AME's and BasicMed

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UTLonghorn_1979 said:
They run that risk in very aspect of their practice, it’s not isolated to BM reviews. So perhaps not practice at all if your goal is to have zero risk to your insurance being canceled.
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Actually, in the ‘normal areas of practice’ and supplemental procedures, which are outlined in my malpractice policy, I will not get cancelled for claims but I will likely get higher premiums depending upon the outcome of the claims. The referenced insurer reportedly would cancel if a claim was incurred from a procedure (BM exam) not considered part of routine practice. I’m looking at it from the underwriter’s perspective, not that I agree that it is reasonable.
 
midlifeflyer said:
It may be hard to extrapolate without a deeper drill down that. You'd want to know whether or not the pilot has some kind of medical issue which was claimed to be causally related to the accident, not? You'd probably want both numbers. For example

In a survey of 1000 claims, there were 3 which included a claim against a BasicMed physician means something a little different than if only 10 of the claims involved a claim there were pilot medical issues.
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Yes, you're correct. I'd ASSumed the denominator in the non-existent data was pilot incapacitation events.
 
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UTLonghorn_1979 said:
There’s nothing improper about extrapolation here because there are no cases to point to in either direction. BM has been in use since 2017 with roughly 80,000 pilots flying under it, and there are no accident findings or documented incidents that attribute causation to BM status. The only thing the real-world data lets us extrapolate is that BM safety outcomes look the same as those under traditional FAA medicals. Absent an actual safety signal, claims that BM is meaningfully different are speculative, not evidence-based.
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Please cite your sources and show the data.
UTLonghorn_1979 said:
Separately, BM isn’t a doctor “signing off” on fitness to fly like an AME does. The physician is certifying that the exam and required discussion happened, and that based on what they’re aware of at that moment, there’s no condition as presently treated that would interfere with safe operation. That’s a narrow, knowledge-based statement — not a regulatory fitness determination. Ongoing fitness is still on the pilot through self-certification, exactly as BM was designed.
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That's an argument. Will it win on a motion to dismiss? Summary judgment? Trial? Either way, immunity is better.
UTLonghorn_1979 said:
That said, the saying is you can sue a ham sandwich if you want.
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I've never heard that saying, but I did have a client once that was a co-defendant with a Mars bar. Are you thinking of the saying that a good prosecutor could indict a ham sandwich?
 
bbchien said:
You left something off:

"....of an airplane". This additon was by the then shill for the ATLA, Senator Feinstein from the floor of the senate... it effecively gives a basis removing the singing off doc from the expert credential list, and to funds for the legal profession.

Very few docs have that credential. No credential, no coverage.
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There is zero legislative record of Feinstein saying that - please provide evidence.

And according the the legislation and procedures, the ONLY credentials needed are state licensed MD or DO, so no credentials, no coverage is also inaccurate.

I like your original post better. Shows true colors:

1769290290661.png
Also, you left out a pretty important qualifier, conveniently. Here's the full sign off wording:

In accordance with section 2307(b)(2)(C)(iv), of the FAA Extension, Safety, and Security Act of 2016 (Public Law 114-190), I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft.

The state licensed MD or DO is ONLY required to go over the checklist. If the applicant meets those criteria, they are good to go. So the MD or DO is only saying that the prescribed exam that already asserts fitness to fly, at time of exam, is true.

PS - according to the cognitive testing professionals so praised here, I was in the 95%tile of higher performing applicants on the full cogscreen battery. My neuropsych doctor did share that. So either the test is credible, or flawed. You tell me Doc.
 
Lindberg said:
Please cite your sources and show the data.
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FYI - I don't know whether this is what UT_Longhorn was referencing, but you might enjoy perusing https://www.faa.gov/sites/faa.gov/f...rtification_Certain_Small_Aircraft_Pilots.pdf . It was done a few years ago to satisfy a Congressional requirement, so it doesn't have the latest data, but a few of the more interesting conclusions include:

-No difference was found in the risk of BasicMed and third-class airmen having an aviation​
accident from the start of BasicMed in 2017 through the end of 2019.​
​
-No difference was found between accident-involved BasicMed and third-class airmen in the​
phase of flight in which their accident occurred.​
​
-No difference was found between accident-involved BasicMed and third-class airmen in fatal​
versus non-fatal outcomes.​
​
-No difference was found between fatally injured BasicMed and third-class airmen in autopsy​
findings.​

Some of the other conclusions require care in reading. For instance,

-When restricted to medically related death, BasicMed airmen had an age- and Special-Issuance-​
adjusted risk of mortality over the study period 53 percent higher than airmen who maintained​
third-class certification.​

That's not talking about in-flight incapacitation, but overall risk of mortality in general. Not surprising, since they found that pilots using Basic Med tend to be an older demographic.

Basically (pun intended), the study showed that a Class 3 medical has no real benefit in comparison to Basic Med. Why don't we just take Class 3 off the FAA's plate and let them and their AMEs focus their limited resources on Class 1 and 2?
 
UTLonghorn_1979 said:
And according the the legislation and procedures, the ONLY credentials needed are state licensed MD or DO physician
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FIFY. In some states, a licensed doctor of chiropracty is a physician and can perform the exams. The rule only requires a physician's license, not a particular degree.
 
Half Fast said:
FIFY. In some states, a licensed doctor of chiropracty is a physician and can perform the exams. The rule only requires a physician's license, not a particular degree.
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Seems to me some on this forum just don't like that there's an alternative basically saying a chiropractor is as qualified as an aviation MD specialist to assess fitness to fly certain aircraft and under certain operations.
 
What I am telling you, is no amount to expostulation on your part has any relevance to the decision of a professsional (who has a lot at state) as to his estimate as to whether or not to stick his neck out on your behalf. And yet you keep going on. And on. And on.

And yet aren't you the one with the psychiatry related (inability so far) to win certification? We have two folks here who I judged (correctly) smart enough and capable enough that I could relieve them of the misery of continued compliance to (in their situation(s) what I think was an overmuch regulatory burden for their situation, and who I felt able to trust as to managmemnt of risk...

UT, the survivors and heirs are going to be beset wtih "you need representation" mail after a wreck. It costs them nothing. It's an INDUSTRY. Why do you think the filing of a claim and a supbpoena and the subsequent nighmare isn't probable?

At very least you could do the courtesy of getting off the da__ed pedestal of declaiming "they (the AMEs, the docs) are unreasonable" and just sit down and get real.
 
Half Fast said:
FYI - I don't know whether this is what UT_Longhorn was referencing, but you might enjoy perusing https://www.faa.gov/sites/faa.gov/f...rtification_Certain_Small_Aircraft_Pilots.pdf . It was done a few years ago to satisfy a Congressional requirement, so it doesn't have the latest data, but a few of the more interesting conclusions include:

-No difference was found in the risk of BasicMed and third-class airmen having an aviation​
accident from the start of BasicMed in 2017 through the end of 2019.​
​
-No difference was found between accident-involved BasicMed and third-class airmen in the​
phase of flight in which their accident occurred.​
​
-No difference was found between accident-involved BasicMed and third-class airmen in fatal​
versus non-fatal outcomes.​
​
-No difference was found between fatally injured BasicMed and third-class airmen in autopsy​
findings.​

Some of the other conclusions require care in reading. For instance,

-When restricted to medically related death, BasicMed airmen had an age- and Special-Issuance-​
adjusted risk of mortality over the study period 53 percent higher than airmen who maintained​
third-class certification.​

That's not talking about in-flight incapacitation, but overall risk of mortality in general. Not surprising, since they found that pilots using Basic Med tend to be an older demographic.

Basically (pun intended), the study showed that a Class 3 medical has no real benefit in comparison to Basic Med. Why don't we just take Class 3 off the FAA's plate and let them and their AMEs focus their limited resources on Class 1 and 2?
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No, we're discussing the risk of a basic-med doctor getting sued (or threatened with suit).

If the risk is exactly zero, as claimed, then someone in insurance should underwrite special polices for free. After all, the fear is completely unfounded.....
 
bbchien said:
What I am telling you, is no amount to expostulation on your part has any relevance to the decision of a professsional (who has a lot at state) as to his estimate as to whether or not to stick his neck out on your behalf. And yet you keep going on. And on. And on.

And yet aren't you the one with the psychiatry related (inability so far) to win certification? We have two folks here who I judged (correctly) smart enough and capable enough that I could relieve them of the misery of continued compliance to (in their situation(s) what I think was an overmuch regulatory burden for their situation, and who I felt able to trust as to managmemnt of risk...

UT, the survivors and heirs are going to be beset wtih "you need representation" mail after a wreck. It costs them nothing. It's an INDUSTRY. Why do you think the filing of a claim and a supbpoena and the subsequent nighmare isn't probable?

At very least you could do the courtesy of getting off the da__ed pedestal of declaiming "they (the AMEs, the docs) are unreasonable" and just sit down and get real.
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I’m not telling any physician to “stick their neck out,” nor am I asking anyone to take on risk they’re uncomfortable with. If a doctor doesn’t want to participate in BM, that’s entirely their call. What I am pushing back on are claims about what the law requires, what the signature legally represents, and what the actual risk landscape looks like.

As for outcomes and risk and as already substantiated by others and myself, BM has been in place since 2017 with roughly 80,000 pilots operating under it, and there are no accident findings or cases pointing to BM status as causal. Lawyers may send letters after any accident — that’s true across all of medicine and aviation — but hypothetical litigation pressure isn’t the same as demonstrated risk, and conflating the two doesn’t help clarify the issue.

One other point that’s getting conflated here is the difference between risk and negligence. Every accident carries litigation risk — letters, subpoenas, and contingency-fee outreach happen regardless of fault. But negligence requires a breach of a defined duty of care, not just involvement.

If a physician performs the BM checklist and exam as prescribed, it’s hard to see a path to negligence. Negligence requires a breach of a defined duty, not just being involved. Under BM, the doctor’s duty is intentionally narrow: perform the checklist-based exam, discuss medications and conditions, and make a knowledge-qualified, time-limited statement (“not aware, as presently treated”). If that’s done and documented accurately, there’s no obvious breach to point to.

To get to negligence, someone would have to show the doctor didn’t actually perform the exam, ignored a disclosed red flag, or documented something that wasn’t true—and then show that specific failure directly caused the accident. An accident occurring later, or lawyers sending letters after a wreck, isn’t negligence. Litigation risk isn’t the same thing as legal negligence.

If the argument is simply I'm afraid I'll be sued, that's completely different from I will absolutely be held responsible for any accident to a pilot I examine for BM.
 
Thats exactly the argument. If I’m a doctor I’m not signing anything the puts my license or insurance at risk or opens me up to legal claims that my insurance won’t defend. Just not worth it
 
wellknow said:
Thats exactly the argument. If I’m a doctor I’m not signing anything the puts my license or insurance at risk or opens me up to legal claims that my insurance won’t defend. Just not worth it
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Well, I'm glad those that help the current 80K pilots see it differently.

Good thing is time will tell if that fear is unfounded or not. 8+ years and 80K+ pilots and counting is a good start.
 
UTLonghorn_1979 said:
I’m not telling any physician to “stick their neck out,” nor am I asking anyone to take on risk they’re uncomfortable with. If a doctor doesn’t want to participate in BM, that’s entirely their call. What I am pushing back on are claims about what the law requires, what the signature legally represents, and what the actual risk landscape looks like.

As for outcomes and risk and as already substantiated by others and myself, BM has been in place since 2017 with roughly 80,000 pilots operating under it, and there are no accident findings or cases pointing to BM status as causal. Lawyers may send letters after any accident — that’s true across all of medicine and aviation — but hypothetical litigation pressure isn’t the same as demonstrated risk, and conflating the two doesn’t help clarify the issue.

One other point that’s getting conflated here is the difference between risk and negligence. Every accident carries litigation risk — letters, subpoenas, and contingency-fee outreach happen regardless of fault. But negligence requires a breach of a defined duty of care, not just involvement.

If a physician performs the BM checklist and exam as prescribed, it’s hard to see a path to negligence. Negligence requires a breach of a defined duty, not just being involved. Under BM, the doctor’s duty is intentionally narrow: perform the checklist-based exam, discuss medications and conditions, and make a knowledge-qualified, time-limited statement (“not aware, as presently treated”). If that’s done and documented accurately, there’s no obvious breach to point to.

To get to negligence, someone would have to show the doctor didn’t actually perform the exam, ignored a disclosed red flag, or documented something that wasn’t true—and then show that specific failure directly caused the accident. An accident occurring later, or lawyers sending letters after a wreck, isn’t negligence. Litigation risk isn’t the same thing as legal negligence.

If the argument is simply I'm afraid I'll be sued, that's completely different from I will absolutely be held responsible for any accident to a pilot I examine for BM.
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What type of insurance do you sell?
 
UTLonghorn_1979 said:
There is zero legislative record of Feinstein saying that - please provide evidence.
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Bruce is mostly correct on this. It was ALPA and it was on the steps of her office not on the floor (so no legislative record). Senator/Lobbyist collusion rarely leaves tracks.

PBOR2 (which included doc protection BTW) passed both houses by a lot, but never got to the floor for a vote and got rolled into an omnibus. The night before the vote Feinstein announced she'd withhold her vote for unanimous consent it they didn't make the change so staffers stuck the CMEC in.
 
bbchien said:
I just love other people telling that my liability is insignificant. Just love it.
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You have posted previously about the very high insurance rates you were quoted if you were to do BascMed. Would it be fair to say that malpractice insurers are the ones that need to be convinced?
 
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Mark K said:
...Anyway, around here chiropractors charge $100 for a basicmed physical....
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I'm surprised to hear that, because I have heard that California does not consider chiropractors to be physicians, thus causing them not to fit within BasicMed's "state-licensed physician" terminology.
 
jbarrass said:
Funny thread. From this thread you'd think that is is impossible, or at least very hard, to find a physician to sign off on BasicMed. But in real life, 80,000 pilots have found a way. ...go figure.
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I wonder if there is some kind of breakdown by types of practice.

For example, I’m in the vicinity of both UNC and Duke medical schools and decided I wanted to take advantage of that environment for my primary care. My existing PCP’s only question was whether the FAA permitted It (apparently there had been a recent change in the DOT CDL medical certification procedure). I can easily see that being part of a large teaching and research hospital could be a factor in my doc’s comfort with the process.

OTOH, I can just as easily see a private physician trying to practice medicine, run a business, and protect themselves from even minor claims balking at something out of normal practice, even if the risk is negligible. After all, most if not all of those who have ever been sued about anything will probably agree it ain’t fun, even when you win.
 
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Anyone here been sued? For anything? I have, twice. Won one, lost one, and total costs far exceeded the price of a nice house in a nice neighborhood in my part of the country.
I can understand a physician giving the big "Nope!" to BM. Mine did.
 
UTLonghorn_1979 said:
They run that risk in very aspect of their practice, it’s not isolated to BM reviews. So perhaps not practice at all if your goal is to have zero risk to your insurance being canceled.
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That's not so. In no other case have I been told that I'd be non-renewed as a result of a single claim. And when they said "non-renewed," I asked for a clarification. They meant non-renewed as in, they wouldn't insure me for anything at all, ever again. That's a threat I've never heard before, even as a consequence of losing a suit.
 
OneCharlieTango said:
That's not so. In no other case have I been told that I'd be non-renewed as a result of a single claim. And when they said "non-renewed," I asked for a clarification. They meant non-renewed as in, they wouldn't insure me for anything at all, ever again. That's a threat I've never heard before, even as a consequence of losing a suit.
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That's why there are multiple insurance carriers in the space, each with different appetites and underwriting guidelines, so have a broker find a carrier that's comfortable with the exposure, if it's something you want to add to your practice.

Then it becomes a question of personal risk, vs. I can't get insured for this.
 
UTLonghorn_1979 said:
That's why there are multiple insurance carriers in the space, each with different appetites and underwriting guidelines, so have a broker find a carrier that's comfortable with the exposure, if it's something you want to add to your practice.

Then it becomes a question of personal risk, vs. I can't get insured for this.
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You have no idea what you're talking about. It isn't like buying car insurance.
 
Palmpilot said:
I'm surprised to hear that, because I have heard that California does not consider chiropractors to be physicians, thus causing them not to fit within BasicMed's "state-licensed physician" terminology.
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Well, this is interesting. I did get a basic med exam from a local DC. Their group is apparently asserting they are qualified to do them. I looked through the chiropractic board website and can't find a clear reference one way or the other and there is case law in CA that chiropractors are "physicians" in regards to workers compensation cases. In addition, they are licensed to do DOT exams, which, honestly, are more comprehensive than a basic med exam. Nonetheless you may be right that this chiropractic group is operating in a grey area by signing off on this forms. Hmmm. A little more investigation may be in order...
 
Chip Sylverne said:
I had a long conversation with an AOPA exec on providing awareness support for Basic Med among the medical community. Story I got was they just don't have the budget.
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AOPA claiming that is absolutely hilarious. The have $125M in net assets and pay Baker a $2M compensation package.
 
bbchien said:
Right, so do you have a health practitioner's license of any sort?
Post when you do.
Like you said to me and answered by TCABM, document that.
It's quite obvious that you have NO IDEA.
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I never said anything of that nature. My firm handles the professional (i.e. med mal) and general liability insurance for over 60K physicians across the US, so yeah, I know a little about it. But keep up the attitude.

Like I said, good thing there are thousands of individuals and physicians groups that are happy to perform basic med exams, and don't insult potential clients along the way.
 
UTLonghorn_1979 said:
I never said anything of that nature. My firm handles the professional (i.e. med mal) and general liability insurance for over 60K physicians across the US, so yeah, I know a little about it. But keep up the attitude.

Like I said, good thing there are thousands of individuals and physicians groups that are happy to perform basic med exams, and don't insult potential clients along the way.
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Nah. The ATTITUDE is you telling the docs that they have little to worry about.....
 
bbchien said:
Nah. The ATTITUDE is you telling the docs that they have little to worry about.....
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That’s not attitude—it’s an opinion grounded in objective facts and evidence.

We now have over 8 years of BM history with roughly 80,000 pilots participating, and to date there are no reported malpractice claims against physicians solely for performing BM exams. I've already stated that I understand the "fear" of being pulled into a suit, but that as the data set shows, it's unfounded.
 
MauleSkinner said:
Good thing you’re not an investment advisor. At least they understand that past performance doesn’t guarantee future results.
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That's literally the dumbest equivalency attempt I've ever read. You do realize that past performance warnings apply when there is historical volatility and loss to analyze, right? Here, there are no losses to analyze...at all.

Congrats, we're now all dumber for that post.
 
UTLonghorn_1979 said:
That's literally the dumbest equivalency attempt I've ever read. You do realize that past performance warnings apply when there is historical volatility and loss to analyze, right? Here, there are no losses to analyze...at all.
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And you’re saying that no past losses guarantees no future losses.
UTLonghorn_1979 said:
Congrats, we're now all dumber for that post.
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Probably just you.
 
Mark K said:
Well, this is interesting. I did get a basic med exam from a local DC. Their group is apparently asserting they are qualified to do them. I looked through the chiropractic board website and can't find a clear reference one way or the other and there is case law in CA that chiropractors are "physicians" in regards to workers compensation cases. In addition, they are licensed to do DOT exams, which, honestly, are more comprehensive than a basic med exam. Nonetheless you may be right that this chiropractic group is operating in a grey area by signing off on this forms. Hmmm. A little more investigation may be in order...
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If you'll pardon the cut and paste from Perplexity:

"A commonly cited list of states that explicitly classify chiropractors as “chiropractic physicians” (or otherwise as physicians under state statute) includes: Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, Florida, Idaho, Illinois, Iowa, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Washington, and Wyoming".

So if you live in one of these, a Chiro should work. I don't know if getting a BM from a state other than your state of residence makes any difference.
 
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