I get a lot of questions from pilots experiencing problems with their medical exams. Most of these problems could have been solved if they had chosen their Aviation Medical Examiner (AME) correctly.
For instance, look at this excerpt from an email response to a pilot with a medical issue I sent out recently:
“You should be yelling at XYZ company’ help get your medical (name withheld to protect the guilty). You paid them money for a job they are not doing. They should have insured that all the medical documents were sent together by a service which requires a signature for receipt (e.g., FedEx) and then made sure you were inline for the review by the cardiologist. I still do not know why people waste their money with companies who promise to help pilots get their medicals. Your AME should have done all this. He is the best source for calling OKC and getting status information on your exam. If your AME will not do that, I suggest you find someone else the next time.”
Select your AME carefully. It is not much of an issue if you are totally healthy; however, if you do have a medical problem take some time to investigate. First of all, ask the pilots around your local airport for recommendations—especially pilots who may have had medical problems. (You do not have to ask which pilots have had medical problems, just ask the old ones!) AMEs who get good recommendations for having gone out of their way to help someone with a medical is great reassurance.
Second, make sure the AME is a pilot. You can do check this out at the FAA database (http://www.faa.gov/pilots/amelocator) where the pilot ratings are listed for each AME.
Why a pilot? There are several reasons. One is that an AME who is a pilot knows how important the ability to fly is for each of us. They generally are more interested in aviation, understand what it takes to be in the cockpit, and will go the extra mile for a pilot who needs help with medical problems that threaten his ability to fly.
Although there are exceptions, non pilot AMEs are using the status to build their practice. Being an AME may be a pain for a physician because of the time it takes for the exam, the data input of exams, keeping up with FAA regulations, and the every-three-year required classes. Most pilot AMEs are doing it as a service and because it keeps them involved in the pilot community. A non pilot AME may be interested in aviation but given the hassle, bringing cash patients through the door is a more likely scenario.
How does the AME make a difference? There are many ways but willingness to spend time is the most important way. When there is any medical issue on a pilot medical application, the AME can deal with it in several ways. For instance, if a pilot has new onset hypertension, the AME can make sure he has the proper documentation from the treating physician or have the pilot get the proper documentation. The AME has 10 days to submit the information so the pilot has 10 days to obtain it. With the proper documentation of good blood pressure control and no side effects from the medication, the AME can issue the medical immediately.
However, if the AME is not paying attention he can grant the medical without the paperwork and the FAA will contact the airman and request all the information.
Even the FAA does not like this way of conducting pilot medicals because the AME is not doing what they are suppose to do and is creating unnecessary work for the FAA.
The worst case scenario is that the AME defers the medical. This saves the AME a lot of time because he just says to the pilot that he has to send everything into the Regional Flight Surgeon or OKC and just checks a box on the form. Easy for the AME—a world of paperwork for the pilot and FAA even if the pilot was deferred inappropriately. (Fortunately, the FAA is cracking down on AMEs who defer inappropriately just like they have on AMEs who grant medicals that should have been deferred.)
There are many cases which absolutely require deferment but the right AME can help here as well. A pilot who has had a heart attack will require review by the FAA for the 1st application after the event. The AME can help by making sure the pilot has all the appropriate paperwork and records for the application. The AME should submit the exam with all the paperwork in the same package and send it to the FAA via a “signature required” service. This insures that the FAA receives all the required paperwork and everyone knows what date it landed at the FAA.
If records and testing are submitted separately, there is no one checking off when the file is complete. A file ready for review may wait until the pilot or AME calls and asks if the file is complete. This is a waste of time for everyone and a good AME will not let this happen.
For renewals, the FAA allows AMEs through their AASI (AME Assisted Special Issuance) program to issue medicals for stable conditions on the spot. The pilot needs to READ THE FAA LETTER which accompanies his initial certification for what testing and reporting will be necessary for renewal and when that testing should occur. If the pilot brings the proper renewal documentation to the AME and it shows a stable condition, the AME can issue the medical right then and send the paperwork into the FAA for review after the fact. Unfortunately, there still are Medical Examiners out there who still do not know how this program works.
Brent Blue MD is a Senior Aviation Medical Examiner in Jackson Hole, Wyoming, who flies a Cessna 340 and just finished building a Blue Bear (a Murphy Moose modified for safety). He was the team physician for the US Aerobatic Team for the 1994 World Competition in Hungary and has served on the EAA’s Aeromedical Council. He also owns Aeromedix.com which specializes in medical and safety products for pilots, their families, and their dogs.