It's a really long detailed discussion. Here it is. The actual guide pages I put on my website (see sigline, go to "photos" to see them).
Here goes.....
Expansion of AME Authority
As a result of efforts by Dr. Tilton and the staff, encouraged by a meeting in Atlanta in May 2012 with some of the AMEs, Nine new protocols were published that allow the AME some additional authority to issue, without “Special Issuance Authorization”. These worksheets are posted in the Photos section in the order below- the last nine photographs “Asthma, through “Renal Cancer”.
ASTHMA: Asthma that required multiple disease modifying medications with any history of episodes was a special issuance requiring annual doc’s evaluations and pulmonary functions. Those with disease modifying medications and only distant episodes were not. The new criteria are: Most of the usual medications, pulmonary fucntions >80% of normal, and no more than two urgent care visits per year, are now office issueable. The down side, is that the middle group are going to now get pulmonary functions. The Agency, while delegating authority, clearly wants objectification. Note that if you are a THIRD class airman, these are only going to be every OTHER year.
ARTHRITIS: We’re talking inflammatory arthritis here. The usual meds, methotrexate, Plaquenil, prednisone, are permitted on exactly the same terms as before, but with the addition of a blood count, Liver functions and kidney monitoring (creatinine) need be normal. The 8500-7 for plaquenil is still required. However if you are a THIRD class airman, these are only required every TWO years, and we just issue it.
GLAUCOMA: The group with IOPs less than 24 mms (23 or less, each eye) and normal Visual fields (Humphrey, Goldman, and now Octopus (cheaper)) on most meds can just be issued. This SI was already a two year period for THIRD class airmen. Some medications remain unacceptable.
HEPATITIS C: When declared by the treating physician to be in CHRONIC STABLE phase, and the liver functions are within 10% over max normal-->issue. And this is a two year issuance for THIRD CLASS.
HYPERTENSION: No essential changes, although the EKG (first time) has been DELETED. No more 3rd class airman getting hit with a stress test for a first time EKG that shows a BUNDLE BRANCH BLOCK.
HYPOTHYROIDISM: Everything is as before- nml TSH <90 days prior, plus the appearance of “euthryoid” state, is now just “issue”. Hallelujah. Long overdue.
MIGRAINE: an IMPROVEMENT! If the treating MD records headache which is non-ocular in either Aura or actual Headache, and no TIA type symptoms occur, the usual meds are permitted provided no more than one episode per month and two or fewer urgent care visits per year. NO MRI, and documentation only at each issuance. Again THIRD CLASS airmen benefit from the reduced burden. AME issues when he has all of the above.
PreDIABETES: There are going to be some simple oral controlled diabetics in this group: Hb A1c <6.5 with a FBG less than 126, +/- Metformin (only Metformin) are permitted. No longer an SI, documentation only with issuances (relief for the THIRD CLASS airman).
RENAL CANCER: If extirpated, and the treating MD says no extension of disease, and the Airman is recovered from surgery, this is “issue”.
