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Discussion in 'Medical Topics' started by bbchien, Jul 14, 2016.
Thank you for that!
to discuss all drugs the individual reports taking (prescription and nonprescription) and their potential to interfere with the safe operation of an aircraft or motor vehicle;
Does this mean that a pilot's physician now* can evaluate a patient's reaction to a drug that is currently prohibited, for example, Phentermine, and sign the form?
*now, being, post Presidential signature and FAA text wrangling?
So it may take up to 180 days from enactment. Darn. I was excited I wouldn't need to renew in September. Oh well.
we don't know what the FAA will put in the "rules" but for now it is safe to say the requirement will be the same as it is now but you can go to your own doctor every four years instead of an AME every two.
I hate to be the one to say this and I hope that I am wrong but what non aviation doctor is going to sign this ?
"iv) to sign the checklist, stating: ‘‘I certify that I discussed all items on this checklist with the individual during my examination, discussed any medications the individual is taking that could interfere with their ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on this checklist. I certify that I am not aware of any medical condition that, as presently treated, could interfere with the individual’s ability to safely operate an aircraft.’’; and "
How many are going to say they have no idea what it takes to safely operate an aircraft and are not going to put their livelihood on the line by signing this.. ?
Good question, iflyatiger.
It will be interesting when the rules come out, to see if the form indeed insists that a physician sign a certification that is so strongly written.
Go see your AME for the exam.. just not with the Third class filled out. They will know what is safe or not. Only they dont have to defer to OKC..
I think the big questions are how much exposure to litigation a physician of any kind will face, when signing such a certification.
And whether you'll be able to find one who'll sign yours, being mindful of that exposure.
1. Go to an AME
2. The doctors I have spoken to, including my endocrinologist, told me, before they prescribe a drug, they have to know what it does, the side effects, etc. I was looking to switch from Phentermine to another appetite suppressant, and the good doctor told me that one may cause diarrhea, and that would enable me to tell a two million dollar story (see the other thread...), so he said that's not a good one.
This was a couple of weeks ago, and I told him about the PBOR2, and he said that he'd "take a look at it" and sign it, if it wasn't a noose. DOT regulations stipulate the same thing, and if you go here page 9, question 11:
11. In your medical opinion, does any one of the listed medications have the potential to compromise the driver’s ability to operate a CMV safely?
This is for an endocrinologist to sign, not a medical examiner for the commercial trucking bureau.
I guess the point I'm making is that doctors signing permission slips isn't new, but I believe that AME's have expressed countering arguments in this site, and I do respect their opinions when they report out different evidence.
I bet over time there will be the "go to" doc in different areas that will happily sign the form. Docs have businesses to run and bills to pay just like everyone else.
Sorta like the CFIs that will sign off a flight review for anyone with a pulse and a $50 bill.
There is a thread over on the red board about this. There are a couple of hand wringers that don't think any doc in their right mind would sign it. However there are maybe a dozen, I am one, who have asked their doc who has said, "sure. I'll sign it". It really isn't any more exposure than they already face and that's why they all have malpractice insurance. I'd bet money that most doc's will sign it as long as what they are signing is true.
Thanks, Bruce. Some of us who have been on hold for a while waiting on the sidelines may be getting back in contact with you once the rules come out.
Docs sign things all the time, its part of the job description. I suspect this'll be a non-issue. And you can always go back to your AME and get your third class if that works for you.
I preflight an airplane I am going to fly. It all checks out. Run up is good. I could I suppose sign a paper saying I have checked out this airplane and I am not aware of any mechanical issues as it presently sits that would interfere with a safe flight.
I could hop in get a few hundred feet above the runway and blow a rod through the side of the engine. Would my signed statement be false? Fraudulent? Negligent? I don't think so.
Doctors sign off on sports physicals all the time for kids and some kids have unknown underlying heart conditions and die. There is no way through a standard physical the doctor would have "been aware of a condition."
One area I could see being an issue is here in rural America there are some people who rarely see a Dr. the office is only manned by a PA. So you may need to go where there is an actual State Licensed Physician. For me that is not the case but the office my kids go to it is.
If there's no MD around there is probably no AME around either, so no real change.
Exactly. The exam will have a checklist, as long as the doctor follows it, has not uncovered anything and is not aware of something potentially incapacitating (or performance-degrading) from the pilot's application, he has done his due diligence and I expect it will not be too difficult to find someone who will be willing to risk the exposure.
Yes, that's the case here. Last year the clinic I go to had two doctors and I saw one of them regularly. Then she left, and the clinic replaced her with a NP. The doctor has a reputation for being a jerk, so I haven't seen him yet, but I guess I will have to... or find a different clinic.
And as others have said, there is nothing keeping you from going to an AME for the 4 year exam. It seems unlikely that all AMEs will consider the risk unacceptable.
As far as rural America - geez any pilot can take a quick hour flight and find an AME, right??
what does this mean for childhood ADHD diagnoses who don't take drugs?
Any idea how much of the 180 days the FAA will actually take to publish the checklist?
My AME retired last year and my medical is good through September.
My guess is they'll take about 400 days or more.
That's one of the big questions now.
It's a big to-do list if they want to create everything that takes care of everyone, from the normal healthy bunch to the "new" rules and requirements for the SI's. If they wait to publish until they cover every small and big item, it will take a while.
My hope is they publish the easy stuff quickly, then release the more difficult items as they become available and are approved. Easy stuff includes the SI items that already have a CACI component (like DM2/pill)
Means they still have to pass one 3rd class medical, and all that entails.
Ugh. And suddenly I am less enthused. However, I am glad it will help others.
Does ADHD fall under:
(III) the individual is aware of the regulations pertaining to the prohibition on operations during medical deficiency and has no medically disqualifying conditions in accordance with applicable law;
I don't know if ADHD is specified by law elsewhere, or if 'regulations' are considered "law".
I'd let the dust settle a bit, and then get with Dr. Bruce on this for 1 on 1 counseling. You may be surprised, in a good way.
That's my plan, wait for the rules to come down, then call Bruce.
Does the PCP physical have to be by an MD vs PA or NP? The NP I see for everything has signed all my documentation provided to both my AME and the FAA directly and I've had no issue with anyone or the FAA questioning it.
This space intentionally left blank for future sarcasm.
(7) the individual has received a comprehensive medical examination from a State-licensed physician during the previous 48 months and—
Read more about getting 3rd class medical with ADHD diag history, others have gone and gotten the original diag disproved and went to a normal 3rd class medical renewal cycle even under the old system. I think others have said that this won't be improved by the new rules but wasn't a problem under the old rules if you can get a diag that you don't have it, never had it(were previously mis-diagnosed).
Don't take my word for it, find an expert who knows, aka Bruce
The text of the bill I read last week says "physician". As a nurse practitioner, and pilot, I had a specific interest in that tidbit. So while one of my colleagues might be the medical provider that supplies supporting documentation, they wont be the one signing off on the medical attestation, just like they weren't eligible to be AME's.
But I'd be interested in it if the opportunity presents in the future.
You'd still have to get the initial 3rd class, which would involve a bunch of tests detailed at: https://www.faa.gov/about/office_or...ces/aam/ame/guide/dec_cons/disease_prot/adhd/
The testing is extensive, hence the reason the post is not overly thrilled with it. Seems like there should be some kind of SODA for flying - hey, I flew for 500 hours as a sport pilot, maybe childhood ADHD isn't actually a factor?
Understood, but what you're citing are the current conditions. The PBOR2 has the 3 items for SI now, so I'm confused on the "prohibited by law" thingy. I do know that insulin controlled diabetes is in the FAR:
§67.313 General medical condition.
The general medical standards for a third-class airman medical certificate are:
(a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control.
(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—
Part 67.313.b is the "wild card" where the Federal Air Surgeon now (prior to signing the law by the President) has authority, but I need to read the new law to see if 67.313.b is now down to the 3 items in 2307.e, essentially taking the 67.313.b authority for Class 3 away from the FAS. It looks like the new law (when signed) puts that now on the person's doctor. (Section 2307.b)
It will be interesting to see how this plays out.
Looks like I was a bit pessimistic. Since the FAA seems to have a track record of not following instructions from Congress, apparently a stipulation was put into the bill that automatically makes this a rule if the FAA sits on it for a year. Here's what I got from the EAA website...
"Now that the legislation has been signed into law, the FAA will begin a rulemaking process to make the regulatory changes required by the legislation. To ensure that pilots don’t have to wait indefinitely, there is a provision in the legislation that says if the FAA has not produced a final rule by July 2017 pilots can operate within the parameters of the legislation without fear of enforcement action. To ensure that pilots don’t have to wait indefinitely, there is a provision in the legislation that says if the FAA has not produced a final rule within one year of the legislation becoming law pilots can operate within the parameters of the legislation without fear of enforcement action. In other words, once the legislation has been enacted, pilots will be able to fly under its provisions within one year. Less if the rulemaking is completed more quickly."
Bolded stuff is mine. The essentially repeated statement is the EAA's.
Right. I hate to beat a dead horse, but to me this does not go far enough when the FAA is requiring 3k worth of tests to disprove childhood diagnoses of "psychological disorders". If the requirement to get these tests is still part of the law, I am disappointed in the AOPA for not including it.
That's what I am wondering too. Will be interesting to see what results we get when Dr. Bruce and others (including aero attorneys) get a good look at this new law.
(I think) I was quoting the requirement to get the initial 3rd class when childhood adhd has been diagnosed.
They should have specifically mentioned that in the law. Or some type of inexpensive streamlined process to get cleared.
There are so many kids I know currently in college who are going to have to deal with this if they want to be a pilot.
Seems like they cut the balls off of this bill, not really surprised.
I flew 4 hours today with an OB/GYN I. The back seat. This topic came up, and she already had heard about it.
She said she would have no problem signing the forms. She said she would even do a better examination than the current ones.
I re-asked the question, and asked what her insurance company would say, and she just laughed.. She said the insurance company would appreciate her doing stuff that didn't involve high risk delivery of babies.
Worrying about Dr's did not seem to be a rational fear.
Good to hear!
What I'm not getting out of any of this is WHEN? if your C3 expires in the next year this has no effect at all - right?
I agree. Maybe the FAA will fix the process when the law is instituted/systems are reestablished but I doubt it.. maybe I'm just naturally pessimistic.