Basic Med- Anal exam???

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Tokirbymd

Pre-takeoff checklist
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Tokirbymd
Why does the basic med exam checklist include examination of the Anus? How does that affect my flying ability? And yet specifically excluding pelvic examination? Last I checked the anus is in the pelvis and immediately adjacent to said organs.
 
Tokirbymd said:
Why does the basic med exam checklist include examination of the Anus? How does that affect my flying ability? And yet specifically excluding pelvic examination? Last I checked the anus is in the pelvis and immediately adjacent to said organs.
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Because Congress said so.

It's also worth mentioning that the same item is included in a part 67 medical exam. Most AMEs simply rely on your history.
 
Brad Z said:
Most AMEs simply rely on your history.
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As does my BasicMed doctor.

My working hypothesis is that it’s up to us as pilots to tell our physicians the FAA requirements. So, on items like this, I send copies of pertinent sections of the AME Guide.
 
My first basicmed was done by Concentra, at a place that dealt with mostly Trucker medicals.

After they handed me my signed CMEC and temporary trucker card (after I informed everyone what the hell a CMEC was) they asked for my CMEC paperwork back, circled the anal exam in highlighter and wrote NO on it, thus invalidating the entire raison d'etre. I had spent weeks calling around and confirming that this place would do a CMEC.

I got a refund. My next stop, at a licensed Chiro, was staffed by a pilot who was content to arch an eyebrow and ask "all good?" and accepted a "yup" which is the maximum two grown men should discuss their anuses.

...it's a problem. I wish they'd remove the requirement. Most pilots are aholes enough to satisfy the non-digital examination requirement, self included.
 
schmookeeg said:
My first basicmed was done by Concentra, at a place that dealt with mostly Trucker medicals.

After they handed me my signed CMEC and temporary trucker card (after I informed everyone what the hell a CMEC was) they asked for my CMEC paperwork back, circled the anal exam in highlighter and wrote NO on it, thus invalidating the entire raison d'etre. I had spent weeks calling around and confirming that this place would do a CMEC.
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I knew my PCP would question that one so I sent her the section on it from the AME Guide.
 
midlifeflyer said:
I knew my PCP would question that one so I sent her the section on it from the AME Guide.
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Just reviewed that- makes way more sense than the basic med checklist. Would be nice to have a box "not indicated" so physicians don't have to lie and say it was examined, when in fact it was not.
 
Tokirbymd said:
Just reviewed that- makes way more sense than the basic med checklist. Would be nice to have a box "not indicated" so physicians don't have to lie and say it was examined, when in fact it was not.
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Our military system will kick it back if the "examined" box isn't checked. The way I handle it for military flight physicals is--after getting an adequate verbal history--to check "examined" but in the comments box put "Not clinically indicated". The reviewing authorities are 100% okay with that.
 
Lets nail the actual question here. prostate check.

My very best FAA certified medical examiner asked if I wanted a prostate check, I responded "Why".

"You are young, and probably have no issue, but I think that a baseline description is valuable".

Description was "Larger than average, no odd shapes, seems normal. No need for confirming x-rays".

Later years, "NO changes from original state", and we were both happy.

I have several friends who have had prostate cancer, some lived, some died, and I want all the early warning I can get. One was diagnosed initially by rectal, confirmed by biopsy, properly treated at about 50, and died in good health last December at 96.

When my old doctor retired, my next doctor declined to do the rectal, " It does not tell us anything". For him, it did not, the old doctor, it did tell us both what we needed to know.


If you do not trust your doctor's finger, change doctors.
 
Tokirbymd said:
as a Board Certified Gynecologist
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One of my best friends is a obgyn and he says "he knew he was destined to become one because he had mastered the digital exam by age 16". I just wonder, is this a common route to the profession?
(he is one of the funniest guys to be around, always cracking everyone up)
 
geezer said:
Lets nail the actual question here. prostate check.

My very best FAA certified medical examiner asked if I wanted a prostate check, I responded "Why".

"You are young, and probably have no issue, but I think that a baseline description is valuable".

Description was "Larger than average, no odd shapes, seems normal. No need for confirming x-rays".

Later years, "NO changes from original state", and we were both happy.

I have several friends who have had prostate cancer, some lived, some died, and I want all the early warning I can get. One was diagnosed initially by rectal, confirmed by biopsy, properly treated at about 50, and died in good health last December at 96.

When my old doctor retired, my next doctor declined to do the rectal, " It does not tell us anything". For him, it did not, the old doctor, it did tell us both what we needed to know.


If you do not trust your doctor's finger, change doctors.
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I don't doubt the utility of a prostate exam, just as I appreciate the utility of a Pap smear for women. But neither has any purpose in certifying safety for operating an aircraft
 
I think it’s like an EKG. Odds of finding something in young folks slim, but on some physicals it’s required. Military class 1A I had both rectal and EKG but subsequent physicals (non long form), they eliminate the need.
 
Tokirbymd said:
as a Board Certified Gynecologist pretty sure I know what a pelvic exam is ;)
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Well that kinda changes the question. From the OP I thought you were complaining about getting the finger. Sounds like you don't wanna give the finger. I'll have to recalibrate my jokes.
 
Ed Haywood said:
Anyone been through an old school MEPS? Nothing like getting a mass digital exam in a gym with 200 of your closest friends. The military has a great way of teaching that you ain't special.
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I remember but I don’t recall the digital rectal. Didn’t get that until my first flight physical.

I always laugh when I hear guys at work complain about the FAA Class II. My class 1W flight phys was digital rectal, EKG, blood & urine, dental, X-rays, hearing, anthro measurements, 100 question health history and you had to have 20/20 uncorrected. Thing took all day to do. My class II is 30 minutes in and out.
 
Tokirbymd said:
Just reviewed that- makes way more sense than the basic med checklist. Would be nice to have a box "not indicated" so physicians don't have to lie and say it was examined, when in fact it was not.
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They don't have to lie. At least with my PCP, she knows my history. I figure if it's good enough for a 1st class medical, it's good enough for BasicMed.
 
flyingcheesehead said:
Anyone been through an old school MEPS? Nothing like getting a mass digital exam in a gym with 200 of your closest friends.
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Yep teaches humility. How about walking like a duck squatting in your underwear to make sure no orthopedic limitations. Wonder if the military is still that way?
 
schmookeeg said:
My first basicmed was done by Concentra, at a place that dealt with mostly Trucker medicals.

After they handed me my signed CMEC and temporary trucker card (after I informed everyone what the hell a CMEC was) they asked for my CMEC paperwork back, circled the anal exam in highlighter and wrote NO on it, thus invalidating the entire raison d'etre. I had spent weeks calling around and confirming that this place would do a CMEC.

I got a refund. My next stop, at a licensed Chiro, was staffed by a pilot who was content to arch an eyebrow and ask "all good?" and accepted a "yup" which is the maximum two grown men should discuss their anuses.

...it's a problem. I wish they'd remove the requirement. Most pilots are aholes enough to satisfy the non-digital examination requirement, self included.
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I was just looking at my old 1W flight physical that was stamped “qualified.” Did someone not catch my T-Rex arms were too short? I don’t know how I was able to reach the cyclic.
IMG_0023.jpeg
 
Velocity173 said:
I remember but I don’t recall the digital rectal. Didn’t get that until my first flight physical.

I always laugh when I hear guys at work complain about the FAA Class II. My class 1W flight phys was digital rectal, EKG, blood & urine, dental, X-rays, hearing, anthro measurements, 100 question health history and you had to have 20/20 uncorrected. Thing took all day to do. My class II is 30 minutes in and out.
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Yep, our version was the HALO/SCUBA physical. Usually done by the flight surgeon. I used to pop hot on the labs and have to get some weird scan that involved fasting overnight and drinking a quart of nasty goo. The SOF docs would roll their eyes because apparently such measurements were common among people who did high intensity exercise.
 
Ed Haywood said:
Yep, our version was the HALO/SCUBA physical. Usually done by the flight surgeon. I used to pop hot on the labs and have to get some weird scan that involved fasting overnight and drinking a quart of nasty goo. The SOF docs would roll their eyes because apparently such measurements were common among people who did high intensity exercise.
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This isn’t the complete physical but a lot of this looks similar to the flight physical.

 
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