The FAA has no desire to help this one. They are not about creating and fostering safety, they are about closing their eyes and saying "We stopped the bad sick people from flying."
I applaud your thinking, but you will get nowhere.
I agree that 'uphill battle' could only begin to describe the challenges involved.
This should not keep us from keeping an open mind as to how to approach the governing agencies however.
Thinking in this direction.
AME's have a high risk ratio; however, seem to be guided within a very narrow set of options which basically include Approval/Deferral/Denial. Yet we take for granted that they have to asess both the risk of each individual aviator's abilities and their risk of incapacitation, all for roughly ~$100 every 1-5 yrs. I for one, would rather have a system in place that gives more control over the risk management process to the trained medical professional, who is likely also an aviator. Of course, along with a graduated scale, would come with some additional risk of it's own to the practitioner. I do understand that medicals would be more expensive due to this risk. However I do believe that insurance companies would balance said risk better than the government would out of the box. I, for one would rather hear my AME say 'John, you can no longer can be practicing Single pilot IFR as I feel it is time for you to move on to a more relaxing level of flight responsibility unless I can determine, from tests and/or a SODA ride, that you are in a safe position to do so.' than, "The FAA has left me no option but to give you an intense battery of tests, at your own expense, after which, they may choose not to certify you to fly any powered airplane."
Does this not alleviate some risk from the FAA?
Does this not also promote the safety of flight?
Does this also not promote the business of aviation in the US?
Does this not also provide the ability for the FAA to shift some financial responsibility (cost save) during a time when it projects the need to do so?
Wouldn't this promote an environment of free communication, trust, and safety amongst all parties involved? I know many, many aviators who live in fear of what the FAA will say or, sadly, what their AME will say if they come forward with their medical issue. Even though this should not be the case, especially when it comes to their AMe.
Sure, some practitioners would choose not to sign off on many things due to risk adversion. Sure, Many would sign off too many at, perhaps, a higher fee. But wouldn't those issues work themselves out as those who would not sign off after a good risk discussion would be less used, and much more importantly, those who sign off too unresponsively would be kicked out by their own peer or government reviews and possibly be open to a high legal exposure rate?
And, yes, I see it coming already... Do AME's asses abilities? Yes they do. The FAA does as well on a medical basis. Using Neuro-Cog as an example: There are a variety of conditions for which the FAA requires a complete neuro work-up that is not required unless said soul has one of those conditions. As a result, the FAA has a bar which they have set within themselves as to what is expected for an aviator and AME's are, at some level, expected to adhear to it.