I was talking to someone today about medicals which leads into some of the silliness of the FAA.

Does anyone know if there is a list on medical caused accidents, comparing class 1, 2, 3, basic, sport?

The question was raised, if we rolled all classes of medicals into basic med, aside from making the system much easier, eliminating tons of gov bloat, if it would actually change REAL safety based on the evidence we have currently.

I was getting old enough to consider blood pressure medication just a few years after AOPA started providing legal services, which I made use of. Personally, and among other National Guard Airmen, medical issues with the FAA became much more problematic. Army Flight Surgeon, no change. Was there a need to find other avenues of sanctions, I don't know. They are just here to help, right?

When you go in to renew your medical, you are entered in the computer before exam. If you don't pass, for any reason say fever or something, you fail. Now a waiver is required. My civilian flight surgeon refused to go on computer. He was dropped. I don't know how to check government records, but during that time I knew of no pilot who was able to get a waiver from Dr. Wilson at Kansas City FSDO. Word on the street was that it didn't happen.

I was thinking more a break down of medical caused crashes and a breakdown by medical. Like NTSB stats

Having a government worker say if someone is fit, give them a pseudo diagnosis, sometimes not even backed up by multiple real MDs acting as a MD and making a dx on their medical license, FAA types never having never laid hands on the Pt, seems like quackery, vs laying out the standard of what said Pt needs to do as a pilot, and having a qualified MD check them off if they are good to go.

Knowing airmen with 1st through basic, I’m just not seeing the difference in health you’d expect based on how the FAA pitches it.

The Nall Report from AOPA MAY offer some insights, but frankly, aircraft accidents with a probable cause as medically related are so rare as to be nearly non existent.

But, therein lies the problem: The FAA can, and does, argue that the aeromedical testing system is so good that it virtually eliminates medically induced aircraft accidents.

Here's the problem: An FAA flight physical is nothing more than a snapshot of a pilot's condition on a particular date/time. Even a Class One medical is good for six months, and a lot can happen medically in six months.

AND, if a pilot is willing to er....forget to mention a few "minor" medical issues to the AME, well, how is the AME to discover many underlying conditions that could be problematic and in fact, disqualifying.

Several years ago, on a commercial flight on the East coast, operated under Part 135, a pilot, who held a current Class one medical certificate, passed out in a diabetic coma in flight. It happened that a private pilot was able to land the plane, saving everyone aboard. That pilot, it turned out, was a Type 1 diabetic, which at the time was a disqualifying condition for holding a medical......

Point being, that pilot was aware of his type 1 diabetes, but had managed to hide it from the FAA for years. I've known pilots who had medical history that would have been problematic (as in requiring a Special Issuance) to medical certification. They simply failed to mention the condition to the AME.

I'm certainly not condoning that approach, just pointing out just a couple of the reasons it is difficult to develop an accurate means to fairly evaluate the effectiveness of the Aeromedical certification process.

Which brings up the primary argument for Basic Med: Your primary care physician may in fact be a far better judge of your health and fitness to operate an aircraft than the AME that you see every few years. There are clearly conditions that the FAA doesn't like which may in fact have near zero negative affects on one's ability to safely pilot an aircraft. The FAA Aeromedical Branch's attitude is that there are lots of pilots....grounding a few is no big deal.

Simple answer: It's a complex situation.

MTV

mtv wrote:The Nall Report from AOPA MAY offer some insights, but frankly, aircraft accidents with a probable cause as medically related are so rare as to be nearly non existent.

But, therein lies the problem: The FAA can, and does, argue that the aeromedical testing system is so good that it virtually eliminates medically induced aircraft accidents.

Here's the problem: An FAA flight physical is nothing more than a snapshot of a pilot's condition on a particular date/time. Even a Class One medical is good for six months, and a lot can happen medically in six months.

AND, if a pilot is willing to er....forget to mention a few "minor" medical issues to the AME, well, how is the AME to discover many underlying conditions that could be problematic and in fact, disqualifying.

Several years ago, on a commercial flight on the East coast, operated under Part 135, a pilot, who held a current Class one medical certificate, passed out in a diabetic coma in flight. It happened that a private pilot was able to land the plane, saving everyone aboard. That pilot, it turned out, was a Type 1 diabetic, which at the time was a disqualifying condition for holding a medical......

Point being, that pilot was aware of his type 1 diabetes, but had managed to hide it from the FAA for years. I've known pilots who had medical history that would have been problematic (as in requiring a Special Issuance) to medical certification. They simply failed to mention the condition to the AME.

I'm certainly not condoning that approach, just pointing out just a couple of the reasons it is difficult to develop an accurate means to fairly evaluate the effectiveness of the Aeromedical certification process.

Which brings up the primary argument for Basic Med: Your primary care physician may in fact be a far better judge of your health and fitness to operate an aircraft than the AME that you see every few years. There are clearly conditions that the FAA doesn't like which may in fact have near zero negative affects on one's ability to safely pilot an aircraft. The FAA Aeromedical Branch's attitude is that there are lots of pilots....grounding a few is no big deal.

Simple answer: It's a complex situation.

MTV

Just this airman’s opinion, it’s a simple answer to a simple situation.

You fit to fly?

I’m a accountability guy, I’m a commission sales fan, I think the rubber need to meet the road.

When a real doc signs his name, it’s his ass if he’s wrong

When a FAA employee signs his name, there is no accountability, ban a good airman, or A OK someone who shouldn’t fly, as long as you don’t have a epic streak that ends up on the nightly news, just keep punching the clock, keep your head down and collect that sweet tax payer pension after X years.

I would much more trust a normal MD signing someone off, seems like doing it like basic med for all classes makes the most sense

FAAs nonsense is pretty simple to find if you look, from the numbers they claim for their HIMS experiment, to the crashes before ADD was a “thing” vs after and their ban, etc etc


“93K, how do you write government employees so well?”

“Well, I take a man, and I remove all reason and accountability”


The problem is people will sell their first born for a half baked sales pitch for “safety” which is why I was asking if there is a list of NTSB findings based on medical as a cause

I know of one Medical related accident (think I'd call it murder but the perp died so it's a moot point) that happened just a few miles down the road last year.

A former Congressman, who'd lost his medical years before because of his eyesight, and who was flying his cub that had an N number on it that wasn't registered to that plane and had EXPERIMENTAL on the plane when it wasn't, was taking off out of Soldotna and crashed into a Beaver and killed everyone.

Not sure that meets with your criteria since he didn't have a medical of any kind.

You might consider reaching out to Ron Wanttaja. He regulary writes articles for Kitplanes and others that focus on statistical analysis of accidents (usually Experimental). If anyone had the access to information and experience parsing the relevant data, I'd think he'd be at the top of the list.

http://www.wanttaja.com/

Mayo Clinic has a program for pilots with iffy medicals, to come to the Clinic get a pre-physical, to evaluate if any medical conditions that may be problematic with the Oke City K-Mart specialists. Then treat those underlying med. conditions, before the actual FAA physical exam. Very beneficial for older big iron pilots, close to their $$$ retirement date. What did the Doc say?..” Lose some weight, watch your diet, exercise and water up, half oz of water, per pound daily, yes, 3 qts,,,!!” Again, what did the Doc say? Mayo Aerospace Med. dept, developed the pressurization suits for pilots, during Double/Double 2. One experience at Mayo, you’ll be hooked...!! Dave B

NineThreeKilo wrote:I was thinking more a break down of medical caused crashes and a breakdown by medical. Like NTSB stats

Having a government worker say if someone is fit, give them a pseudo diagnosis, sometimes not even backed up by multiple real MDs acting as a MD and making a dx on their medical license, FAA types never having never laid hands on the Pt, seems like quackery, vs laying out the standard of what said Pt needs to do as a pilot, and having a qualified MD check them off if they are good to go.

Knowing airmen with 1st through basic, I’m just not seeing the difference in health you’d expect based on how the FAA pitches it.

Your point? Every Aviation Medical Examiner (AME) is in fact a practicing physician. They are NOT "government workers", they are authorized by the FAA to administer aviation medical exams.

Now, if an AME chooses (important term) to "defer" or "deny" an applicant, or if the applicant puts something on the application which is on the list of no-nos, THEN and only then, the application is bounced to "government employees", who also happen to be licensed physicians.

If you want DATA, then as I said, go to the Nall Report, produced annually by AOPA. It is THE best source of data on accidents, hours flown etc, etc.

Bear in mind that the NTSB doesn't even investigate the vast majority of general aviation accidents....they defer to the FAA. And, in many cases, neither agency even looks at the airplane or accident site.....let alone evaluate the physical condition of hte pilot at the time of the accident.

But, the Nall report is the best source I've found of actual data.

MTV

I wasn’t talking about AMEs, I was talking about the duck pond in OKC and DC

IMHO unless you’re going to put YOUR MD on YOUR call, you’re not acting as a doctor, or any type of practitioner, I think things would be VERY different if those who make all those silly calls, both to issue and not to issue, and the rules over there, many not backed by science, if they had to be PERSONALLY responsible things would be very different.

But my main quandary was if a 1st class is really, provable, safer than a basic med guy.

Where have we seen credible reports of non-physicians evaluating pilot medicals of any class, and making substantive decisions on either special issuance or denial? I don't recall any mention of non-physiciansmaking those decisions in any article I've read in AOPA or EAA 'zines, or in any aviation 'zine. I am a frequent reader of NTSB accident reports I pull from the NTSB's aviation DB. What I generally see are reports of pilots who lied on their FAA Medicals, theb successfully hid serious health issues (and prescribed, OTC, and illegal drugs on from the AME or Basic Med physiciam)... then kill themselves & others in an aircraft accident.

I haven't been legal to kill people in an airplane or helicopter for years, but I still have a driver's licence. No, I'm not saying I am safe, just held to a much, much lower standard. And I would be less dangerous to others spraying crops or flying pipeline than driving on the freeway.

PapernScissors wrote:Where have we seen credible reports of non-physicians evaluating pilot medicals of any class, and making substantive decisions on either special issuance or denial? I don't recall any mention of non-physiciansmaking those decisions in any article I've read in AOPA or EAA 'zines, or in any aviation 'zine. I am a frequent reader of NTSB accident reports I pull from the NTSB's aviation DB. What I generally see are reports of pilots who lied on their FAA Medicals, theb successfully hid serious health issues (and prescribed, OTC, and illegal drugs on from the AME or Basic Med physiciam)... then kill themselves & others in an aircraft accident.

Happens all the time if OKC or DC get involved, I mean walk me through one time someone was able to go after anyone in the FAA for malpractice due to a bad decision.

Airmen lie? Sure, but many of those crashes are still primarily due to other causes, but the subject wasn’t lies, though the FAA doesn’t exactly foster a healthy environment, especially for depression etc

https://www.huffpost.com/entry/pilots-m ... 05129e235a

Thankfully I’ve managed to make it through life without any diagnosis of any kind, but still, it seems just having a real MD acting as a MD sign a airmen off as fit to perform the duties a pilot would have to preform, a doc known to the airmen (maybe their primary GP) would be much better than the very screwed up system we have with the FAA and their class 1-3

NineThreeKilo wrote:

PapernScissors wrote:Where have we seen credible reports of non-physicians evaluating pilot medicals of any class, and making substantive decisions on either special issuance or denial? I don't recall any mention of non-physiciansmaking those decisions in any article I've read in AOPA or EAA 'zines, or in any aviation 'zine. I am a frequent reader of NTSB accident reports I pull from the NTSB's aviation DB. What I generally see are reports of pilots who lied on their FAA Medicals, theb successfully hid serious health issues (and prescribed, OTC, and illegal drugs on from the AME or Basic Med physiciam)... then kill themselves & others in an aircraft accident.

Happens all the time if OKC or DC get involved, I mean walk me through one time someone was able to go after anyone in the FAA for malpractice due to a bad decision.

Airmen lie? Sure, but many of those crashes are still primarily due to other causes, but the subject wasn’t lies, though the FAA doesn’t exactly foster a healthy environment, especially for depression etc

https://www.huffpost.com/entry/pilots-m ... 05129e235a

Thankfully I’ve managed to make it through life without any diagnosis of any kind, but still, it seems just having a real MD acting as a MD sign a airmen off as fit to perform the duties a pilot would have to preform, a doc known to the airmen (maybe their primary GP) would be much better than the very screwed up system we have with the FAA and their class 1-3

I’m pretty sure ALL the “decision makers” in the Aeromedical Branch are in fact physicians.

It seems to me that what you’re talking about are the actual written guides that spell out what’s acceptable for issuing a medical and what’s not. That’s the problem, in my opinion, not so much the people signing the “yes or no”. The problem is, there’s not a lot of room for “interpretation”. And very little for common sense.

MTV

NineThreeKilo wrote:
But my main quandary was if a 1st class is really, provable, safer than a basic med guy.

From what I can tell, all the 1st class does is add an ECG after age 35, so unless you have a glaring arrhythmia the answer is no.

mtv wrote:

NineThreeKilo wrote:

PapernScissors wrote:Where have we seen credible reports of non-physicians evaluating pilot medicals of any class, and making substantive decisions on either special issuance or denial? I don't recall any mention of non-physiciansmaking those decisions in any article I've read in AOPA or EAA 'zines, or in any aviation 'zine. I am a frequent reader of NTSB accident reports I pull from the NTSB's aviation DB. What I generally see are reports of pilots who lied on their FAA Medicals, theb successfully hid serious health issues (and prescribed, OTC, and illegal drugs on from the AME or Basic Med physiciam)... then kill themselves & others in an aircraft accident.

Happens all the time if OKC or DC get involved, I mean walk me through one time someone was able to go after anyone in the FAA for malpractice due to a bad decision.

Airmen lie? Sure, but many of those crashes are still primarily due to other causes, but the subject wasn’t lies, though the FAA doesn’t exactly foster a healthy environment, especially for depression etc

https://www.huffpost.com/entry/pilots-m ... 05129e235a

Thankfully I’ve managed to make it through life without any diagnosis of any kind, but still, it seems just having a real MD acting as a MD sign a airmen off as fit to perform the duties a pilot would have to preform, a doc known to the airmen (maybe their primary GP) would be much better than the very screwed up system we have with the FAA and their class 1-3

I’m pretty sure ALL the “decision makers” in the Aeromedical Branch are in fact physicians.

It seems to me that what you’re talking about are the actual written guides that spell out what’s acceptable for issuing a medical and what’s not. That’s the problem, in my opinion, not so much the people signing the “yes or no”. The problem is, there’s not a lot of room for “interpretation”. And very little for common sense.

MTV

My understanding is they are not acting as such, or under a FAA umbrella

If you go to your docs office, he looks you over and gives you a dx, that dx causes you to lose your job, home etc, and it turns out you didn’t have the disease, you’re likely to get paid, that’s why real docs need malpractice insurance

If the FAA says you have a issue, they are not officially medically giving you a dx, the person in OKC doesn’t even see you as a pt, but will quasi dx you which could end your career, cost you a house and family, if it turns out you didn’t have that disease, g’ luck going after that doctor

Having power and no accountability is the issue.

All this “think of the children” also seems to not hold water when looking at the stats and not seeing the safety these people try to balance the scale of their beyond reproach powers.

The point you’re missing is that flying is a “privilege” by definition, NOT a “right”.

And “safety of flight” trumps pretty much everything, and of course, who is the decision maker re: Safety of flight?

You guessed it.

MTV

mtv wrote:The point you’re missing is that flying is a “privilege” by definition, NOT a “right”.

And “safety of flight” trumps pretty much everything, and of course, who is the decision maker re: Safety of flight?

You guessed it.

MTV

As time goes on more and more will become a “privilege”

Funny thing, their employment at the FAA is also not a right but a privilege, and a position of trust to the tax payers, abuse that trust and it should cost them their job and pension.

Ours not the reason why. Wait! What about "we the people"?

This hatred of the FAA medicals is hilarious to me. People are arguing that it's a pilot's job to self regulate based on health? What a joke - nearly everyone with a disqualifying condition probably thinks they are okay to fly. If you can't pass a medical, and then can't get a special issuance or appeal, sorry but move along.

If anything, I think medicals should be stricter for commercial pilots. Am I saying this because I'm 30 and I haven't hit all those bumps in the medical road? Probably. But do you really want your family flying on airplanes with people who a medical doctor determines can't hold an actual medical but they can have basic med?