Basic Med after SI

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I currently have a third class medical with an SI. The FAA has since renewed my medical and SI once based on records from my therapist. I'm now approaching the need for a new exam, and I'm considering Basic Med.

Two concerns: If I ever want a medical again, does dropping to Basic Med while my SI is active look bad (evasive) to the FAA? Also, how onerous is the Basic Med exam? I've read horror stories online, and I'm not really feeling the desire for a rectal exam right (and before anyone chimes in, no, I don't have a prostate).
 
from the FAA:

"However, if your application was previously denied and you subsequently received a new medical certificate or a special issuance, you may operate under BasicMed."

If you wish to re-instate you 3rd class medical you would need to re-appy. BasicMed is not at all onerous. I welcome other opinions on this as I have never encountered such. A call to the FAA would be wise on your part.
 
I have SI’s for OSA and Diabetes type 2. As soon as Basic Med went live, I did the steps and flew under that. 2.5 years ago, I obtained my commercial pilot certificate and applied for a second class medical.

AME gave me a bored “okay” response when I answered his question about the gap in time between “regular” certificates.

So if no disqualifying issues, shifting between “regular” and BasicMed is a non-event.*

*make sure to have all documentation items the SI letter specified when going back to “regular”.
 
AggieMike88 said:
I have SI’s for OSA and Diabetes type 2. As soon as Basic Med went live, I did the steps and flew under that. 2.5 years ago, I obtained my commercial pilot certificate and applied for a second class medical.

AME gave me a bored “okay” response when I answered his question about the gap in time between “regular” certificates.

So if no disqualifying issues, shifting between “regular” and BasicMed is a non-event.*

*make sure to have all documentation items the SI letter specified when going back to “regular”.
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Makes sense, thank you. The isolation surrounding covid has been difficult on my mental health, and while my therapist says I'm perfectly ok to fly, I worry the FAA might have other ideas if I renew my third class now. I'd just like to buy some time to get 100% better in their eyes, if that makes sense.
 
I went from a 3rd class with SI to BasicMed about 2 years ago, and it was very easy. Not sure that it would be to go back to a third class, but probably not that much different than what a "normal" renewal would be.

Also, your Dr. does not have to perform the rectal exam for the BasicMed physical. Mine didn't, although I've heard of others whose Dr's did. :(
 
I've not had an AME ever give me the finger in the ass. My regular provider does so (along with drawing blood for PSA). BasicMed probably doesn't steer him much off what he'd have done if I just asked for my regular physical.
 
It does not look bad if you go to BasicMed.

the exam is simple. That ...errr...check....is visual only, which is bad enough. Other then the eye test, it’s very much like my regular annual physical.
 
bflynn said:
It does not look bad if you go to BasicMed.

the exam is simple. That ...errr...check....is visual only, which is bad enough. Other then the eye test, it’s very much like my regular annual physical.
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Hmm, maybe I'll take my chances with the FAA, then. Not so comfortable taking my pants off in front of some old dude (especially since I've never so much as had a nurse in the room during an exam with any AME...all of whom skipped that part of the checklist).
 
flyingron said:
I've not had an AME ever give me the finger in the ass. My regular provider does so (along with drawing blood for PSA). BasicMed probably doesn't steer him much off what he'd have done if I just asked for my regular physical.
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I don't have a regular physician, so this would be at an urgent care/CDL kind of place. Blood draw for PSA not required.
 
Anonymous said:
Hmm, maybe I'll take my chances with the FAA, then. Not so comfortable taking my pants off in front of some old dude (especially since I've never so much as had a nurse in the room during an exam with any AME...all of whom skipped that part of the checklist).
Click to expand...
Maybe you could ask to have a nurse in the room if he asks you to disrobe.
 
Anonymous said:
Not so comfortable taking my pants off in front of some old dude (especially since I've never so much as had a nurse in the room during an exam with any AME...all of whom skipped that part of the checklist).
Click to expand...

There are some doctors who are young dudes if that's more comfortable. I've also heard of doctors who were female. I wouldn't have thought it possible. But sure enough my Ex-wife is a Doctor, as is the AME who did two of my 3rd class medicals. She wasn't old or young, she was about my age.

I'm on BasicMed now. The dude who signed that off never asked me to lower my drawers.

YMMMV
 
Palmpilot said:
Maybe you could ask to have a nurse in the room if he asks you to disrobe.
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I could, if I was that assertive. But I suppose my point is that I've never, ever disrobed in front of an AME, which makes Basic Med more onerous on its face. Is that purposeful? I'll have to think on this.
 
Anonymous said:
Hmm, maybe I'll take my chances with the FAA, then. Not so comfortable taking my pants off in front of some old dude (especially since I've never so much as had a nurse in the room during an exam with any AME...all of whom skipped that part of the checklist).
Click to expand...

the doctor can...should be your regular doctor, whoever knows your overall health the best and is licensed by your state. If that’s “some old dude” that you’re not comfortable with, get a new doctor. You aren’t doing yourself any favors seeing someone that you can’t talk to.
 
Anonymous said:
I could, if I was that assertive. But I suppose my point is that I've never, ever disrobed in front of an AME, which makes Basic Med more onerous on its face. Is that purposeful? I'll have to think on this.
Click to expand...

The same inspection is listed for an AME exam. The only difference is that when Congress wrote the law that created BasicMed, they based it on an AME exam form, but neglected to include the instructions for that form, which say that the AME's response to that item can be based on either direct examination "or history." It looks like an unintended consequence to me.

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/guide.pdf (See bottom of page 110.)

So there is nothing to stop an AME from doing the same inspection.

By the way, the BasicMed exam form specifically excludes digital examination. (It also excludes pelvic examination for the G-U system.)

https://www.faa.gov/documentLibrary/media/Form/FAA_Form_8700-2.pdf (See page 8.)
 
bflynn said:
the doctor can...should be your regular doctor, whoever knows your overall health the best and is licensed by your state. If that’s “some old dude” that you’re not comfortable with, get a new doctor. You aren’t doing yourself any favors seeing someone that you can’t talk to.
Click to expand...

I don't have a regular doctor. Lots of people don't.
 
Palmpilot said:
The same inspection is listed for an AME exam. The only difference is that when Congress wrote the law that created BasicMed, they based it on an AME exam form, but neglected to include the instructions for that form, which say that the AME's response to that item can be based on either direct examination "or history." It looks like an unintended consequence to me.

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/guide.pdf (See bottom of page 110.)

So there is nothing to stop an AME from doing the same inspection.

By the way, the BasicMed exam form specifically excludes digital examination. (It also excludes pelvic examination for the G-U system.)

https://www.faa.gov/documentLibrary/media/Form/FAA_Form_8700-2.pdf (See page 8.)
Click to expand...

Yes, I've read up on that, which is partly why I'm not comfortable taking my pants off. If history was good enough for multiple AME's (and frankly, not one of them has ever asked about anything below the waist), it's good enough for a regular doctor. Especially without a nurse in the room.
 
Anonymous said:
I don't have a regular physician, so this would be at an urgent care/CDL kind of place. Blood draw for PSA not required.
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I agree, the FAA Is unconcerned with it. The form just says "anus." The doctor knows all pilots are a--holes and checks the box,
 
Anonymous said:
Yes, I've read up on that, which is partly why I'm not comfortable taking my pants off. If history was good enough for multiple AME's (and frankly, not one of them has ever asked about anything below the waist), it's good enough for a regular doctor. Especially without a nurse in the room.
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Multiple AMEs, so multiple medicals, so you must be an adult. It's time to get a regular physician who you're comfortable with, just for your general health. I don't want to make assumptions about why you are so concerned about a medical professional seeing you naked, but I would say it's something you may need to work to overcome. FAA aside, it's important to have regular physical exams. In the meantime, there are AMEs who perform Basic Med exams. Mine is one. He uses the 3rd-class guidelines. Maybe it would solve your immediate problem if you find an AME who'll do Basic Med.
 
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Anonymous said:
Hmm, maybe I'll take my chances with the FAA, then. Not so comfortable taking my pants off in front of some old dude (especially since I've never so much as had a nurse in the room during an exam with any AME...all of whom skipped that part of the checklist).
Click to expand...


Are you comfortable disrobing for a gynecologist? Any state-licensed physician can do a Basic Med exam; it doesn't have to be some old dude.

My doc didn't do the rectal exam, but he did want to witness me providing the urine sample. So even if you don't have to have your fanny examined, you might still need to drop your pants in front of the doctor or at least a nurse.
 
Most health care centers will list all their doctors on a web page. So if you do a little research before calling, you can request a specific one (of a particular gender, for instance... doctors come in all genders these days!) You can also request that a second person be in the room for a nudity-sensitive exam. I've been to OB/GYN places where this was the default behavior, but I've also been to places where it wasn't, where you had to *ask* if it is a service you want. So ask, when you make the appointment.

You can also ask ahead of time what exactly that doctor will do during a BasicMed exam, since (clearly) different ones do different things. I imagine that if I were a doctor, I would want to do whatever standard stuff I consider part of gauging the general health of a patient. But if this matters to you, and you don't want surprises, ask.

I'm a woman in my late 40's, so I have been through lots of different medical exam procedures that some might describe as "humiliating". (Yes, rectal too!) It was difficult when I was young, but over the years I have learned to separate the medical necessity of these things in my own mind, and appreciate their necessity. The female reproductive system is a highly complex system with multiple points of critical failure -- some of which I've experienced-- so getting them all inspected regularly is very important, just as for any of one's other organs and systems. A doctor is a professional. (Do not tolerate one who is not!)

In my youth, I moved around a lot, and rarely had a "regular doctor". Even now, I seem to find doctors who then retire and I have to find a new one. So this I understand. Maybe think of this BasicMed exam as "taking a doctor for a test-drive" as someone you can go back to if you're happy with how he or she treats you.
 
kath said:
Most health care centers will list all their doctors on a web page. So if you do a little research before calling, you can request a specific one (of a particular gender, for instance... doctors come in all genders these days!) You can also request that a second person be in the room for a nudity-sensitive exam. I've been to OB/GYN places where this was the default behavior, but I've also been to places where it wasn't, where you had to *ask* if it is a service you want. So ask, when you make the appointment.
Click to expand...
I will add that I know it is sometimes intimidating to even make the request, and you mentioned that you don't consider yourself very assertive, but you are not unique. Sorry if you thought you were. ;) Requesting a female physician, requesting a nurse in the room, and dozens of other requests are par for the course in medical practices, so no one will bat an eye. I've had uncomfortable conversations with doctors, I've had uncomfortable conversations with staff--until a friend told me that you can actually call a doctor's office and make an appointment without telling them what it's for--but none were as uncomfortable as I anticipated. And in this day and age, I'd question any doctor who wasn't happy to have a nurse in the room during an exam, male or female. So not to minimize your concerns, but please ask for what you need to make you comfortable. You might be surprised that they also want you to be comfortable and by asking, you're actually helping them do the right thing. If that means asking up front if you will be required to disrobe, and if the answer is yes, asking for a nurse, that's OK. No one is going to think that's a strange request, they won't refuse, and I guarantee they won't even ask you why.
 
kath said:
Most health care centers will list all their doctors on a web page. So if you do a little research before calling, you can request a specific one (of a particular gender, for instance... doctors come in all genders these days!) You can also request that a second person be in the room for a nudity-sensitive exam. I've been to OB/GYN places where this was the default behavior, but I've also been to places where it wasn't, where you had to *ask* if it is a service you want. So ask, when you make the appointment.

You can also ask ahead of time what exactly that doctor will do during a BasicMed exam, since (clearly) different ones do different things. I imagine that if I were a doctor, I would want to do whatever standard stuff I consider part of gauging the general health of a patient. But if this matters to you, and you don't want surprises, ask.

I'm a woman in my late 40's, so I have been through lots of different medical exam procedures that some might describe as "humiliating". (Yes, rectal too!) It was difficult when I was young, but over the years I have learned to separate the medical necessity of these things in my own mind, and appreciate their necessity. The female reproductive system is a highly complex system with multiple points of critical failure -- some of which I've experienced-- so getting them all inspected regularly is very important, just as for any of one's other organs and systems. A doctor is a professional. (Do not tolerate one who is not!)

In my youth, I moved around a lot, and rarely had a "regular doctor". Even now, I seem to find doctors who then retire and I have to find a new one. So this I understand. Maybe think of this BasicMed exam as "taking a doctor for a test-drive" as someone you can go back to if you're happy with how he or she treats you.
Click to expand...

(WARNING - brief thread hijack)

BTW, Kath - haven't seen an update from you for a while. Hope your own journey is progressing well.
 
Half Fast said:
(WARNING - brief thread hijack)

BTW, Kath - haven't seen an update from you for a while. Hope your own journey is progressing well.
Click to expand...

There's not much to update... I've got 5 weeks remaining in the 27-week Chemo regimen. The good news is the tumor has shrunk to the point where no one can really feel or detect it anymore (even with ultrasound!), so next comes the kind of surgery and radiation designed to remove and zap any evil little boogers that might have survived. So summer will be a different stage of the journey. <sigh>

I'll be shopping for my own BasicMed physician after that. :)
 
kath said:
There's not much to update... I've got 5 weeks remaining in the 27-week Chemo regimen. The good news is the tumor has shrunk to the point where no one can really feel or detect it anymore (even with ultrasound!), so next comes the kind of surgery and radiation designed to remove and zap any evil little boogers that might have survived. So summer will be a different stage of the journey. <sigh>

I'll be shopping for my own BasicMed physician after that. :)
Click to expand...


:fcross:

Basic Med solves many many problems. Hope Canada will come on board soon, though, or else you're locked into the itty-bitty confines of Alaska. :D
 
Half Fast said:
Are you comfortable disrobing for a gynecologist? Any state-licensed physician can do a Basic Med exam; it doesn't have to be some old dude.

My doc didn't do the rectal exam, but he did want to witness me providing the urine sample. So even if you don't have to have your fanny examined, you might still need to drop your pants in front of the doctor or at least a nurse.
Click to expand...

In 15+ exams, I have literally never peed in a cup in front of the AME. This is a thing?
 
Thanks everyone, but I think I'll up my therapy and take my chances with the third class. Not really interested in a more thorough, humiliating exam just because Congress got the wording of the regulation wrong or something. If keeping my clothes on is good enough for the AME, there's no good reason it shouldn't be good enough for a regular doctor. Ordering the clothes off seems like a power trip, honestly.
 
Anonymous said:
In 15+ exams, I have literally never peed in a cup in front of the AME. This is a thing?
Click to expand...
I’ve heard of it happening for drug tests before on certain occasions, but I’ve never had to whiz in front of anyone when due for an AME visit.
 
RyanB said:
I’ve heard of it happening for drug tests before on certain occasions, but I’ve never had to whiz in front of anyone when due for an AME visit.
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Never had to pee in front of the AME, but I've watched as he dipped my urine. All they're required to check is sugar and protein. Chances are they use a seven way strip that tests for a few otherthings like Ketones. This caused me grief with the turd AME that ended up having me grounded (compounded by the joklahoma city people being incapable reading sentences with more then four words in it).
 
Anonymous said:
In 15+ exams, I have literally never peed in a cup in front of the AME. This is a thing?
Click to expand...
No. Definitely not a requirement for an FAA exam. Maybe for some drug test protocols, but the most I've ever had was someone monitoring in the bathroom while I was in a stall.
 
Anonymous said:
Thanks everyone, but I think I'll up my therapy and take my chances with the third class. Not really interested in a more thorough, humiliating exam just because Congress got the wording of the regulation wrong or something. If keeping my clothes on is good enough for the AME, there's no good reason it shouldn't be good enough for a regular doctor. Ordering the clothes off seems like a power trip, honestly.
Click to expand...
Is that easier than calling the doc you might use and asking if you'd have to disrobe? I haven't ever had to for a 2nd or 3rd class or Basic Med exam.
 
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