AME's and BasicMed

  • Thread starter Thread starter Curious Guest
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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. …Hmmm. A little more investigation may be in order...
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From a BasicMed perspective, the term is state licensed physician.

The CMEC should include a state medical license #. If you search that license # what kind of license does it return as?
 
Could a podiatrist do a Basic Med Exam? In CA, they are considered state licensed physicians.
 
Ask your insurance carrier if a podiatrist, chiropractor, or ? are considered physicians. I worry more about are they going to cover me than what the FAA says. Avemco will cover me with a “yearly” BM and flight reviews, but not if done by a chiropractor, even though I live in a state on the above list.
 
More of a rhetorical question, as I am exercising First Class privileges.

I do have my annual checkup with my PCP this Thursday, and I will bring the CMEC form and see if he's OK with filling it out. Will report back. Curious after reading the thread. May as well get BM done while getting my annual checkup.

I would agree with you. While the FAA may be OK with a podiatrist or chiropractor signing off the CMEC, I'd prefer to know what AVEMCO has to say on that matter.
 
Joe Schmoe said:
More of a rhetorical question, as I am exercising privileges of my First Class. But I thought BM would be good to have. I do have my annual checkup with my PCP this Thursday, and I will bring him the CMEC form and see if he's OK with filling it out. Will report back. Curious after reading the thread

I would agree with you. While the FAA may be OK with a podiatrist or chiropractor signing off the CMEC, I'd prefer to know what AVEMCO has to say on that matter.
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Every policy will have limitations and/or conditions of coverage. DEFINITELY make sure that the "physician" performing the exam meets the definition of the carrier of qualified examiner.
 
UTLonghorn_1979 said:
Every policy will have limitations and/or conditions of coverage. DEFINITELY make sure that the "physician" performing the exam meets the definition of the carrier of qualified examiner.
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What are the limitations on the policies you sell? And which malpractice underwriters are OK with doctors completing Basic Med CMECs?
 
Lindberg said:
What are the limitations on the policies you sell? And which malpractice underwriters are OK with doctors completing Basic Med CMECs?
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They vary by carrier and by pilot experience...but he and I are talking about personal aircraft liability/hull, not professional liability for Drs.

I don't give out free advise, that's intellectual capital, but there are literally dozens and it then depends on your overall practice, jurisdiction, size of group/practice size, etc. That's what brokers do...I'm not a State Farm agent, buddy.
 
"I don't give out free advise, that's intellectual capital, but there are literally dozens and it then depends on your overall practice, jurisdiction, size of group/practice size, etc. That's what brokers do...I'm not a State Farm agent, buddy."

I mean what's the harm. Would be great for folks here to get some advice on the topic from an expert in the insurance field.

Dr. Bruce has been more than gracious to take some time out of his busy schedule to give out free advice to fellow pilots.
 
Joe Schmoe said:
"I don't give out free advise, that's intellectual capital, but there are literally dozens and it then depends on your overall practice, jurisdiction, size of group/practice size, etc. That's what brokers do...I'm not a State Farm agent, buddy."

I mean what's the harm. Would be great for folks here to get some advice on the topic from an old expert in the insurance field.

Dr. Bruce has been more than gracious to take some time out of his busy schedule to give out free advise to fellow pilot
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Dr B isn't seeking autonomy.

As I said, it depends on state/jurisdiction, size of practice, breakdown of practice by service (by %), Dr. experience and claims history, so there's not one size fits all answer. Find a good broker in the space and they will navigate it for you. If you are married to your carrier or in a physician group that mandates a carrier, it's less likely you will get that coverage if not already provided.
 
I don't need BM, I fly for a 121.

Was just curious of the process as there seems to be a bit of a "grey zone" regarding the definition of a state licensed physician.

Regardless, now I am curious if my MD will sign off on BM. Granted I have been going to him for 10 years so there is an established patient doctor relationship, and I'm not some rando off the street asking him to complete the form. Will find out on Thursday

Just wild that a DC can sign off on a CMEC but not for a scuba physical.
 
Joe Schmoe said:
I don't need BM, I fly for a 121.

Was just curious of the process as there seems to be a bit of a "grey zone" regarding the definition of a state licensed physician.

Regardless, now I am curious if my MD will sign off on BM. Granted I have been going to him for 10 years so there is an established patient doctor relationship, and I'm not some rando off the street asking him to complete the form. Will find out on Thursday

Just wild that a DC can sign off on a CMEC but not for a scuba physical.
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If it's not specifically defined (i.e. MD or DO, etc) then it will fall to the legally defined "state licensed physician."

More importantly, many personal aircraft policies will dictate a current, at least, class 3 medical, so you need to make sure that's removed and they agree to you operating under BM or sport pilot, for that matter.
 
Joe Schmoe said:
More of a rhetorical question, as I am exercising First Class privileges.

I do have my annual checkup with my PCP this Thursday, and I will bring the CMEC form and see if he's OK with filling it out. Will report back. Curious after reading the thread. May as well get BM done while getting my annual checkup.

I would agree with you. While the FAA may be OK with a podiatrist or chiropractor signing off the CMEC, I'd prefer to know what AVEMCO has to say on that matter.
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A good friend of mine just turned 80. In addition to getting a " Master Pilot" award from the FAA, he got a letter from AVEMCO stating at renewal he will have to get a class 3 annually, as well as an annual flight review if he wants to continue flying his Comanche. If he went to a 172 or Cherokee, he could continue on Basic Med and BFR's. Oh, and the premium is nightmare material.

He's also in Maryland, so an MD is required, but his personal physician is also an AME so swapping back from BM is not an issue.
 
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Chip Sylverne said:
A good friend of mine just turned 80. In addition to getting a " Master Pilot" award from the FAA, he got a letter from AVEMCO stating at renewal he will have to get a class 3 annually, as well as an annual flight review if he wants to continue flying his Comanche. If he went to a 172 or Cherokee, he could continue on Basic Med and BFR's. Oh, and the premium is nightmare material.
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I don't do personal aircraft coverage, but I'm finding Avemco to not be very competitive vs. groups like Starr, HDI Specialty, Acceleration or AIG.
 
UTLonghorn_1979 said:
I don't do personal aircraft coverage, but I'm finding Avemco to not be very competitive vs. groups like Starr, HDI Specialty, Acceleration or AIG.
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True, and never has been except for low limit per person fixed gear under 180 HP. However, they seem to be more accommodating for octogenarians than most others, but they get their pound of flesh for it.
 
UTLonghorn_1979 said:
If you are married to your carrier or in a physician group that mandates a carrier, it's less likely you will get that coverage if not already provided.
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Almost everyone is married to a carrier, especially if they have Claims Made coverage. An obstetrician in Illinois, whose malpractice premium is over $100k and might be $300k, will have to buy prior acts coverage to leave one carrier for another. That’s typically 2 years’ premium. So it costs $200k to dump one carrier, plus the new premium of another 100. More realistically, $400k for the tail and $200k for the new policy, for a total of $600,000.

No one wants to do BM exams that badly.
 
OneCharlieTango said:
Almost everyone is married to a carrier, especially if they have Claims Made coverage. An obstetrician in Illinois, whose malpractice premium is over $100k and might be $300k, will have to buy prior acts coverage to leave one carrier for another. That’s typically 2 years’ premium. So it costs $200k to dump one carrier, plus the new premium of another 100. More realistically, $400k for the tail and $200k for the new policy, for a total of $600,000.

No one wants to do BM exams that badly.
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That can be true, some carriers won't require you to purchase the tail year for latent claims, and as long as you sign a warranty that you're not aware of any current or potential suits, they can waive the prior acts exclusion for continuity of coverage. Many even have automatic extended period reporting for another year at 100% of the current premium, sometime less a %. Just depends on the knowledge and skills of your broker.

I agree that some may say it's not worth it, and stay with their existing carrier. My only point is it's not as dire as this forum seems to make it.
 
UTLonghorn_1979 said:
That can be true, some carriers won't require you to purchase the tail year for latent claims, and as long as you sign a warranty that you're not aware of any current or potential suits, they can waive the prior acts exclusion for continuity of coverage. Many even have automatic extended period reporting for another year at 100% of the current premium, sometime less a %. Just depends on the knowledge and skills of your broker.

I agree that some may say it's not worth it, and stay with their existing carrier. My only point is it's not as dire as this forum seems to make it.
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For clarification, does your firm sell malpractice coverage to doctors who do BasicMed exams?
 
Quick update.

I went to my PCP for my annual physical. He has been my PCP for about ten years.
The day before, I emailed his office the AOPA Physicians Guide to Basic Med.

He took no issue with performing the exam and signing off on the CMEC form.

I asked if he would be open to performing exams for Basic Med. He stated while he had no problem performing the Basic Med exam for me (or any other established patient), he would not do a Basic Med exam for some random pilot off the street looking to get one done.

I think that is fair on his end as it’s his hard earned medical license.
 
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Chip Sylverne said:
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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So, here is a follow up question.

I am a California resident. My pilots certificate lists my CA address.

Let’s say a California GA pilot is looking to get their Basic Med med. They go out to Vegas for a few days of fun and decide to search out for a DC who is willing to perform a Basic Med exam.

So now, a pilot with a CA address has a Basic Med exam performed out of state (Nevada for example) by a DC who isn’t considered to be a physician in CA. To the attorneys on here, curious if this would present a grey zone for the pilot? Especially from a liability perspective, since the definition of a state licensed physician (I.e. DC) varies from state to state.

Obviously, with an AME , I can get my FAA medical in any state with any AME.

But to me at least, going out of state to get a Basic Med exam done by a DC, when your state doesn’t consider a DC to be a physician, could potentially open up a pilot to some liability. Just thinking out loud.
 
Joe Schmoe said:
So, here is a follow up question.

I am a California resident. My pilots certificate lists my CA address.

Let’s say a California GA pilot is looking to get their Basic Med med. They go out to Vegas for a few days of fun and decide to search out for a DC who is willing to perform a Basic Med exam.

So now, a pilot with a CA address has a Basic Med exam performed out of state (Nevada for example) by a DC who isn’t considered to be a physician in CA. To the attorneys on here, curious if this would present a grey zone for the pilot? Especially from a liability perspective, since the definition of a state licensed physician (I.e. DC) varies from state to state.

Obviously, with an AME , I can get my FAA medical in any state with any AME.

But to me at least, going out of state to get a Basic Med exam done by a DC, when your state doesn’t consider a DC to be a physician, could potentially open up a pilot to some liability. Just thinking out loud.
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IANL. My first thought is shere in 14 CFR 68 does it require a pilot to have the CMEC completed by a physician licensed in the state in which the pilot resides/address as listed on their pilot certificate?

Suppose I moved states shortly after my last CMEC was completed; does that invalidate the CMEC, open me to some type of liability, or create a gray zone?
 
TCABM said:
IANL. My first thought is shere in 14 CFR 68 does it require a pilot to have the CMEC completed by a physician licensed in the state in which the pilot resides/address as listed on their pilot certificate?

Suppose I moved states shortly after my last CMEC was completed; does that invalidate the CMEC, open me to some type of liability, or create a gray zone?
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Great question, if the exam was performed by an MD or a DO, I don’t see how it could invalidate the CMEC since MDs and DOs are considered state licensed physicians in every state….DCs on the other hand are a hit or miss when it comes to physician classification as that can be state specific.

For me personally, it would be safer to err on the side of caution, and get a Basic Med exam done by a MD or DO. No potential grey areas. The older I get with more assets and responsibilities to boot, the fewer grey areas in life, the better IMHO.

But I will defer to the attorneys as this is outside of my lane and I am genuinely curious about this potential “grey zone“ scenario.
 
Joe Schmoe said:
For me personally, it would be safer to err on the side of caution, and get a Basic Med exam done by a MD or DO. No potential grey areas. The older I get with more assets and responsibilities to boot, the fewer grey areas in life, the better IMHO.
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Never paraphrase a statute. Looking at the actual regulation where do you see a gray area?
 
Another good question and you are correct regarding the statute the way it reads. I'm just approaching it from a liability perspective.

A CA pilot goes out of state to get Basic Med done in NV by a DC who isn't considered a state licensed physician in CA. Yes, per the Basic Med statute the NV DC can perform the Basic Med exam.

But from a liability perspective, if the pilot was involved in an accident or incident due to a medical issue, I'm wondering if some attorney could use a BM signed by a DC as some sort of proof of negligence on the pilots end, since the exam was done by someone who isn't considered a physician in the pilots state of residence.

Could an insurance company also use that as an excuse not to pay out a claim?

I honestly don't know the answer to either that is why I am asking as this is outside of my lane.
 
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Joe Schmoe said:
But from a liability perspective, if the pilot was involved in an accident or incident due to a medical issue, I'm wondering if some attorney could use a BM signed by a DC as some sort of proof of negligence on the pilots end, since the exam was done by someone who isn't considered a physician in the pilots state of residence.
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Did that fact contribute to the accident?
Joe Schmoe said:
Could an insurance company also use that as an excuse not to pay out a claim?
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What does the policy say?
 
Joe Schmoe said:
But from a liability perspective, if the pilot was involved in an accident or incident due to a medical issue, I'm wondering if some attorney could use a BM signed by a DC as some sort of proof of negligence on the pilots end, since the exam was done by someone who isn't considered a physician in the pilots state of residence.

Could an insurance company also use that as an excuse not to pay out a claim?
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Lindberg said:
Did that fact contribute to the accident?
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If the pilot's medical condition contributed to the accident, it's on the pilot for not self grounding as required. In that case I could see an attorney making a case on the pilot's knowing he wasn't medically qualified and deliberately going to a doctor (chiropractor) who'd be less likely to catch it. Not as a direct cause (as the exam is legal in the eyes of the FAA) but helping to establish culpability.

If the medical condition didn't contribute, I can't see it ever coming up.
 
Dana said:
Call me cynical, but Basicmed (and sport pilot) threaten the AME's monopoly on airman medical certification.
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Maybe it’s just me being cynical, but are new AMEs an endangered species where you are too? Around here, we’ve lost two to retirement, and it’s starting to feel like you need a tracking tag and binoculars to spot the next new one.

If an AME offered BasicMed exams, they could probably charge the same as a third-class and still afford to keep the lights on. After all, one MD told me that the Basic Med is a formal “fitness for duty” exam that is structured like (but not the same) as the truck and train physical exam.

I could go back to the doc who did my FAA exams, but these days BasicMed fits my flying life just fine. Last time, my MD turned the visit into a full medical adventure with a gallon of blood, tests, questions, a bonus lecture on 'gotta lose some weight" and then wrapped it up with a “you’re good to go!” The best part.. I was only $20.00 out of pocket.
 
Dana said:
If the medical condition didn't contribute, I can't see it ever coming up.
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I would still considered it negligence by the pilot. If a pilot isn't supposed to be PIC because of known medical condition, why is he hitting stuff with airplanes? It's hard to have an accident if you're not in control of something. If someone knows they have a grounding condition, and misleads a physician to get BM, they know they shouldn't be PIC, therefore negligent.

Any intentional dishonesty used to obtain a license or meet another requiement to do something that is regulated, automatically equals negligence, in my eyes. I may be completely wrong about if it considered negligence, from a legal perspective.
 
Fiveslide said:
I would still considered it negligence by the pilot. If a pilot isn't supposed to be PIC because of known medical condition, why is he hitting stuff with airplanes? It's hard to have an accident if you're not in control of something. If someone knows they have a grounding condition, and misleads a physician to get BM, they know they shouldn't be PIC, therefore negligent.

Any intentional dishonesty used to obtain a license or meet another requiement to do something that is regulated, automatically equals negligence, in my eyes. I may be completely wrong about if it considered negligence, from a legal perspective.
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The conditions that make one ineligible for a class 3 are not necessarily disqualifying for basicmed. The physician isn't certifying that the pilot has nothing disqualifying him for a class 3; he's saying:

"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."​

If the FAA intended than any condition disqualifying for a class 3 was also disqualifying for basicmed (or SP) they would have said so. But they didn't. The only medical conditions listed as specifically disqualifying for basicmed are certain mental, neurological, or cardiac conditions.

But what I meant was: Say for example, a pilot has kidney stones to the extent that it would be disqualifying for a class 3. But for whatever reason, the pilot and his doctor determine that he's safe to fly. If the pilot then crashes due to debilitating kidney stone pain, he's guilty. If he crashes due to a sudden heart attack or stroke, he can't (or shouldn't) be found negligent for flying with a kidney stone.
 
Actually they intend in the instruction sheet to the "State licensed physician" to put the onus on the local medical doc, the "Do not Fly " meds list. But nobody pays any attention.
 

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bbchien said:
Actually they intend in the instruction sheet to the "State licensed physician" to put the onus on the local medical doc, the "Do not Fly " meds list. But nobody pays any attention.
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But it says, "should consider", not "shall"...
 
I've been lucky in that my physician was always able to just tack on basic med to my normal (insurance covered) physical. It took some back and forth with my new doctor sending her the "yes, you can do basic med physicals" article, but she relented.
 
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