Going Direct: The Blessed Insanity Of The New Medical Rules

The passage into law of the 3rd class pilot medical certification just last week as I write has changed the way hundreds of thousands of pilots will get their medicals. It’s a fundamental change in regulations for private aviation that I’ve been pushing for these past 20 years, and it’s finally here. Victory for the good guys, with props to EAA and AOPA for getting behind it with their own years-long lobbying efforts. Your membership dollars at work. Hooray.

The reaction in the industry has been one of unreserved optimism, with few exceptions—thank goodness for the few curmudgeons still taking a skeptical view of aviation’s evolution. I guess, in this case, I’m one of them.

So I’m not misunderstood, let me make it clear that I, too, view the reform to medical cert as a huge win for light GA, for us personal transportation and recreational pilots, and for the American way. Truth, at least to a good degree, has won out. Hooray, again.

Here’s the big “but.” The rules for this whole thing have not yet been written. The new law just requires the FAA to do that within a year. How those rules come out looking is an open question. Will they be subject to the standard Notice of Proposed Rulemaking practice? If they are, a year’s time isn’t enough for the FAA to get all of this done. And, if they’re not subject to review, then the FAA will have free rein to create whatever complications to the process they so desire. Remember that this law wasn’t initiated by the FAA but imposed upon it by Congress. The bottom line is, there’s a lot about this whole thing that we don’t know about yet, and some of it could be messy. I hope I’m wrong, but I’ve been reporting on the FAA for a long time, and there’s risk here.

Regardless, the changes will positively affect the flying lives of pilots like you and me, but, unfortunately, they’re not as simple as they could be. Since the law was created by federal legislators, it would have been naïve to expect that the final regulation would be straightforward—our elected officials never saw a common-sense rule they couldn’t make more to their liking by confabulating it or throwing in some additional elements to please special interests and donors.

In this case, the engine for a number of extraneous requirements was the same big lie we’ve been dealing with for decades: that checkups, even every six months, make the flying public safer. In terms of private flying, it’s a hard case to make. Our checkups are done every two years. If you show up at the AME’s office in cardiac arrest, they might serve as a safeguard to keep you from going flying later that afternoon. Otherwise, they’re spot-checks of our health that rely on pilots’ accurate reporting of their health history. That reporting, as I’ll discuss in a bit, is often full of holes. We’ll have to live with those additional requirements, and hopefully, the way they’ll be implemented will be straightforward.

The law does have some baseline requirements of the rules the FAA develops that aren’t really open to reinterpretation. Here are the big takeaways.

To exercise private pilot privileges under the 3rd Class Medical Exemption:

  • Fly for personal transportation, business or recreational purposes (so, no commercial flying).
  • Pilot an aircraft up to 6,000 pounds max takeoff weight.
  • Fly IFR or VFR, no limitations there.
  • Climb on up to 18,000 feet.
  • Keep the airspeed at 250 knots indicated or lower.
  • Take along up to five passengers, so six people, including the pilot.
  • Visit a “state-licensed” doctor at least every four years and have them fill out a medical checklist. This is kept in your logbook and not sent to the FAA, though they can ask to see it.
  • Take an FAA online medical self-assessment every two years.
  • Pass an initial FAA medical, even with a special issuance, within the last 10 years.

So, the reform is, on balance, a good thing. Unfortunately, the bad things are all based on that same misguided and scientifically unsupported notion that regular checkups make for safer pilots. They might make for slightly healthier pilots, true. The pressure of having to pass a flight physical every two years, as is required for the 3rd class medical, does keep some of us watching our weight, exercising more than we would otherwise and getting medical guidance about health conditions we might ignore otherwise. But I’ve never seen a connection between private pilot medical certification and safety. Pilots who are incapacitated in flight—an extraordinarily rare event—almost always often have a valid medical at the time of their incapacitation.

Here’s the worst thing about medical certification under the reformed rule designed to eliminate the 3rd Class Medical Certificate; it will still require you to get a 3rd Class Medical Certificate, at least once. And it will require you to exit the FAA certification process with a passing grade on a standard FAA medical exam within the last 10 years (we’re guessing counting from when the FAA’s rules are enacted). If the FAA does take longer than a year to issue a rule, what will pilots do then? Will those of us whose certificate has expired need to get a new 3rd class medical exam? I’m thinking we’ll need to do just that. And there’s likely no downside to the FAA for it taking longer than a year to make the new rule happen. The agency has a history of stretching deadlines, even those imposed by Congress, one might argue, especially those imposed by Congress.

The idea behind the requirement for at least one FAA Medical Certificate is, I’m guessing, to allow the FAA to get at least one baseline assessment of the pilot-applicant’s health to ensure that the pilot will be a reasonably good bet to be fit enough to use the new self-certification model. In addition to needing the FAA’s blessing before embarking on medical certification lite, you’ll also need a health professional’s quasi-official blessing every four years.

The good news here is that all of these things are livable for the vast majority of pilots, as long as they’re honestly implemented, that is. It’s not great news, however, for those pilots who haven’t yet passed their last FAA flight physical. They’re still going to have to do that, even if it means jumping through special issuance hoops.

The old system gave rise to shortcuts and overreactions on every side. Pilots lied on their medical histories. Physicians overlooked known ailments and a small number gave extremely cursory exams, essentially trading one form of paper (a passing medical certificate) for another (U.S. currency). And, in the case of special issuance certificates, the FAA held pilots’ feet (and checkbooks) to the fire with required and often dubious follow-up visits, specialist exams and ongoing testing, making the medical certificate a huge hassle, and a costly one.

The new system will likely give rise to a whole new set of games. Many pilots who are aware of health issues that they haven’t yet had to report on a medical application will likely hold off on visiting their aviation medical examiner until the rule takes hold. Pilots will likely visit physicians they have never seen before to get their FAA checkup checklist signed off, so the new doctor won’t be aware of previous complaints.

As you probably know, falsifying the 3rd class medical application is a felony, and some pilot-applicants have been busted for doing it. While there are no data we know of on how many pilots fib on their medical application, conventional wisdom on the subject is that it’s a lot of them. Will this be another opportunity to catch pilots in creative forgetfulness?

Hopefully, the FAA won’t create a checklist that is, in essence, a reworking of the existing 3rd class form, with the same kind of legal language associated with it, but here’s betting that this is exactly what they do, essentially working a form of the 3rd class physical back into the new system in disguise. Fingers crossed that I’m wrong on this and it doesn’t happen, but, as I said, I’m skeptical.

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