How much to trust medical professionals

[Guest]

I'm taking my first steps in obtaining a 3rd class SI (adhd,depression) and would like to know just how much to trust my HIMS AME, the psychiatrist, and later, the neuropsychiatrist. Should I be an open book or should I measure my answers and responses? I just don't know how careful I should be during this process. Not that I'm trying to hide anything, I just don't know what to expect.

 

[Daleandee]

If two people know something ... it's no longer a secret. Being guarded is a proper human response. I'm not talking about hiding anything either but what ever doesn't need to be shared should not be. Only you can determine that with proper guidance from those you trust. As for me ... the number of people I trust are very few!

 

[Chris Charanza]

I think that the testing isn't really that subjective. I mean sure the doctors will form an opinion based on their conversation with you and your subsequent performance but my experience with the Cogscreen and neuropsychological testing tells me that it's not so much about trust as it is about your performance. There isn't really a need to try and craft and answer to what you think they want to hear. I think they have a set of guidelines they follow and that's it. The best advice I can give you is to go in with an open mind and be honest with them and yourself. If you've disclosed whatever issues you are dealing with then it's just part of the process.

 

[danhagan]

I'm medical, but a different observation:

My wife got talked into an EKG, it came back "abnormal" ... second EKG indicated the same, but it was not a double blind (they were aware of the first abnormal). Echocardiogram inconclusive ... A Nuc Med stress test was ordered, but the one at rest using medication rather than treadmill, wife complained of cold room and shivering, test came back as possible myocardial infarct. We have a cardiologist in our group that reads echocardiograms only, but we didn't do my wife's - he indicated possible "diaphragm artifact", but only an angiogram would clear it. Angiogram ordered (6k with 3k deductible) ... all is "NORMAL" ... am guessing between all the other tests, we are about 6k into a "all is well angiogram"

My wife did the EKG on her own ... I've told pilots I know NEVER allow an EKG unless you're at a cardiology office or in the ER with chest pain ...

 

[idahoflier]

I have no experience with this and I can't answer your question, but I think unless you are trained in psychology any "measured" responses may lead to an undesirable outcome. If I was in your position I would lean more towards the "open book" stance. All that said, unless you are looking at becoming a professional pilot or have already been deferred, I would go Sport Pilot and not even start down this path...

Good Luck!

 

[Clip4]

Admit to nothing
Deny everything
Demand proof.

 

[bbchien]

Well I have been saying good for MANY years: never do an “extra test”……and there’s why!

 

[Pinecone]

You don't think that the questions have built in indicators that you are not being fully truthful?

 

[Chris Charanza]

You don't think that the questions have built in indicators that you are not being fully truthful?

I second this. I know that at least the MMPI has the built in questions that detect anomalies or something. For me when I took it a couple months ago it was 567 benign repetitive questions that I'm sure some of which were designed to pick up on deception. I'd imagine that isn't the only one that has that sort of stuff built in.

 

[samiamPA]

I'm medical, but a different observation:

My wife got talked into an EKG, it came back "abnormal" ... second EKG indicated the same, but it was not a double blind (they were aware of the first abnormal). Echocardiogram inconclusive ... A Nuc Med stress test was ordered, but the one at rest using medication rather than treadmill, wife complained of cold room and shivering, test came back as possible myocardial infarct. We have a cardiologist in our group that reads echocardiograms only, but we didn't do my wife's - he indicated possible "diaphragm artifact", but only an angiogram would clear it. Angiogram ordered (6k with 3k deductible) ... all is "NORMAL" ... am guessing between all the other tests, we are about 6k into a "all is well angiogram"

My wife did the EKG on her own ... I've told pilots I know NEVER allow an EKG unless you're at a cardiology office or in the ER with chest pain ...

I understand you are annoyed at the cost, but what if the angiogram had found coronary disease and a life saving stent had been placed? That 6k angiogram would have seemed like a much better deal. It's easy to say a test was a waste of money if it came back normal, but you never know that until it was done.

Of course tests should not be done if they are not medically indicated, but following up on an abnormal result is not inappropriate.

 

[danhagan]

I understand you are annoyed at the cost, but what if the angiogram had found coronary disease and a life saving stent had been placed? That 6k angiogram would have seemed like a much better deal. It's easy to say a test was a waste of money if it came back normal, but you never know that until it was done. Of course tests should not be done if they are not medically indicated, but following up on an abnormal result is not inappropriate.

Was pointing out that a "perfect storm" of exams demonstrating their absolute weaknesses at the same time can occur. We did the angio for the exact reasons you state, but being in the medical imaging field, our facility straightens out a LOT of bad calls ... problem is, we're ultrasound only and don't deal with NucMed PET scans and angios ....

 

[SoCal 182 Driver]

I'm taking my first steps in obtaining a 3rd class SI (adhd,depression) and would like to know just how much to trust my HIMS AME, the psychiatrist, and later, the neuropsychiatrist. Should I be an open book or should I measure my answers and responses? I just don't know how careful I should be during this process. Not that I'm trying to hide anything, I just don't know what to expect.

You should hire Dr. Bruce Chien or Dr. Lou Fowler and have them walk you through the process. You might think an answer is benign, when in fact the way you respond could have significant impact on your application. Better to have one of the experts on board to guide you, and you should follow their advice to the letter.

Good luck.