Med exam

[enielsen]

Originally Posted by BobTurner

Some years ago they were trying to get colonoscopies mandatory.

Well at least that's a little more fitting as we all know its a bunch of ****.

I know what you mean though, my mom, who was a nurse told me when I was a kid that eye doctors make more than brain surgeons. By pumping more patients through the gates. It baffled me when I was 10yrs old but made more sense later on.

[n981ms]

I am a physician, not an AME. My partner who is an AME is in favor of rescinding the third class medical so I am not so sure about the profitability. He regularly considers stopping secondary to the hassles of AME certification. I am also for the elimination of the third class medical.

The issue of sleep apnea is that it can sometimes (not usually in my experience) cause uncontrollable daytime sleepiness. Snoring does not diagnose it but asking about it is a screening tool. Albeit a poor one in my opinion since many snore and do not have sleep apnea. I will try to keep this apolitical:

When you ask the populous "Do you want pilots falling asleep as they fly over your house?" They will answer no, do whatever it takes." I feel it is not much of an issue in that people who are actually having uncontrollable sleepiness will choose to not put themselves in harms way until they are treated adequately.

Incidentally I perform DOT truck driver exams. DOT tried to mandate all drivers of certain weight and or neck circumference have sleep apnea testing at $1000 each. The unions fought it and won.

[samiamPA]

Originally Posted by BobTurner

You need to understand that giving 3rd class medicals is incredibly lucrative for MDs. Every year I get 4-5 postcards from AMEs soliciting my business. Now, all the evidence indicates that these exams are a complete waste of money, and there is some pressure to eliminate them. So the medical establishment keeps dreaming up new things to try to justify continuing the exams. Sleep apnea is just the latest. Some years ago they were trying to get colonoscopies mandatory.

I am also a physician, and a new AME. I would not say, by a long stretch, that 3rd class medicals are "incredibly lucrative." We charge $70, so the reimbursement is much less than for any other office visit I do. It often takes more time as well (admittedly because I love to chat about flying) and the paperwork is a hassle. But I do it for the love of flying.

FWIW I am strongly in favor of driver's license medicals in lieu of 3rd class. And in regards to the sleep apnea issues, which I know get more than their fare share of flack from groups like the AOPA, I like to think that the issue is raised in good spirit - untreated sleep apnea is not just a sleep issue, but leads to higher blood pressures, higher risk of heart problems, and many other health issues that can ultimately cause the pilot to be disqualified from flying.

A good AME should be on your side, trying to keep you healthy for the long run and safe in the skies.

[lbgjb]

As a senior AME I see some misinformation here. You must fill in 8500 either for medical or student pilot/medical on line. The BEST thing then to do is for YOU to print it out and bring it to your AME. (Don't just bring the number) Then, if he is a pilot friendly AME ( not all are!!) he will review the form with you BEFORE he goes online. If there is major problem there is no problem stopping the exam and not getting into the position of denial or deferral. ONCE the AME goes online with HIS login, the exam is official and there is no turning back. It always amazes me that people come for exams taking FAA forbidden meds, having disqualifying medical conditions etc. If you have doubts check with AOPA, Left Seat dot Com or with a good AME. And, regarding the exams being lucrative--most docs do the exams because they enjoy aviation and pilots, and don't do it for the $$. i also strongly support the Aviation Pilot bills in Congress doing away with the 3rd Class Medical.

[N15JB]

As a retired physician, former USAF flight surgeon and AME, I no longer have a dog in this hunt; but I agree with the comments of the other physicians in this thread. Doing flight physicals is hardly lucrative; the fee is the same as, or less, than a physician could bill doing other things. By the time you factor in the paper work hassles and brain damage of trying to work with the FAA, it becomes a losing proposition. I always enjoyed working with other pilots, but gave up being an examiner because of the FAA(and the occasional pilot, who like Bob, felt we were just trying to scr*w them over).

While not totally useless, the 3rd class medical accomplishes very little, and should be eliminated

[aerhed]

I'm not a doctor, or a scientist for that matter. I do know that I'm stuck on a special that I shouldn't be with no path out. Mine costs me 2 days, 400 miles, and two grand out of pocket annually. For nothin'. Its not my AME's fault either, so I like what you guys are saying.

[Waterobert]

$2k a year for a medical! That is a crime, sorry about that.

[Larco]

Originally Posted by BobTurner

The way it is supposed to work is that once you come in the door for an FAA medical the exam is started, it's too late to reconsider. You could of course schedule an exam with an MD to just chat, then schedule an appointment for your FAA exam. The FAA now requires that you fill in the form, on MedXpress.gov, BEFORE you appear at the MD's office. Bring the confirmation number with you to the exam. BTW, this web site only works with Internet Explorer, not Safari.
For a student you do not your medical until you are ready to solo, but it's a good idea to get it earlier, just in case there is a problem.

FWIW. No offense meant, but I have filed my last two forms using safari and it worked fine. Larry

[BobTurner]

Originally Posted by LARCO

FWIW. No offense meant, but I have filed my last two forms using safari and it worked fine. Larry

Maybe it depends on the phase of the moon. I just did mine, and forgot that it says "must use Internet Explorer". It seemed to work okay with Safari, except that the "save" button didn't appear! Maybe it would have saved automatically, I don't know.

Let me clarify. I don't think I'm being screwed by my AME. He's a nice guy, performing a required service. But if he's losing money after charging me $140 for less than 10 minutes of his time (another 5 minutes for his assistant) something is wrong. And why do I get 4 to 5 postcards every year from AMEs whom I've never met? Because they want me to come to them so they can lose money? Or they'd just like to talk to a pilot? That seems hard to believe.

My issue is with the consultants. Evey time the issue of third class medicals comes up, the FAA runs and hides by hiring consultants. And who do they hire? Why, people blessed by the AMA, of course. And these consultants have always advocated for more, never less, medical oversight. It's a classic example of the foxes guarding the hen house.

[mturnerb]

Originally Posted by lbgjb

As a senior AME I see some misinformation here. You must fill in 8500 either for medical or student pilot/medical on line. The BEST thing then to do is for YOU to print it out and bring it to your AME. (Don't just bring the number) Then, if he is a pilot friendly AME ( not all are!!) he will review the form with you BEFORE he goes online. If there is major problem there is no problem stopping the exam and not getting into the position of denial or deferral. ONCE the AME goes online with HIS login, the exam is official and there is no turning back. It always amazes me that people come for exams taking FAA forbidden meds, having disqualifying medical conditions etc. If you have doubts check with AOPA, Left Seat dot Com or with a good AME. And, regarding the exams being lucrative--most docs do the exams because they enjoy aviation and pilots, and don't do it for the $$. i also strongly support the Aviation Pilot bills in Congress doing away with the 3rd Class Medical.

I think some people who are experiencing high costs related to medicals are forgetting to point out that most of these costs are "external" to the AME: what's expensive is testing and referrals to other specialists (like cardiologists). No one is getting rich doing physicals of any stripe. It's not fair to blame or attribute all the costs to the AME - as others have pointed out they are bound by a very specific and defined set of requirements.

As a former flight surgeon as well, I agree with my colleagues who support the DL medical for third class: there simply is no compelling evidence that the FAA process effectively weeds out patients at risk for in-flight incapacitation: the VAST majority of cases of in-flight incapacitation occur without previously identified risk factors or after screening that "cleared" the pilot. A better strategy to save lives in these cases is to get "pinch hitter" training for passengers.