Basic Med Physical Exam Question

[Marauder]

So, I’m up for my first Basic Med renewal. I had a physical in November but my primary care physician says he won’t sign off until he does an updated physical. My November physical was fine, I’m not on any prescribed meds.

 

Anyone go through this? Is there a requirement the physical be done in the same month as the expiration date?

 

 

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[EricJ]

1 minute ago, Marauder said:

So, I’m up for my first Basic Med renewal. I had a physical in November but my primary care physician says he won’t sign off until he does an updated physical. My November physical was fine, I’m not on any prescribed meds.

Anyone go through this? Is there a requirement the physical be done in the same month as the expiration date?

My first Basic Med was done coincident with my usual annual physical, but those, due to the program I'm on, slip a little every year, so that by the time my Basic Med renewal came up my annual was a month late.   My GP suggested just doing a "mini-physical" in time for the Basic Med and we covered it that way.   That worked well in my case, so maybe that's an option.

[midlifeflyer]

No. There is no requirement that the physical be done the same month as the expiration date any more than there was a requriement to wait until the expiration month to take another FAA medical exam.

Not expecting a problem, I do my BasicMed physical on the same schedule as the BasicMed course. Every two years instead of four. Every other annual physical.

[Pinecone]

My doc was the same. He would not sign based on a complete physical a couple of months before.

He did a quick exam and then did the paperwork.  But I am in a concierge service, so there was no charge.

I will do it this year with my normal physical.  He also does my SCCA medical at that time.

[Marauder]

My first Basic Med was done coincident with my usual annual physical, but those, due to the program I'm on, slip a little every year, so that by the time my Basic Med renewal came up my annual was a month late.   My GP suggested just doing a "mini-physical" in time for the Basic Med and we covered it that way.   That worked well in my case, so maybe that's an option.

Thanks for the reply. My original annual physical was at the same time as Basic Med but due to COVID, the timing got skewed as well.

I would have thought they built in a provision to say that if you had a physical within X months, you don’t need to set up a whole another physical 3 months since my last one.


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[rbp]

24 minutes ago, Marauder said:

Thanks for the reply. My original annual physical was at the same time as Basic Med but due to COVID, the timing got skewed as well.

I would have thought they built in a provision to say that if you had a physical within X months, you don’t need to set up a whole another physical 3 months since my last one.


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I think that since the doctor is the one signing off, he has discretion as to how he wants to conduct the exam

if you don't like his answer, find another doctor

unlikely you're going to get the doctor to change his mind

[midlifeflyer]

1 hour ago, Marauder said:

I would have thought they built in a provision to say that if you had a physical within X months, you don’t need to set up a whole another physical 3 months since my last one.

What "they" are you referring to? 

faa? "If you didn't have a CME  3 months ago, we will pretend you had  one anyway."

your physician? "I will sign something today about your health without seeing you today." Or, "sure, I always backdate things I swear to."

Is either how you conduct your business?

Edit: sorry. That sounded harsh. But as I read your post it sounds like, "I kinda screwed up but someone else should take responsibility."

[Hank]

I just get mine at the local.urgent care. Twenty minutes, $60, I'm on my way home.

[Marauder]

What "they" are you referring to? 
faa? "If you didn't have a CME  3 months ago, we will pretend you had  one anyway."
your physician? "I will sign something today about your health without seeing you today." Or, "sure, I always backdate things I swear to."
Is either how you conduct your business?
Edit: sorry. That sounded harsh. But as I read your post it sounds like, "I kinda screwed up but someone else should take responsibility."

The “they” I am referring to is the FAA. A physical is a snap shot in time and by no means is it an absolute whether you’re 100% healthy at the time of that snapshot. You could have a physical today and tomorrow die of a ruptured abdominal aortic aneurysm because the physician didn’t do an ultrasound even though you’re 65 and were a past smoker.

I would have thought since Basic Med relies on part that you as the participant have obligations under the medical self declaration, there would be some flexibility in time when the physician’s assessment could be done. They already give you to the end of the month to renew. So what’s the big deal if the actual date of the physical exam was 2 months ago and reported as such?

And I’m sure there are others like me who have visited physicians multiple times throughout the year and that my actual health status is much more well known than when I was getting 2nd or 3rd class medicals.

Another issue the cost. Most private medical plans only pay for one physical per year. Since my last physical was the end of November, the next time my insurance will cover it is 2024.


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[PeteMc]

I will admit I haven't read all of this thread...  But there are a few articles with AOPA by Dr. Brent Blue on the topic of Basic Med.

Everyone doing the Basic Med might want to research those.  If you're out west, you may want to reach out to "Doc Blue" through AOPA and see about a Basic Med Physical with him.  I understand he does them weekly at KDIJ (Driggs, ID).  Or you can fly into KJAC and make an appointment.

(I don't do the Basic Med as I want the option to go into the FLs, even though that's not my typical flight plan.)

 

Edited February 1, 2023 by PeteMc

[midlifeflyer]

11 hours ago, Marauder said:

would have thought since Basic Med relies on part that you as the participant have obligations under the medical self declaration, there would be some flexibility in time when the physician’s assessment could be done. They already give you to the end of the month to renew. So what’s the big deal if the actual date of the physical exam was 2 months ago and reported as such?

The FAA also relies on holder of a first class medical is to make a medical self-assessment on every flight.  You seem to be complaining that the ability to use your own doctor, have a CME exam within 4 years before a flight isn't flexible enough. You're right. It's no more a big deal that an AME signing off on a third class medical based on your last one. Or a CFI signing off on a flight review today based on a flight last year. Or for that matter, one of us deciding to fly IFR  when out of instrument currency? After all, I was legal only two days ago! I shouldn't have to track my currency. There should be some leeway!

Based on my read of your posts on multiple topics I'm actually shocked by your take on this.  Comes across as a "I want to make a purely 'me problem' somebody else's fault." 

[Pinecone]

16 hours ago, rbp said:

I think that since the doctor is the one signing off, he has discretion as to how he wants to conduct the exam

if you don't like his answer, find another doctor

unlikely you're going to get the doctor to change his mind

THIS ^^^^^^

 

[Marauder]

The FAA also relies on holder of a first class medical is to make a medical self-assessment on every flight.  You seem to be complaining that the ability to use your own doctor, have a CME exam within 4 years before a flight isn't flexible enough. You're right. It's no more a big deal that an AME signing off on a third class medical based on your last one. Or a CFI signing off on a flight review today based on a flight last year. Or for that matter, one of us deciding to fly IFR  when out of instrument currency? After all, I was legal only two days ago! I shouldn't have to track my currency. There should be some leeway!
Based on my read of your posts on multiple topics I'm actually shocked by your take on this.  Comes across as a "I want to make a purely 'me problem' somebody else's fault." 

I really don’t get your attitude towards my post or the discussion. It seems you are the one making it a problem by providing examples that are really off base of what I am asking. I simply asked why there isn’t flexibility allowed for a physician around the timing of a Basic Med physical especially if you are the constant care of said physician. My primary care physician sees me several times a year and also gets the medical reports from other practitioners who see me. Like I said previously, my doctor knows more about my health than ANY AME who conducted an FAA medical on me. What difference does it make if my physical was done one or two months earlier than the due date if my entire health dossier is available to them?

I’m guessing you’re one of the CFIs who strictly goes by the book when conducting the flight review of one of your closest and oldest friends. Everything evaluated per the book.


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[Parker_Woodruff]

You can redo the physical as many times as you want in the 4 year period.  There's no need to wait until the end of the 4 years.

[midlifeflyer]

5 hours ago, Marauder said:

why there isn’t flexibility allowed for a physician around the timing of a Basic Med physical especially if you are the constant care of said physician. My primary care physician sees me several times a year and also gets the medical reports from other practitioners who see me. 

Any time in a four-year spread resetting the clock for another four years isn't flexibility?  Nothing prevents you from getting the exam any time you want to. And I don't see anything in the statute, the regulations, the form, or the physician instructions that prevents a physician from  signing the form days, weeks months, or, theoretically, even years after an exam.  Even the certification talks about the "Date of Examination" not the date the physician signs. Please don't take my word for it. Read it all and see if you can find the prohibition. 

If your physician is willing, there is nothing preventing your physician from signing the form today but putting this past November as the date of the exam. There's not even a space for the physician to indicate the date they signed. Nothing that is, except of course, for your physician's position being, "I won't sign something today based on an exam I performed three months ago." 

[carusoam]

This is an interesting situation… that is probably more healthcare system related than anything…

1) Our doctor visits give us an AW inspection that says we are now airworthy at the time of the inspection…

2) Once we leave the office… anything can change.

3) Getting them to fill out the form days or months later…. Makes them need to be an expert on the Basic Med system…

4) Sounds like you need a doctor that is also a pilot at the same time…

5) My first experience with Basic Med… I was the first patient making the request with this doctor….

6) Things went much smoother the second time….  

7) Scheduling wise… I needed the Basic Med before I was schedule for the annual doctor’s visit…. Lucky!

PP thoughts only… certainly not a doctor… or FAA documentation expert…

Best regards,

-a-

[Fly Boomer]

1 minute ago, carusoam said:

1) Our doctor visits give us an AW inspection that says we are now airworthy at the time of the inspection…

2) Once we leave the office… anything can change.

This is how I explained it to my doc.  You aren't guaranteeing anything about tomorrow or even five minutes after I walk out the door.

[Pinecone]

3 hours ago, Marauder said:

I simply asked why there isn’t flexibility allowed for a physician around the timing of a Basic Med physical especially if you are the constant care of said physician. My primary care physician sees me several times a year and also gets the medical reports from other practitioners who see me. Like I said previously, my doctor knows more about my health than ANY AME who conducted an FAA medical on me. What difference does it make if my physical was done one or two months earlier than the due date if my entire health dossier is available to them?

It is up to your doctor.  Mine redid the basic things before signing mine.  And I had a complete workup a couple of months before.

[Rick Junkin]

12 hours ago, Marauder said:

I’m guessing you’re one of the CFIs who strictly goes by the book when conducting the flight review of one of your closest and oldest friends. Everything evaluated per the book.

Wow. Disappointing.

I’m one of those CFIs. My closest and oldest friends deserve nothing less. I want them to be competent and confident, and that’s why they come to me for their FR.

Cheers,
Rick

[Hank]

^^^^ THIS!!

When I was away from IFR for a year or so, I flew with a by-the-book Naval Aviator CFII, not until she was ready to sign my IPC, but until I was comfortable again.

It's my butt in the seat, sometimes with trusting passengers. I won't gamble all of our lives on a "friendly" signoff!!

[Ragsf15e]

@Marauder is a pretty congenial and helpful person to mooneyspacers.  Maybe people don’t agree with him on this, but I can kinda see his point… maybe my doc would sign, maybe he wouldn’t, but I’d like him to.  Either way, Marauder has a lot of good stuff to share after a very long ownership, so be respectful.  Id like him to stay here.

[ilovecornfields]

27 minutes ago, Ragsf15e said:

@Marauder is a pretty congenial and helpful person to mooneyspacers.  Maybe people don’t agree with him on this, but I can kinda see his point… maybe my doc would sign, maybe he wouldn’t, but I’d like him to.  Either way, Marauder has a lot of good stuff to share after a very long ownership, so be respectful.  Id like him to stay here.

I like him too. Even when he posts pictures that my eyes can’t unsee. But I do think junkman made a pretty damn good argument about why you wouldn’t want someone to sign you off who doesn’t do things by the book.

I don’t sign people off for basic med, mostly because I don’t practice outpatient internal medicine anymore. If I did, I would go by the book. I do see friends, colleagues and children of friends and colleagues quite often and I would do them a disservice if I took shortcuts with their care. If I’m not 100% ready to be signed off for my FR/IPC then you’re not doing me any favors by signing me off. Quite the opposite. Doctors who take shortcuts or document things that aren’t true don’t get a lot of respect from me either.

[midlifeflyer]

8 hours ago, Rick Junkin said:

Wow. Disappointing.

I’m one of those CFIs. My closest and oldest friends deserve nothing less. I want them to be competent and confident, and that’s why they come to me for their FR.

Cheers,
Rick

Mine too. Since some are even older than me, they insist on my honest evaluation. I really should thank @Marauder for the nice compliment 

Besides, "by the book" for a flight review is flight training that includes 

"A review of those maneuvers and procedures that, at the discretion of the person giving the review, are necessary for the pilot to demonstrate the safe exercise of the privileges of the pilot certificate."

So, yes, I absolutely do do it by the book and it gives me plenty of leeway to treat deviations from someone I have flown with for years with a different tape measure than I might use with a first timer or returning rusty pilot. 

But no, my close friends who come to me for flight reviews do not expect me to pencil whip an endorsement based on having flown for breakfast 2-3 months ago.

[midlifeflyer]

7 hours ago, Ragsf15e said:

@Marauder is a pretty congenial and helpful person to mooneyspacers.  Maybe people don’t agree with him on this, but I can kinda see his point… maybe my doc would sign, maybe he wouldn’t, but I’d like him to.  Either way, Marauder has a lot of good stuff to share after a very long ownership, so be respectful.  Id like him to stay here.

I like him too. A lot actually. Which is exactly why I was taken aback by the post. It seemed so out of character to me. 

[rbp]

so, my son is a CFI/II/MEI, and one time he was giving me an IPC. We are on the ILS and I'm under the hood

son: "how's this looking?" 
me: looks good. 
son: I show you half a dot high
me: half a dot? really???

he is just getting back at me for all those times....