EDITORIAL: The Spring 1999 issue of the "Federal Air Surgeon's Medical Bulletin" came as a shock to the nation's Aviation Medical Examiners. It announced a new plan whereby AMEs would be required to transmit FAA Form 8500-8 medical applications to Oklahoma City via the Internet, starting October 1, 1999. That was expected. What was completely unexpected — and unwelcome — was a requirement that this data be entered online, transmitted to OKC, and validated by a new FAA computer system before the AME may issue a new medical certificate to the airman applicant. AVweb's Brent Blue explains why this new scheme will probably mean delays and higher exam fees for pilots.
April 15, 1999
Doctor Warren Silberman took on a big job last year when he
assumed the reins of the Civil Aeromedical Institute (CAMI), which is responsible for
all FAA Airman Medical Certification. The place was a mess of paperwork with over 50,000
medical certificate applications caught up in the quagmire. Silberman quickly reduced that
backlog to 10,000 medicals, and began to computerize the entire process so that every
medical certificate application would be in the computer, and any medical records sent to
CAMI in Oklahoma City would be scanned in also.
In the Spring 1999 issue of The Federal Air Surgeon's Medical Bulletin,
Silberman announced that the process was ready to move to the next level by using the
Internet to transmit medical applications to Oke City. He told AMEs that the new
Aeromedical Certification System (AMCS) Internet software program will be up and running
by October 1, 1999 — considered a drop-dead date because the old software currently in
use is not Y2K-compliant — and its use will be mandatory for all AMEs from that date
forward. This news was pretty much in line with what AMEs expected, and most are happy to
see CAMI's continued efforts to streamline the processing of medical certificates.
FAA Approval While You Wait?
However, Silberman's announcement contained an unexpected curveball that AMEs were not
expecting, and that has many of them alarmed. It seems that not only will each medical
certificate application (FAA Form 8500-8) have to be entered online by the AME into CAMI's
computer system, but the AME will have to receive electronic approval online before
issuing the certificate to the airman! Uh oh!
In the past, AMEs would typically check over the applicant's 8500-8 for accuracy, give
the exam, type up the new medical certificate, hand it to the airman, and send him happily
on his way. Later on, the information would be entered into the computer and sent to
Oklahoma City by modem. If the CAMI computer was down, or if it didn't like one or more
data items on the application form (which happens frequently), the airman wasn't affected.
Under the new AMCS scheme announced by Dr. Silberman, however, the AME cannot issue the
certificate until the data has been entered into the CAMI computer and an approval
returned online. Under the best of circumstances, this will mean the airman will have to
wait a few more minutes for his certificate. But if the CAMI computer is down or cranky,
or if the AME's Internet service provider is down, or if the AME's modem isn't working, or
a whole host of other potential problems arise, it could mean a long delay for the
applicant. In some cases, the applicant would have to return later to pick up the
certificate, or perhaps even wait to receive it by mail.
Now, the FAA seems to think all AMEs have staff which enter the data, and it is no
hassle for the physician. I do not know about the other guys, but I do about 100 physicals
a year and I enter all the data myself. Since 80% of AMEs in the U.S. do 30 or fewer exams
per year, I bet they also enter the data themselves ... if they use the computer at all!
Why do I enter the data myself? Because the expensive custom software the FAA created
is horrible! In fact, on every medical I have submitted over the past three years,
there has been a glitch in the software which asked why I am issuing the certificate in
spite of the "problem" with the application. For the past three years, the
response I've entered has always been "Bad Computer Program." Sometimes I add
"Please Contact Me" just to see if anyone reads the things in Oke City. No one
ever has ever contacted me.
Now, call me a doubting Thomas, but if I have to submit a medical in real time on the
Internet and the approval has to come from Oklahoma City electronically prior to my
printing a certificate, there are going to be some unhappy cowboys in my office!
I consider myself to be pretty computer- and Internet-literate. I run a business that
is Internet-based, I am the Medical Editor for AVweb, and I have been an Assistant
Sysop on Compuserve's AVSIG forum for years. If I'm having this much trouble with the CAMI
computer system, just imagine what impact it will have on AMEs that are less cybersavvy.
Somehow, I'm not convinced that it is in the best interests of either the FAA or the pilot
community to make this leap of faith to a compulsory real-time Internet-based approval
process, especially considering that the FAA has not gotten the worms out of the current
modem-based program that we've been using for years.
Not All AMEs Are Net-Ready
The new system will also drive some computer-phobic AMEs out of the system, which is
both good and bad. On one hand, it certainly will encourage some of the less interested
ones to drop their AME status. At the same time, it may also discourage some rural AMEs
who only perform the medicals as a service for geographically challenged pilots.
Currently, all AMEs are "supposed" to submit medical applications and EKGs
electronically by modem to Oklahoma City. The fact remains that only about half of AMEs do
so, in spite of an absolute requirement that ALL EKGs be submitted via modem, and that all
recently-appointed AMEs must submit the 8500 exam form electronically.
Don't get me wrong: There is nothing wrong with online submission. It's basically a
good idea. The only part of CAMI's plan that's a bad idea is the new requirement that
prevents an AME from printing a medical certificate until all the data on the Form 85800-8
has been entered online and an approval received from Oke City. No longer will the AME
have the option of issuing the certificate first and entering the data later. So if the
online system hiccups, the pilot doesn't get his certificate in a timely fashion.
My suggestion for Dr. Silberman would be twofold. First, get all current AMEs
up-to-speed with the existing modem-based software before moving to the Internet. Second,
use the Internet for data entry of applications and EKGs, but not for real-time
approval. Leave the immediate approval, referral, or denial in the hands of the AMEs where
it is now. The present system can work with some minor modifications, but raising the
stakes when the AMEs are not ready may be a step backward for an agency that is trying to