I have been an observer but not directly connected with the thinking/logic of this proposal for a while. Admittedly, with superficial information (one-liners) I have been on the fence. The idea of the certificate elimination is appealing. The thinking is that we, pilots, can at any time go fly with conditions far less than ideal for safety. Through experience and self awareness , our physical and mental condition, is a judgement call for self evaluation. The medical, 3rd class, certificate seems to be factually and statistically decoupled from accidents (The 1.8% cited in the NTSB white paper notwithstanding). On the safety side, there are many medical conditions/medications and physical factors that could affect we pilots. It would seem a flight surgeon, would be the ideal consultant for such discussions. Many of us might already get a physical from a Dr periodically. I am not so sure that the excellent experience and skills of the physician for walking around health are equally applicable to flight factors for piloting an aircraft. For that reason it would be quite good (it would seem) to have a flight physical periodically in which a pilot could freely discuss conditions and medications and their effects/risks to safe flying. This would be for the purpose of consultation and self awareness, not a regulatory absolute. While the 3rd class does not full fill the full physical needs, it does offer the opportunity for some coaching from the physician. We all probably get that in the process. I recognize the issue as being the necessity for this (3rd class) single, "test" to be the sole event that allows one to fly or not fly as being inadequate and not linked to the statistical facts of accidents.
So if there is no certificate, is there a need for a "flight" physical to generate the discussion and self awareness in order to retain that "judgement" for fitness to pilot the plane? Does anyone see this as a potential problem with the 3rd class certificate elimination?
The problem is the way flight physicals have been implemented.
For one, it is my strong suspicion that the requirement for a medical certificate was instituted during the tenure of an ex-military aviator as FAA/CAA administrator, who said to himself "in the military we had to pass a physical to fly, so these danged civilians should have to, too". And I bet the standards were either developed by a slight relaxation of the standards for fighter pilots, or by a civilian doctor with no flight experience who just wrote down his idea of "here's what a healthy person looks like". They certainly were
not developed by analyzing medically-caused accidents and figuring out what tests would detect those problems before they occurred. It may be illuminating to note that, up until sometime in the 90s, women were required to get a pelvic exam as part of even a third-class medical. That has even less to do with being able to fly an airplane than a hernia check on males.
Anyways, the point is to note that (a) most of the standards for medical certificates often have nothing at all to do with flying an airplane, and (b) the FAA guidance on what the AME should look for is so vague as to give open license to go on "fishing expeditions" and look for anything they want.
Point 2 is that when the default position than any anomaly, no matter how slight, is a grounding condition until you prove otherwise to some OKC desk-driver's satisfaction, and the FAA's position that once you start the paperwork, you're committed, it becomes readily apparent that the system is structured as a trap. The slightest misstep, the slightest interpretation, and the FAA says "gotcha!" It's an extremely adversarial environment, and adversarial environments are bad for safety. They discourage people from reporting problems, because people know that in doing so they have turned a
potential problem into a
definite one, at least for themselves, and so there's almost no incentive to report. Even the FAA knows this (or at least some parts of it do, anyway)--look at the way ASRS is set up. It explicitly removes the immediate threat of punishment by anonymizing the data and prohibits the FAA from scanning the reports to find violations, and even better, provides a "get out of jail free" card of sorts for genuine mistakes by contrite individuals.
That's also why NTSB findings are prohibited from being used in legal proceedings, and why the military conducts closed-door confidential accident review boards (as explained elsewhere on VAF). They want participants to be open and not hold anything back when safety is an issue. But medical exams are different; as they say so often on
Law and Order, "anything you say can and will be used against you". And once the denial or hold is in your record,
it never goes away. I know of one guy denied a first-class medical due to what was eventually determined to be a false positive; not only was he grounded from
all flying (even his own light airplane) until it was resolved, but now that denial follows him around at every single medical exam he takes in the future, and permanently casts a shadow of doubt at every visit.
Given all of that, is it any wonder that pilots are hesitant and reluctant to discuss things with an AME, especially if it's a condition that's successfully being treated by their own personal doctor who's much more familiar with them and said condition than the AME will ever be?
For any kind of required medical exam to be acceptable to GA pilots, the whole attitude will have to change. Instead of mandating immediate reporting and issuance of a hard denial after the slightest hint of anything the AME doesn't like, the AME needs to be able to just not say anything at all until the issues have been resolved. If instead of issuing a denial and then having to fight the bureaucracy, we could just let the medical expire while the issue is worked with the pilot's regular doctor, and then reissue the medical when it?s resolved, that might help pilots be more comfortable reporting potential issues. If the guidance and standards were limited to only things that have a genuine impact on flying, and not a catch-all net, people might be more willing to accept them as valid. And if the FAA?s position on medication was not ?you?re denied if you ever take this? but rather ?evaluate the effects of this drug before you fly while taking it?, like it already says about driving and operating heavy equipment, people might talk those things over with the doctor too. And if (at least for third class) the exam could be conducted by a regular doctor, and not an AME who has the FAA's gun to his head, maybe things might improve.
But as long as the FAA insists on playing ?gotcha?, pilots will continue to opt for the possible problem over the certain one.
Incidentally, just got the same form-letter reply. Rebuttal to be posted when complete.
