Time to renew the medical

[N5922S]

I'm sure this has been covered before, so excuse my redundancy. I haven't used the MedXPress system before -- should I do the online part before contacting an AME? Is there a time limit? Any gotchas to watch out for?

Thanks,
Jim

 

[NJP_MAN]

Hit the website first. It is not very difficult and then call up the AME office. It was pretty easy if I remember correctly.

 

[AggieMike88]

should I do the online part before contacting an AME?

Yes

Is there a time limit?

If the information you input has not be downloaded by an AME within 60 days, it will disappear in a puff of electrons.

Any gotchas to watch out for?

The usuals, including falsifying information by intent or omission. And most important, the form does not go live until you hand over the confirmation number and the AME or staff enter it into their system and download the application. This is a big deal as you will see below.

The big new thing to remember is the following.

1. Before you start entry, find and install one of the free PDF creation tools out there. The one that will act as a printer but save the output to the hard drive. (you will see why in a second).
   
2. After inputting everything, you will be given the chance to review and print. THIS IS A ONE SHOT DEAL, so don't get distracted and skip past the step.
   
3. Print the document using the PDF printer to save it to your hard drive. Then print it off for real. The virtual copy is for your reference for future visits.
   
4. At the bottom of the real copy will be a "confirmation number". Using scissors, cut this off of your document and put it into your pocket.
   
5. The reason for doing that is if you have any likelihood of failing the exam, by not turning over the confirmation number, the visit remains a consultation and not an official examination. The distinction is if something is found that causes a denial or worse, deferral, a live exam (where you turned over the number when you weren't supposed to) puts you in a world of hurt trying to get the issue figured out. And could jeopardize your opportunity to fly LSA's. When it's a consultation, there is no chance of being denied, deferred, or lose your LSA privileges.
   
6. Once the AME says all is well, THEN AND ONLY THEN, turn over the confirmation number.
   
7. If the AME says he cannot do the exam as a consultation and insists on getting the number before he does anything, vote with your feet. In no way or form are you required to turn it over until you know you pass.

Did all that make sense?

 

[Papa Foxtrot]

Excellent Mike! That should be a stickie in the Medical Topics section.

 

[N5922S]

Yes



If the information you input has not be downloaded by an AME within 60 days, it will disappear in a puff of electrons.



The usuals, including falsifying information by intent or omission. And most important, the form does not go live until you hand over the confirmation number and the AME or staff enter it into their system and download the application. This is a big deal as you will see below.

The big new thing to remember is the following.

1. Before you start entry, find and install one of the free PDF creation tools out there. The one that will act as a printer but save the output to the hard drive. (you will see why in a second).
   
2. After inputting everything, you will be given the chance to review and print. THIS IS A ONE SHOT DEAL, so don't get distracted and skip past the step.
   
3. Print the document using the PDF printer to save it to your hard drive. Then print it off for real. The virtual copy is for your reference for future visits.
   
4. At the bottom of the real copy will be a "confirmation number". Using scissors, cut this off of your document and put it into your pocket.
   
5. The reason for doing that is if you have any likelihood of failing the exam, by not turning over the confirmation number, the visit remains a consultation and not an official examination. The distinction is if something is found that causes a denial or worse, deferral, a live exam (where you turned over the number when you weren't supposed to) puts you in a world of hurt trying to get the issue figured out. And could jeopardize your opportunity to fly LSA's. When it's a consultation, there is no chance of being denied, deferred, or lose your LSA privileges.
   
6. Once the AME says all is well, THEN AND ONLY THEN, turn over the confirmation number.
   
7. If the AME says he cannot do the exam as a consultation and insists on getting the number before he does anything, vote with your feet. In no way or form are you required to turn it over until you know you pass.

Did all that make sense?

Yes, thanks, Mike. But re items 5-7, my bud and I (both with marginal BPs) tried to find an AME to do a "consultation" first at our last exam 2 years ago -- no joy. There are only 3 AMEs in Smith Co. and ZERO in Cherokee Co.

p.s. I can't get over how DTO has grown. I used to fly into there in the 70s when it was just a cow path -- I was based at Goode (6 mi W of DFW)

 

[MooneyDriver78]

I did web stuff in the Doctors office, didn't know new system...fortunately the web system works a lot better than healthcare.gov
Took maybe 15-20 minutes...you need access to your email during the process

 

[mnewb1]

Yes


[*]The reason for doing that is if you have any likelihood of failing the exam, by not turning over the confirmation number, the visit remains a consultation and not an official examination. The distinction is if something is found that causes a denial or worse, deferral, a live exam (where you turned over the number when you weren't supposed to) puts you in a world of hurt trying to get the issue figured out. And could jeopardize your opportunity to fly LSA's. When it's a consultation, there is no chance of being denied, deferred, or lose your LSA privileges.

[*]Once the AME says all is well, THEN AND ONLY THEN, turn over the confirmation number.

[*]If the AME says he cannot do the exam as a consultation and insists on getting the number before he does anything, vote with your feet. In no way or form are you required to turn it over until you know you pass.
[/LIST]

Not really Kosher! Maybe I am naive and there are a lot of AMEs who will do this, but I know I am not one (still waiting for my designation number BTW) I have often joked that I will be the most ethical physician in the unemployment line, but I'll sleep better at night.

YMMV

 

[AggieMike88]

Waznot kosher? Holding back the conf#? Or you taking the tact that the exam is consult first to ensure passage, then paperwork second if the airman meets/exceed standard?

 

[AggieMike88]

Yes, thanks, Mike. But re items 5-7, my bud and I (both with marginal BPs) tried to find an AME to do a "consultation" first at our last exam 2 years ago -- no joy. There are only 3 AMEs in Smith Co. and ZERO in Cherokee Co.

IIRC, elevated BP issuance has changed within the last 12 months. If you meet certain criteria, the AME can do a CACI issuance (but check with Bruce on this to be certain).

Elevated BP needs to be addressed. Bruce has chased us airmen around the hangar more than once on this topic, as have the cariac docs that post here. Untreated, hypertension is a time bomb that can go off at anytime and in the worst ways. Treated, even with meds, it's a simple thing and an easy adjustment to your lifestyle.

And if you already know what the AME needs to see, then a consult isn't needed. Just bring the right labs and reports and it becomes a simple comment on the AME's side of the form, and an admonishment to keep it under control.

p.s. I can't get over how DTO has grown. I used to fly into there in the 70s when it was just a cow path -- I was based at Goode (6 mi W of DFW)

About to get a bit bigger. Plans are in works for 2nd runway (5000ft parallel) and development on the west side of the field.

 

[N5922S]

IIRC, elevated BP issuance has changed within the last 12 months. If you meet certain criteria, the AME can do a CACI issuance (but check with Bruce on this to be certain).

Elevated BP needs to be addressed. Bruce has chased us airmen around the hangar more than once on this topic, as have the cariac docs that post here. Untreated, hypertension is a time bomb that can go off at anytime and in the worst ways. Treated, even with meds, it's a simple thing and an easy adjustment to your lifestyle.

BP is such an up-and-down thing. Most of the time it's OK, but seems to spike when you don't want it to. My PCP finally relented and called it "benign hypertension", but she's not an AME.

But let's get real here: if I buy the farm while flying my killer airplane, I'll probably wipe out a half dozen pine trees. On the other hand, if you're driving a Ford Exterminator when the reaper calls, you could easily take out a carload of nuns. What's up with that?

 

[AggieMike88]

Benign hypertension is the yellow arc of your cardio vascular system. But "damage is damage" and you want to work on capturing control and keeping it there.

I was tagged with benign HT when I was dx'd with Type II Diabetes and told to take a Lisonopril. IIRC, I was about 130 over high 90's at that time. Fortunately, with lifestyle and diet changes, plus continuing to take the meds, it's improved over time and my PCP was very encouraged when I posted 118/80 at the beginning of the month. I may never shed the BHT moniker, but extending my life through good control is what it's all about.

 

[AggieMike88]

But let's get real here: if I buy the farm while flying my killer airplane, I'll probably wipe out a half dozen pine trees. On the other hand, if you're driving a Ford Exterminator when the reaper calls, you could easily take out a carload of nuns. What's up with that?

And this has what to do with the original question and topic?

My counterpoint to your comment is that we want you to not get to where receiving reaper calls or suddenly purchasing agriculture properties becomes a common or required occurrence. So "Health First, Fly Later". Get the BP in control first, then bring what's needed to the AME once that control is established and documented.

But your original question was about completing the MedXpress form and working with your PCP and AME.... correct?

 

[denverpilot]

Not really Kosher! Maybe I am naive and there are a lot of AMEs who will do this, but I know I am not one (still waiting for my designation number BTW) I have often joked that I will be the most ethical physician in the unemployment line, but I'll sleep better at night.

YMMV

I'd say not allowing a patient a consult prior to a visit that's on the FAA record is more unethical than the patient learning to withhold the little strip of paper and the code.

Yes, you may charge for both visits. I have no problem with that. In visit #1 you're their doctor. You're educating and discussing the things the FAA may or may not have heartburn about, but they're not paying you to be examined, they're paying you to understand their health situation. In visit #2, you're a representative of the FAA and must follow their guidance for the examination.

Because of visit #1 you can be prepared and know much of how visit #2 is going to go, so you can help your patient/customer around any bureaucratic minefields you know are laid.

You have information your patient can't get anywhere else about how a third party to your patient/doctor relationship behaves. The key is you and the patient taking care of the patient's health first. The being prepared for the exam part in the final visit, is just icing on the cake because you already did the homework.

 

[AggieMike88]

Well said Nate.

And add me to the list of airmen who would say it's worth paying the going rate for Visit#1 if it means that Visit #2 is a simple and sure thing.

 

[mnewb1]

Sorry, but it strikes me the same as someone who would ask to abort the exam in the middle if some problem came to light...in the pre-medexpress days, one could not do that and ask for the 8500-8 to be destroyed...that was not allowed...if the airman did not complete the form, it had to turned-in to the FAA anyway.

The scenario presented was that the airman, with his medexpress number in hand was coming in for a physical...if you call me up and schedule a physical then the medexpress number, to review the history, must be the first part of that process.

If you call me and state that you want to come in for a consultation about aeromedical requirements, then that is a different situation all together.

However that was not the scenario presented. So I stick with my initial position, that the scenario as presented is not Kosher, and I would not be willing to start a physical exam without the medexress number first.

 

[denverpilot]

Would you do a physical if they hadn't filled out some dumb web form? Would you counsel them on whether or not they would be able to meet FAA standards from the result of that non-FAA physical?

MedXpress is nothing more than a form. If I don't hand the form to you and am forthright about wanting a non-FAA physical with your professional opinion of whether I would pass an FAA physical, would you do that?

This is the problem with bureaucracies. You're focused on the expectations of " the system " over the needs of the customer/patient.

Just my opinion.

No one is trying to get around the system. You can't. If you want the medical you will jump through the hoops. As Doc Bruce and others have noticed, the hoops can be known, the tests and everything else accomplished, and the issuance can be in-office with a phone call... Or you can drag the future pilot through a multi-month ordeal. The outcome is the same: a pilot who meets the FAA requirements with all supporting documentation.

Not sure why you find service leading to better service as an ethical issue. You can't change the applicant's medical conditions. You can however, make their experience inside the system orders of magnitude better.

 

[AggieMike88]

You can however, make their experience inside the system orders of magnitude better.

Please become this type of AME. We need more who practice like Dr. Bruce does.

 

[bbchien]

Sorry, but it strikes me the same as someone who would ask to abort the exam in the middle if some problem came to light...in the pre-medexpress days, one could not do that and ask for the 8500-8 to be destroyed...that was not allowed...if the airman did not complete the form, it had to turned-in to the FAA anyway.

The scenario presented was that the airman, with his medexpress number in hand was coming in for a physical...if you call me up and schedule a physical then the medexpress number, to review the history, must be the first part of that process.

If you call me and state that you want to come in for a consultation about aeromedical requirements, then that is a different situation all together.

However that was not the scenario presented. So I stick with my initial position, that the scenario as presented is not Kosher, and I would not be willing to start a physical exam without the medexress number first.

Newps, check you PMs. You may need to think about this a bit.

Dr. Bruce