also been stated that AME's are angry over the BasicMed.  Why?  Again, same exam, less paperwork effort equals more profit." 

Again, this sounds logical to me.........................it's the same exam, new patient or existing patient for the AME.  So why not?  Why is the FAA discouraging the BasicMed for AME's?  Interesting!

Actually, it's not the same.  BasicMed has no minimum requirements or anything to be sent to the FAA.  The only checklist is a guideline for an exam, and the physician only affirms that he "reviewed" those systems, but does not document the findings.  He only signs to the fact that he provided normal medical treatment, reviewed any problem medications, and performed such an exam. 

An AME medical exam would not be providing "normal medical treatment," and, quite honestly, I would say he was unqualified to do so unless he was his "treating physician," which he is not.  Morally and ethically, an AME does not and should not become "your doctor," just the same way that a court-appointed physician does not become your doctor when he examines you for a court case.  THAT would seem to be a great way for an AME to get himself sued successfully.

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Maybe it's a bit of a regional thing, too.   When I was transitioning from a Class 3 to Basic Med I was also transitioning personal physicians.   One of our local AMEs told me if I had any trouble getting the Basic Med stuff done with a physician to just come see him and he'd do it.   My physician was fine with it so I didn't need to take him up on it.

 

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I have a Basic Med certificate and would gladly go back to my AME for a 3rd class IF the FAA would make some rule changes for those over 50, such as a minimum of three years between physicals (four would be better). I think a genuine 3rd class eliminates a lot of the ambiguities that surround the Basic Med.

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15 minutes ago, flyboy0681 said:

I have a Basic Med certificate and would gladly go back to my AME for a 3rd class IF the FAA would make some rule changes for those over 50, such as a minimum of three years between physicals (four would be better). I think a genuine 3rd class eliminates a lot of the ambiguities that surround the Basic Med.

I'm begging to agree with you at this point.   I do like the 4 year length on BasicMed.  That's what drew me to it initially.  Let's see how this all play out. 

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59 minutes ago, flyboy0681 said:

I have a Basic Med certificate and would gladly go back to my AME for a 3rd class IF the FAA would make some rule changes for those over 50, such as a minimum of three years between physicals (four would be better). I think a genuine 3rd class eliminates a lot of the ambiguities that surround the Basic Med.

Practically, I think the idea of BasicMed is of little benefit to pilots who are completely healthy, or those with significant issues requiring an SI.  It's the ones in between that would benefit most.  They'd be the ones who'd be seeing there primary physicians all the time for less severe issues, so their docs would know them reasonably well and be able to say those issues are addressed.  Ironically, the healthy ones don't see their primary docs but once every couple years for the flu, and they'd be the ones their docs would not know as well so they might be less inclined to sign off on BasicMed.

In any case, if you can get it to work, it's fine--exams every 4 years (no cost with health insurance) and (free) annual medical courses might not be much better than a 3rd class medical if you're completely healthy, but the $90 for a 3rd class medical pays for 2 weeks of my hangar rental :rolleyes:

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2 minutes ago, jaylw314 said:

In any case, if you can get it to work, it's fine--exams every 4 years (no cost with health insurance) and (free) annual medical courses might not be much better than a 3rd class medical if you're completely healthy, but the $90 for a 3rd class medical pays for 2 weeks of my hangar rental :rolleyes:

Last time I paid $90 for a 3rd class was during the late 20th century, you are getting off cheap.

That $90 pays for seven days of my hangar.

 

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25 minutes ago, flyboy0681 said:

Last time I paid $90 for a 3rd class was during the late 20th century, you are getting off cheap.

That $90 pays for seven days of my hangar.

 

That's because you live in the land of retirees :) 

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On ‎3‎/‎11‎/‎2018 at 11:16 AM, 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 believe Dental School is more competitive than Medical School.  Reasons are Obama care and lifestyle. 

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