As the details of the new third class FAA medical came to light, I made the mistake of letting my enthusiasm for the overall concept color my reaction to the actual rule. The new regs, BasicMed, were supposed to represent the FAA’s regulatory translation of what we really wanted: to get rid of the Third Class medical and replace it with our driver’s license as proof we can safely get around in a small transportation vehicle. I think we all wanted to do away with the FAA medical altogether, never think about it again, and just go flying. Like most of you, I was fine with there being limits on the new non-medical, including the size and speed of what we fly, as well as how many passengers we carried. That makes sense.
But instead of putting our long-awaited driver’s license medical into the language of the FARs, the FAA created a whole new kind of medical certification that, for most of us, will be neither easier nor cheaper.
Instead of leaving it essentially up to us whether or not we’re fit to fly—as we do every day of our flying lives regardless of the medical certification we hold—the FAA just replaced its current system with an almost identical system that makes us do even more than we had to do before. To satisfy the requirements of BasicMed, we get put through the ringer. We need to do online testing and we need to see a doctor, one who’s familiar with our medical histories, whatever that means, and one who then fills out an approval for us to go flying, just as our Aviation Medical Examiners used to do. In what way is this better than it used to be?
In terms of cost, it’s not better. My AME charges me $100 for a third class exam. With my high-deductible (is there any other kind?) insurance, I’ll pay around $150 out of pocket for the visit to my doc for BasicMed certification. Yes, “certification,” because that’s what it is. I wasn’t a math major, but $150 is more than $100. Not better.
I need to take an online course—as yet the details of this aren’t public—which will tell me all the things I need to know about not having to worry about my pilot medical. I’m sure it will help me understand that I shouldn’t fly if I’m having a heart attack, if I suffer a stroke, or if I have any one of a number of disqualifying conditions. We all pretty much know this stuff. And it won’t help stop pilots who shouldn’t fly from flying anyway. A pilot who has a coronary, doesn’t disclose it to their AME and then goes flying doesn’t do it because they don’t know that a heart attack is disqualifying (without jumping through a lot of expensive hoops, anyway). They go flying after the heart attack despite the fact that they know it’s disqualifying. Education will do nothing to change that kind of decision.
Let’s talk about anxiety and depression. In many of these cases, people with these conditions who are on medication that helps choose to go flying despite their condition, not because they don’t know it’s disqualifying, but because they believe it shouldn’t be disqualifying. For the vast majority of sufferers of mild depression and anxiety, the treatment is successful in treating a condition that, if left untreated, would still allow them to safely fly airplanes. Taking medication that helps them overcome their condition becomes a choice between flying or living a better life. Many of them choose to keep doing both and don’t reveal their treatment to their AMEs. This is one of many, many conditions about which the FAA is overly cautious. They seem to forget, too, that we pilots are human beings and any of us could become disabled at anytime. It’s a remote possibility, but the FAA needs to remember that it is a possibility.
We also need to be concerned about going to a doctor for our BasicMed signoff who doesn’t know jack about aviation. My AME, who’s a pilot and a great guy, knows flying and pilots inside and out. He knows what it takes to get a medical and he knows what it takes to lose it. He knows how to help his patients stay fit to fly and he knows when it’s time to tell them their health is a bigger concern than flying, which is sometimes the case, I admit. Would a general practitioner who’s not a pilot know any of these things? The answer is no. I’m fairly confident, moreover, that we’ll be the ones educating our doctors on why we’re in their office and what they need to do. Improvement? Hardly.
On top of all that, we’ll still need to ask their permission to go flying, and these non-aviation-savvy docs will be the ones to sign us off, just as it used to be, except this time they won’t have the judgment to know what’s okay to allow and what isn’t. If I were a non-flying doctor new to all of this, my instinct would be to cover my bases and take the conservative path, which is to say no to flying if I were at all unsure about it. With most AMEs, I’m guessing, and with every one I’ve ever been to, the approach was to err on the side of letting pilots go flying. Is this kind of uncertainty over the kind of judgment your doc will have over your flying future an improvement? It is not.
For private pilots flying modest aircraft, the hope for the driver’s license medical was for it to once and for all get the FAA out of our medical business and let us make our own decisions, which we’ve largely been doing ourselves anyway.
Six months ago, I proclaimed that I’d likely taken my last FAA physical. That has changed. I have no intention of going the BasicMed route. There are too many variables and too much risk associated with it for me. I’m in good health and know I can pass a third or second class FAA physical. I’ll do that instead. It will cost me less, it will be with a doc who knows aviation and knows pilots, I won’t need to jump through any Internet hoops to do it, and I’ll know when it comes time to render a verdict on my fitness to fly, my doc will make the right call.
If it got to the point where I was worried I could no longer pass an FAA physical while still being, in my view, safe to go flying, I might then go with BasicMed. My hope would be that it would give me a window to keep flying small planes. But for those of us who believe we can still pass the conventional FAA physical, it’s probably smarter and safer to do that.
In drawing up these supposedly liberalized rules, the FAA essentially replaced one form of governmental oversight for the same level of oversight in another form. The FAA was doing what the FAA does best. It was maneuvering to hold onto the power it had while limiting the rights of pilots, even when the stakes were low and Congress directed it to do something else altogether.
This is a tough time for our member organizations. On the one hand, they have helped achieve what we long hoped would be a great victory for pilots in liberalized medical certification rules. It’s not easy for these same organizations to turn around and say, “Hey, that’s not what we had in mind.” For one, their members, like me and, hopefully, you, will be disappointed when they learn the truth about what was promised and what we got. It’s also a tough argument to make to our friends in Congress to make the FAA go back and start over with these rules. But that’s what needs to happen. And that’s what I’m asking them all to do.
Why John King’s Fight is Not Over
As many of you know, John King, co-founder along with wife Martha, of King Schools, was in a prolonged battle wth the FAA to regain his medical certification after he suffered a seizure in 2014 with no recurrences since. Just as we were going to press, King regained his certificate, the timing of which makes one wonder if the FAA gave in to public pressure to do the right thing. If so, we’re good with that.
The denial of King’s medical was understandable, at least at first. But as time went on, it became harder to see the FAA’s point of view. King had been seizure-free for years, and the majority of people who suffer a seizure for unknown reasons never have another. Despite this data and King’s clean bill of health since, the FAA denied him medical certification.
But King persisted in his attempt to win back his medical, even though the agency seemed to be closing its eyes and digging in its heels. So it was a huge surprise when a certificate showed up in King’s mailbox.
There were more than a few people who advised King to give up, to admit that the FAA had won and be satisfied that he had enjoyed a good run and leave it at that.
I’m glad he didn’t do that, though, admittedly, not as glad as he is. In the spirit of full disclosure, John and Martha are good friends. I’ve known them for 25 years and have passed with flying colors many an FAA exam thanks to their products. As is the case with me and probably with you, too, flying is everything to John and Martha. John would just as soon give up breathing as flying, so for him, fighting to regain his medical was a no-brainer, and it was lucky he had the resources to wage that war.
In the end, regardless of the outcome, the real question is, does the FAA provide fair treatment of pilots in the way it writes rules and issues denials? From a purely organizational point of view, the answer is “no.” The medical branch bases its medical judgments on decades-old ideas about health, illness and recovery, and updates its opinions about as often as Halley’s Comet swings by. The agency is the judge, jury and executioner in these matters, too. When it reviews an enforcement action, the arbiter is the same organization that issued the original finding. The deck is stacked.
Like many of you, I’m tired of putting up with outdated and archaic institutions that abuse the rights of the people they’re supposed to be serving. Can the FAA medical division be reformed? If you’re in doubt, please refer to my discussion of BasicMed above. Our best hope is to dismantle the FAA’s aeromedical branch and start from scratch. If our representatives are being honest about wanting to transform government, I can think of few better places to start the process.