Mister701 wrote:MTV:
You never could fly LSA if you KNEW that you had a disqualifying medical condition. You never could fly LSA if you were taking a prohibited medication whether you knew it was prohibited or not.

The strong point of this new process is that you don't have to give a medical history all the way back to circumcision and the form never reaches FAA. The exam is about the here and now.

Yes, its' true that to fly LS, you cannot have or be aware of a disqualifying condition, be it a condition or meds.

As to medical history, the bill VERY specifically requires that you answer (in your "checklist") the same set of questions that you are required to answer during a flight physical.....note the specific reference to the form 8500-8 in the bill, and note the questions....."do you have or have you EVER had....." . So, medical history is still a big part of this bill.

Under LS, you simply cannot suffer from a disqualifying condition....there we're exempt from history. Maybe. But, not with this bill. You'll still have to report you had hay fever when you were five.....or whatever.

MTV

OK, you nay-sayers have convinced me-- I'm emailing my Congressman & telling him to vote NO on this piece of shit bill so we can start over and get it perfect. Another four or five years and we might be able to get it right. Thanks for opening my eyes.

hotrod180 wrote:OK, you nay-sayers have convinced me-- I'm emailing my Congressman & telling him to vote NO on this piece of shit bill so we can start over and get it perfect. Another four or five years and we might be able to get it right. Thanks for opening my eyes.

I'm not suggesting that at all. All I'm saying is before you go all starry-eyed with wonder, take the time to actually read the text of the bill.

It's obvious that many have not, and they have inflated expectations as to what this bill does for aviation medical reform. Read the TEXT of the bill and judge for yourself if this really helps you in your situation. And, bear in mind that the remaining wild card will be the REGULATIONS that (guess who?) the FAA will develop to implement this bill, if it's passed. Still a long ways to go in this process.

MTV

MTV

mtv wrote:

hotrod180 wrote:OK, you nay-sayers have convinced me-- I'm emailing my Congressman & telling him to vote NO on this piece of shit bill so we can start over and get it perfect. Another four or five years and we might be able to get it right. Thanks for opening my eyes.

I'm not suggesting that at all. All I'm saying is before you go all starry-eyed with wonder, take the time to actually read the text of the bill.

It's obvious that many have not, and they have inflated expectations as to what this bill does for aviation medical reform. Read the TEXT of the bill and judge for yourself if this really helps you in your situation. And, bear in mind that the remaining wild card will be the REGULATIONS that (guess who?) the FAA will develop to implement this bill, if it's passed. Still a long ways to go in this process.

MTV

+1

Yeah, as it turns out it's a steaming pile. If it passes and is implemented, we'll all be shopping for the perfect doctor relationship, like TomD said. It's basically just a crowdsourcing for the Aeromedical division. I admit I was a little starry-eyed at first but it's becoming evident this is only slightly better than the 3rd class protocol because of the 4-year duration for the slip for us 40+ guys.

After reading this thread I kind of feel bad for all the non AME physcians who will be asked to sign off on this.

hotrod180 wrote:OK, you nay-sayers have convinced me-- I'm emailing my Congressman & telling him to vote NO on this piece of shit bill so we can start over and get it perfect. Another four or five years and we might be able to get it right. Thanks for opening my eyes.

... and neither have I suggested that. Its really just wait and see for now.

There's probably enough tinfoil hat wearing Bongos running around doing just that and I think it would be very counterproductive to any sort of collective movement. We'd all look like fools, too. The damage from it is not bigger than the use of it, so let our enemies play their part and speak against it. The only worry I have is if it will leave Sport people free of harm, mid to long term.

A major combat term like "Medical Reform" sets very high expectations. Like Mike mentions, starry eyes, lots of hearsay and guessing. I assume people hate to read. If its more than one sentence and there isn't a button to push that does all the work... things may remain untouched.

The only people who could possibly benefit from this are special issuance candidates who have several conditions that would otherwise require FAA Medical Branch judgment (time-consuming, expensive and nearly impossible to get). Instead, they get to run to several different specialists and try to convince each of them to sign their house, their yacht, their families and their Mercedes Benz away. Pilots will pay dearly for it, but at least there is a chance of the person being examined in person, rather than just being run through a risk analysis/ assessment database at the FAA. They judge by numbers and determine your risk without EVER touching you or talking with you, remember?

If your life insurance has an aviation exclusion clause, imagine what Dr. Jane Fritz's (MD Family Medicine) insurance company will say. So, Mrs. Fritz got no clue about aviation, aviation medicine, but she signs Jonathan Schmuck off, to go fly his twin engine aeroplane at night, IFR and with 5 people on board. Haaaahahahahaha!

I am sure there's a couple of "attorneys" around here who could shine a light at the liability involved.

just went back and looked at my Third class medical. The AME used to sign to this:
This certifies that pilot has met the medical standards prescribed in part 67, Federal Aviation Regulations, for this class medical certificate.

Pretty straightforward for the doctor. Very specific requirements, etc.

With this new bill, the doctor has to sign their name to this:

“I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual’s ability to safely operate an aircraft.”

Quite a bit of difference between the two, the AME used to sign that he "certifies the pilot has met the medical standards prescribed……."

On the new, he is not "certifying" the pilot, but he is certifying that "he has discussed all items on the checklist….. he discussed any medical condition that could interfere….., and performed an examination". Finally, he certifies that he is not aware of any medical condition that could interfere with….the ability to safely operate an aircraft"

With the original, the AME took all responsibility and point blank said "This certifies" i.e. he was certifying. With the new, it's all "I discussed, I discussed, I performed an exam, and I'm not aware of anything"

As a physician I believe this actually does represent significant relief even though the disqualifying conditions have not changed. This allows for you to work out your medical issues locally with your GP or AME without waiting for the FAA to respond. I have high blood pressure and got held up by the FAA who requested more info without specifically outlining what they wanted. My AME was satisfied and did not know what they were requesting so I got an stress echo and they passed me after spending 1000 bucks for the experience. That was a 6 month delay. Then I went and had a kidney stone and now the special issuance. Physical every year with xray to rule out stone being present, mind you xrays only see stones in 60 percent of cases. One time after sending in the same documentation on my special issuance for 4 years in a row they sent me a letter 9 months after my local AME cleared me and said I did not provided sufficient info and if I did not provide it my medical would be invalid in 30 days. I promptly sent in the same info and they cleared me. 3 months later I had another kidney stone, so much for their screening process, should have sued them. The real issue is all of us are a hair away from a special issuance which is the real problem. Not having to deal with OK City, priceless. And for those of us that are older and where on the every 2 year physical every 4 seems a lot better. Being able to resolve medical issues with your local doctor will be much more expeditious and practical.

So let's say that I'm reasonably healthy (for a fat bastard), but I do need some mild (not drastic) medication to keep a common medical condition (not immediately life-threatening) under control. Under the existing system I might need a special issuance to be legal. Under the proposed new system, I am assuming that the difference would be that my GP or AME would now write me a prescription for this medicine, tell me to take my pills on schedule, and send me on my way with the new form signed (without a special issuance). The difference being that the physician had the authority to put me on the medication without disclosing this to the FAA.

Do I have this correct, or is there something in the new bill that would not allow this to happen without a special issuance?

Bill, The disclosure requirement for prescribed or nonprescribed medications remains the same. The applicant has a legal duty to disclose. If something is known or withheld, we're falling into falsification of records and probably the same kind of emergency revocations as currently done. The doctor remains responsible to examine the person diligently (due diligence) and just like any AME, will make sure all the i's are dotted and all the t's are crossed. I have not been schooled (yet) on just how deep the FAA is allowed to dig into the patient file of a pilot who sits for the medical examination with their PHCP. So far, pilots could somewhat mitigate by making sure the AME is not the PHCP. No clue what's going to happen when your private doctor has doubts. Will they be able to request everything?

I have not seen a part of the bill that addresses non approved medications and antipsychotic medications, but am also too lazy to go search for it now. The special issuance apparatus doesn't appear to be unhinged. I am sure any doctor will receive some sort of pamphlet with an advisory circular or instructions on how to look, what to look for, and when to call Mommy for help.

In 2 years a person can develop a boatload of health related issues and while the now extended validity of 4 years sounds fantastic, it only serves to amplify the idiocy that has gone into this whole thing. If there wasn't a realistic way of keeping a tab on peoples health with Class III Medicals, this one shoots the bird square out of the Christmas tree.

EZFlap wrote:So let's say that I'm reasonably healthy (for a fat bastard), but I do need some mild (not drastic) medication to keep a common medical condition (not immediately life-threatening) under control. Under the existing system I might need a special issuance to be legal. Under the proposed new system, I am assuming that the difference would be that my GP or AME would now write me a prescription for this medicine, tell me to take my pills on schedule, and send me on my way with the new form signed (without a special issuance). The difference being that the physician had the authority to put me on the medication without disclosing this to the FAA.

Do I have this correct, or is there something in the new bill that would not allow this to happen without a special issuance?

Bill,

The problem is that at present, nobody knows the answer to that question. It seems that just about everyone seems to think that this bill will effectively eliminate special issuances, or at least take them out of the hands of the FAA.

I for one don't believe for a moment that the FAA will allow that to happen. At the very least, I suspect that the FAA is going to require the same tests as for a third class medical, but verified by your doctor during the exam and prior to the doc signing. And if they require tests be repeated every year now, why would anyone suggest that this bill would exempt that requirement? Remember, the FAA has determined and published what is required to safely fly an airplane, including tests required for a SI.

So, your gynecologist friend is your new "AME" for this purpose......but he doesn't get to DECIDE what constitutes "safe to fly"...the FAA has already established those standards. If he signs off on any condition or med that the FAA requires specific testing or waiting period for without doing those tests or delays, he has just opened himself wide open to litigation, and I'm sure the FAA will develop a "consequence" for any non AME who does this.

Again, the FAA has already thoroughly documented what constitutes "safe to fly".

Again, even after this bill passes and is signed into law, the FAA still has to develop regulations to implement the bill. I can't believe that the FAA, having demanded specific tests for SI for decades for a pilot to be "safe to fly" is going to suddenly announce those specific tests are no longer necessary, or they can be done every four years instead of annually. If you believe that, I've got a couple bridges I'd be willing to part with at "reasonable" cost.

The point is, until the FAA weighs in on this thing, the way it's worded, I'd say plan on doing whatever you've been doing for your medical. Me, I'm sticking with LS.

MTV

Aeromedical factors are a tiny, teency factor in aviation safety statistics. The situation is more comical if you prune out hypoxia or carbon monoxide (these things will never show up on a medical exam) from the nearly invisible amount of evidence that exists on the matter.

After all this, alcohol remains the biggest coincident factor. I think few would find a 3rd class flight physical as effective in detecting episodic alcohol abuse.

For the morbidly curious, here is a paper aimed at the threat hordes of suicide pilots that await the day for the FAA to drop its guard:
https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2000s/media/200605.pdf

TL;DR...It's really small. Less than 0.5% of fatal accidents. How many of those does anyone REALLY think will be able to be identified by examinations on a 4-year basis by a PCP, or even an incredibly talented AME? 2 year basis? 1 month basis? That does not happen in the real world very often. It doesn't make sense to emphasize the effort if the effort makes no difference at all, especially when false negatives will probably be far more prevalent than accurate assessments. That's the trouble with statistics like these.

The only other FAA pub out there with numbers seems to be this one from ages ago:
http://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/1960s/media/am69-02.pdf

Here is a study that looks at REAL SCIENCE in evaluating cardiovascular risks to flight safety. Imagine that:
https://www.researchgate.net/publication/5338839_Flight_Safety_and_Medical_Incapacitation_Risk_of_Airline_Pilots
(you can register to get a copy). We need more assessments like this to craft intelligent policies.

Little is known about the actual severity of aeromedical issues in actual flight safety, and this is a tragedy given the emphasis and consequences of the pilot medical certification system. The presence or absence of current 3rd class aeromedical examination practices does not seem likely to have any meaningful effect on safety compared to things like keeping gas in the tanks and learning not to fly into weather when you are not prepared. If this is the case, why is the idea of pruning back the exam process so terrifying to so many?

I don't think the FAA medical exams have anything to do with us as pilots; I don't think that eliminating aeromedical factors in crashing is the goal, but rather making the public feel warm, fuzzy, and safe.

Mountain Doctor wrote:I don't think the FAA medical exams have anything to do with us as pilots; I don't think that eliminating aeromedical factors in crashing is the goal, but rather making the public feel warm, fuzzy, and safe.

Absolutely, positively, 100 % accurate.

MTV

According to AOPA discussions if you develop an issue that that would trigger a special issuance you still have to go through the special issuance process only once and not on an annual basis. It is unclear whether 4 years later your local doctor will have to follow the same process as the FAA on the original special issuance. After the President signs the PBOR2 the FAA has the opportunity to write the rules that would interpret this law. That I believe is when all our questions will be answered.

mtv wrote:

Mountain Doctor wrote:I don't think the FAA medical exams have anything to do with us as pilots; I don't think that eliminating aeromedical factors in crashing is the goal, but rather making the public feel warm, fuzzy, and safe.

Absolutely, positively, 100 % accurate.

MTV

To be fair, the flight plans and ELTs help out quite a bit too.

According to AOPA discussions if you develop an issue that that would trigger a special issuance you still have to go through the special issuance process only once and not on an annual basis.

This will be a pretty big deal in itself if true for those that would have to jump this hoop every year.

I'm thinking along the same lines as MTV, I am not as well 'worded' so I just sit here and read while stewy over what I feel was a great waste of AOPA and EAA resources. I understand that it is all with good intentions but as I had mentioned on another forum, the government rarely (if ever) concedes to having less power or control.
Lately I have been trying to make up my mind if I am going to renew my medical. After this mess with PBOR2, I will be flying LSA and be happy. I just had my BFR a month ago, I enjoyed the economy and reliabilty of the 172 I have owned for 28+ years, I guess it is time for someone else to enjoy it. It has been sitting in the hangar waiting to be flown again. The RANS will be my primary and the 172 listed for sale come spring. Hopefully by then I can get all the bugs worked out and finally get some quality time in it.

WWhunter wrote:
The RANS will be my primary and the 172 listed for sale come spring.

That's an awful lot of family history to give up without a fight Keith... is there any way you can hold off on that decision until this medical issue gets sorted out in detail? I'm pretty sure you don't have too many more payments left on the 172, so can't you just wait and see?