No. Must be MD or DO. State licensed physician.
https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/
No. Must be MD or DO. State licensed physician.
Note that in some states chiropractors may also conduct the physical exam...
That's worrisome.
DCs managed to write their licensing rules in some states in a way that prints the word 'chiropractic physician' on the license.
I know several chiropractors...licensing aside, I don't know any that I'd trust to take a history or do a physical exam on me. I'd be vastly more comfortable with a history and physical exam from a Nurse Practitioner or Physician Assistant.
I know several chiropractors...licensing aside, I don't know any that I'd trust to take a history or do a physical exam on me. I'd be vastly more comfortable with a history and physical exam from a Nurse Practitioner or Physician Assistant.
Lack of training, knowledge, and experience with General Medicine. Perhaps the most obvious example, the patient's medications must be reviewed for nature and dosage. Among other deficits in General Medical topics, and unlike Nurse Practitioners and PA's, chiropractors have no pharmacology training and no license to prescribe. That alone should disqualify them from performing a Basic Med exam, or any exam relative to operation of a motor vehicle, including aircraft.OK, I'll bite... Why?
The Mirriam-Webster dictionary definition of chiropractic is pretty limited in terms of their training and expertise. There's a lot more to the human body than bones, muscles, and the nervous system.OK, I'll bite... Why?
Mirriam-Webster said:Definition of chiropractic
: a system of noninvasive therapy which holds that certain musculoskeletal disorders result from nervous system dysfunction arising from misalignment of the spine and joints and that focuses treatment especially on the manual adjustment or manipulation of the spinal vertebrae.
Lack of training, knowledge, and experience with General Medicine...
Probably not, if one views Basic Med as kind of a joke....the extreme other end of the spectrum from an AME's exam and the FAA's arcane and rather arbitrary AME exam process. But if the FAA takes the validity of the BM exam at all seriously and is going to let chiropractors do the exam, they should at least do away with the part where they're asking a chiropractor to actually practice medicine and do evaluations and make decisions outside of their education/training and for which they are unqualified. If chiropractors can do it, no reason you shouldn't be able to just have the lady at the DMV do your Basic Med exam when you get your driver's license.OK, I thought that may have been your angle...
In the 28 years I have been jumping through the FAA Aeromedical hoops I have never gone to an AME for anything other than a medical certificate. My experience has always been that the nurse in the practice performs about 90% of the required tests and the remaining 10% is followed up by the AME which generally took 5 min. or less. No questions were ever asked about previous medical appts in the last 3 years, etc. Checked the boxes, signed the cert and off I went.
My point is that I don't think I would classify the above as a comprehensive physical exam. I jumped through the hoops and the AME jumped through the hoops to satisfy the FAR's. BasicMed is no different. As long as you don't have a disqualifying condition, which is only a list of 11 items, you're good to go. Nothing pertaining to the physical ever goes to the FAA other than the date of the exam and the name and license of the medical professional performing the exam.
So does it really matter that a chiropractor can perform these exams?
Probably not, if one views Basic Med as kind of a joke....
If chiropractors can do it, no reason you shouldn't be able to just have the lady at the DMV do your Basic Med exam when you get your driver's license.
Not allowing a NP to perform something as basic as the basicmed exam is akin to limitations in the certified world.
Nope. The state-licensed physician must perform the exam. Others may assist, but the doc can’t sign off on it without physically interacting with the person.I would say they can perform the exam, but the attending doctor must sign off on it. The law uses two terms at different times, “state licensed physician” and the lesser “physician”, implying a difference in role.
Nope. The state-licensed physician must perform the exam. Others may assist, but the doc can’t sign off on it without physically interacting with the person.
it is up to the doctor to decide what they sign off. They have two specific points that they must legally do personally.
It sounds like you are assuming Congress meant the same thing, but the law uses two different terms with two different definitions. In the legal world, that implies an intent to differentiate.
Once my mother’s doctor went to a concierge practice, the doctor almost never saw patients, with most work being done by PAs. That form of medical practice has been around for decades, so I think we cannot assume Congress was ignorant of it. If they had intended that the state licensed physician was required to personally perform exams, they would have stated that explicitly.
it is up to the doctor to decide what they sign off. They have two specific points that they must legally do personally.
It sounds like you are assuming Congress meant the same thing, but the law uses two different terms with two different definitions. In the legal world, that implies an intent to differentiate.
Once my mother’s doctor went to a concierge practice, the doctor almost never saw patients, with most work being done by PAs. That form of medical practice has been around for decades, so I think we cannot assume Congress was ignorant of it. If they had intended that the state licensed physician was required to personally perform exams, they would have stated that explicitly.
I have made it a habit not to comment on the abilities of DCs.
Lol. I agree. We have chiropractors that tout the ability to treat GERD, seizures, even atrial fibrillation. In fact in our area we had a chiropractor treat a person for seizures- then told them it’s ok to stop your seizure meds- they do. Patient had a near fatal seizure and went back on meds after ER trip. The chiropractor had the balls to adjust her again. And say now you can stop them again. - pt died. Chiropractor did time. Denied in court saying ok to stop meds until family produced a tape.
i had a chiro tell one of my pts to stop their anticoagulant-Coumadin- because he adjusted them to get rid of a fib. Pt called me fortunately and I had to have a talk with that chiro.
the “meat and potato” adjusters and manipulators of spine who stick to that are great. Know their limitations.
The ones that sell the snake oil, feel the bumps on your head and tell pts that they had trouble in the womb as a child (local guy does this) are the dangerous ones
That tractor trailer coming the other direction on a two lane road may be driven by someone who obtained his DOT card from a chiropractor at the truck stop. Just something to think about.
Chiropractors generally practice their trade without the encumbrance of having to adhere to tricky little problems like "standards of care". Their "treatments" don't require randomized, prospective, peer-reviewed validation...they can just make stuff up. Some of them...the good ones...stick with spinal manipulation, and maybe nutrition and a bunch of holistic mumbo-jumbo. Mostly harmless. Others branch out into some really whacky ****. I find the fact that they can review a pilot's medications and approve him/her to fly an airplane to be indicative of the arbitrariness of the entire FAA medical certification process.Lol. I agree. We have chiropractors that tout the ability to treat GERD, seizures, even atrial fibrillation. In fact in our area we had a chiropractor treat a person for seizures- then told them it’s ok to stop your seizure meds- they do. Patient had a near fatal seizure and went back on meds after ER trip. The chiropractor had the balls to adjust her again. And say now you can stop them again. - pt died. Chiropractor did time. Denied in court saying ok to stop meds until family produced a tape.
i had a chiro tell one of my pts to stop their anticoagulant-Coumadin- because he adjusted them to get rid of a fib. Pt called me fortunately and I had to have a talk with that chiro.
the “meat and potato” adjusters and manipulators of spine who stick to that are great. Know their limitations.
The ones that sell the snake oil, feel the bumps on your head and tell pts that they had trouble in the womb as a child (local guy does this) are the dangerous ones
If an investigation determined that the physician signing the CMEC never actually examined the applicant, the FAA would consider that signature to not be valid. Whether that would result enforcement action would depend on the facts of the case.
Good point. You could send an email to the FAA if you would like clarification. That said, as noted in the FAQ quote above, the physician must conduct the examination, and it's hard to conduct an examination if you've never seen the patient.I don’t believe you know that, it is an opinion.
Again, you are assuming that Congress used words carelessly.
I am a PA. I have had ppl bring basic med stuff and and I just have my attending see them. I know could do the whole thing and get it signed off but as a pilot knowing the rules I don’t feel comfortable with it. I do agree with you that it would be worth a letter to FAA requesting opinion/clarification. As a pilot and a PA it’s a fair question.Good point. You could send an email to the FAA if you would like clarification. That said, as noted in the FAQ quote above, the physician must conduct the examination, and it's hard to conduct an examination if you've never seen the patient.
FWIW- I don’t think congress had intended on allowing chiropractors to perform BasicMed examinations. I suspect if they had it would have been explicit in the statute. The law said state-licensed physician, so the FAA went with state-licensed physician and left it to the state to sort it out.
At last count there were approximately 18 states that license chiropractors as physicians.In this state, they make a statutory distinction between Medicine and Chiropractic. AFAIK, chiropractors aren’t defined as physicians around here.