Survey Looks At Pilot Medical Attitudes


If fear of losing your medical has ever influenced your healthcare decisions, researchers in the U.S. and Canada want to hear from you, anonymously, of course. Georgetown University and the University of Alberta are asking pilots to fill out a survey on the impact of preserving a flight medical might have on their overall health care. The survey for U.S. pilots is here and Canadian pilots can fill it out here. The designers of the survey said the intent is to “determine how pilots perceive aeromedical care and whether the risk of losing their license due to medical complications inhibits the seeking of medical advice.”

Canada has maintained a conventional medical standard for most classes of pilots requiring personal examination by a Transport Canada-appointed doctor. The U.S. now has BasicMed but pilots still have to tell the FAA the truth about the state of their health. “Pilots may be receiving less than the standard of care because they aren’t able to openly share pertinent medical information,” the survey authors said. “This study will help expand the current scientific knowledge regarding pilot health and aeromedical standards.” 

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  1. I have a Sport Pilot cert because I’m afraid of trying to get a third class medical and failing. If that happens, then I can’t even fly Sport Pilot until I get approved! Since my last third class med was 20 years ago, I can’t even do Basic Med until I get a third class.

  2. Aren’t fatal accident rates with and without medicals nearly identical? What in the HELL is taking so long for the Sport Pilot umbrella to be expanded to incorporate THOUSANDS of simple safe AFFORDABLE legacy AMERICAN aircraft like 150/152/172, Piper Colt/TriPacer, Aeronca 11CC, Luscombe 8E/F, Citabria 7ECA, etc. etc?
    I’ll tell you: first AOPA screwed the average low slow local older middle income GA pilot by offerig FAA an UNSOLICITED initial medical requirement for Basic Med so their fat cat friends like incompetent defiant rulebreaker Inhofe could legally keep flying [and crashing] their 230mph Harmon Rocket and twin. Since then Dan Johnson and the import LSA manufucturers have thrown as many complicating demands as they could at FAA certification revisers to slow progress and salvage a few more sales of their sleek $180,000 styrofoam cups.
    Dear FAA: Just do it! Take a quick poll of your in-house experts and make a list of a dozen more of the simplest legacy aircraft and announce those at SunNFun 2020 as legal for SP! All the above and a few more should be on it. THANK YOU

  3. Having learned the hard way, if, hypothetically, I suspected I had a condition which could possibly disqualify me from flight, I would seek treatment from the hypothetical FAA-Designated ME who I now see every couple of years. For further care I would follow his/her referral or recommendation, hypothetical HMO notwithstanding. This would make me a little or a lot more confident the motive would be to keep me FAA-legal and not simply in an ongoing-care loop. Hypothetically, that is. And The DME to which I refer is Distance Measuring Equipment, just to clarify for the hypothetical data-mining surveillance botcrawlers.

  4. I just took the survey. It seems to be preoccupied with doing a telephone interview to discuss one’s medical issues as it relates to the ability to fly as PIC. It doesn’t ask the right questions as all. It’s missing the main points that people worry about.

    I am aware that a certain AME region in the US started scaring their AME’s into NOT doing BasicMed exams. They told them that doing an official FAA Aeromedical Exam protected them from liability whereas the BasicMed exam did not. It’s obvious that the FAA AME bunch doesn’t want to lose control and so they’re doing everything they can to stay in charge.

    To Wise Old Man … you’re right on track with respect to raising the LSA weight limitation for legacy simple GA airplanes to allow no medical flight. The statistics prove this out. Medical incapacitation of ALL pilots is SO low as to make any statistical analysis irrelevant. That said, you are WAY OFF TRACK with respect to what Sen. Inhofe did. He was a godsend to many an older pilot. The DOT / FAA was sitting on their duffs with the initial AOPA / EAA requests to change the medical rules. I went to at least two — maybe three — Airventure forums where the former Administrator INSULTED the standing only crowd waiting for good news on that front only to be told that he couldn’t discuss it. All of a sudden, the FAA needs funding, Sen. Inhofe senses an opportunity and forces a much more useful form of medical change down their throats. I actually met him, thanked him and we took a pic together. You’re wrong about him. The AME community hates BasicMed but it’s now in law. And after four years — as you opine — BasicMed pilots aren’t falling out of the sky in any different numbers than their normal AME or LSA brethren.

    We agree on Dan Johnson and LAMA, however. Every time I read one of his articles, I have to wipe the saliva offa my laptop. He thinks even reasonably well heeled GA drivers who want to shun dealing with medicals are gonna buy a $180K Styrofoam cup. Well put. I won’t. I’ll buy myself a new Corvette and fly that way if and when the time comes.

    • Inhofe announced this will be his last term in Congress. He has received a lot of bashing IMHO emanating from less than full and open reporting of the facts surrounding incidentes any of us could be involved in. His leadership in General Aviation legislation has served us very well. We may never have another champion in Federal Government that so deeply shares our passion for GA. I say Thank you Mr. Inhofe for what you’ve done for us.

      • That’s EXACTLY what I told him, CDavid !! I told him that we needed more members of Congress exactly like him. Hopefully, he’ll be able to serve out his full term? I can report to everyone here that he is PASSIONATE about GA. He even put his staff with me to work on some other allied things I feel very strongly about … and I’m not even one of his constituents.

        At prior Airventures, he put on a Saturday forum. Seek him out if any of all ya’ll are there.

  5. I have had many patients, in my private practice and my aeromedical practice who have compromised their health care due to fear of FAA repercussions. In one case, a friend of mine that I cared about very much, an IA with CFI experience from Luscombes to DC-3’s who died rather than work up his chest pain.

    Thank God my health remains excellent, and I ride a bicycle 150+ miles a week, all year long, and I’m vegetarian, but someday my health will give out also. As long as I’m safe top fly, I will transition to Basic Med.

    • You bring to mind two other salient albeit tangential issues, Dr. K. One you’d likely agree with as an MD and the other I’d know of being an A&P.

      MANY people who retire have nothing that “makes their blood boil” as I very often say. They retire, are physically inactive — the opposite of you (or me) — and turn themselves into couch potatoes. This inactivity leads to physical health issues which often shortens their lives. Couple it with bad habits like smoking or alcohol or stress and you have a ready made concoction for serious health problems. Aviators have something “to live for.” They have to fight the good fight to keep all the items necessary to be legal to fly up and going. Just the mental stimulus HAS to be good for them. I worked for a week prepping for a Flight Review just last week and I discussed this during same; the CFI agreed 110%. So what do you think happens when an aging pilot loses the ability to fly … they probably degrade pretty fast unless they have other hobbies that provide the same impetus. I’d bet you’d agree and have seen this? A pilot / MD neighbor just passed away last year for exactly that reason. He wasn’t in practice and he couldn’t fly so … I think that his mental state likely just gave out because he had nothing left.

      Point two. I’ve noted that many aging airplane owning pilots are shunning upgrades to their airplanes because the period of cost recovery is insufficient to make upgrading worth their effort. Under normal AME rules, that’s two years and under BasicMed it’s now four. Who in their right mind would spend $20k to $30K or more to upgrade their airplane’s panel or engine or paint for such short use? Even moving over to LSA is too big a step to take for many. So … they just soldier on the best they can … until they can’t.

      There are SO many reasons to raise the no medical requirement empty weight of an airplane now that LSA and BasicMed has proved that less onerous medical requirements are working just fine. In fact, EAA proposed adding a category of Airworthiness to match that of Canadian rules … Primary Aircraft. An airplane meeting the Primary aircraft rules would only require an A&P to sign it off as airworthy. It was a wonderful idea worked on for five years but it went nowhere. Instead, FAA came out with NORSEE which helps but is nowhere near what Primary Aircraft category would have been. And now EAA is touting MOSAIC as a similar change but I dare say most of us will be in the Granite Courtyard before someone gets off their butt. CFI’s are going to the airlines and are getting hard to find in places. IA’s are aging and are giving it up, too. Personally, I think this is THE strategy of the boys in Okie City. Attack from all angles and soon enough, all those pesky GA drivers will be gone … one way or another. They’re taking the long view. SIGH!

      And we haven’t even discussed the insufficient use of many FBO’s leading to the death of many GA airports.

  6. Thanks, Larry. I was going to take the survey until I saw your note.

    I visit my family doctor four times a year for “wellness checks”. I make sure that one of those visits (the one just prior to my biennial visit with my AME) includes a full physical workup with EKGs and bloodwork. I am not a commercial pilot, but he’s quite aware of my desire to maintain my medical, and I want to know about anything before my AME does.

    About two years ago, an unusual combination of external stressors so affected my sleep that I mentioned it to him and he prescribed a medication I had never heard of. His description was basically that it would let me get better and longer sleep at night (and make me less grumpy). I specifically asked him if it would have any effect on my medical when I reported it on my next AME visit. His response was, “I don’t see how. More likely they’ll take that as being pro-active when dealing with a temporary problem.”

    I filled the Rx and went home to do a little online research on the FAA Aeromedical site. This was a complete waste of the entire afternoon. Finally, I dropped a note to the AOPA to ask them what they thought. A very helpful response arrived the next morning, consisting of (slightly paraphrased) “Hell, yeah. They’re gonna revoke it immediately and you’ll have to prove that you haven’t taken it for a year before you can reapply, submit all sorts of lab results to Oke City, then sacrifice a black chicken under a full moon and use its blood to sign the forms.”

    I took the full bottle back to my doctor, told him to note on my medical record that I had done so, and let him know of my dissatisfaction with his prescription. He was dutifully chastened and we both learned something.

    • Chip … I’m glad you didn’t have a problem.

      I would urge ALL GA drivers who don’t need a third class or higher medical to use BasicMed. At this time, something around 1/3 of pilots who fly non-professionally have gone that route. Find a good doctor who is amenable and just do it. Like you, I’m seeing my GP doc now twice a year and things are good. There’s no reason to tempt fate … especially as you age. If your GP doc won’t do it … THAT says a lot … dump him.

    • Late reply, but could be useful for someone. I have suffered from insomnia for many years, sometimes it’s worse, sometimes not so bad. During a particularly bad period I asked my doctor, who has my deep respect, what could be done. He said he could prescribe a drug intended for anxiety or depression, I forget which, that produced relaxation and deeper sleep in people who do not have the symptoms the drug is intended to address. It’s called “off-label” prescribing. The name of the drug tingled my SPidey-sense and I asked him if it was on the list of meds disallowed by the FAA. He paused for a second and said he was not aware of such a list. I told him the list is on the FAA website and he said “Use my computer, I want to see the list.” After 15 minutes I found it and sure enough, there on the list was the drug. According to the FAA page one addition to the consequences you mention as described by the AOPA is that the patient must also demonstrate being SYMPTOM-FREE for one year after stopping the drug, from the reason the drug was prescribed in the first place, even if it was an off-label prescription, and provide a note from the treating physician verifying same. My insomnia comes and goes. I doubt I will ever be symptom-free. But rather than chastise my doctor, we found the relevant info on the FAA website and before it got ugly we both found some new knowledge to be used in the future.

  7. I’m 73 and have been flying for almost 59 years–I’ve taken a lot of medicals. I’ve been fortunate in that I’ve never had to see a doctor about a medical complaint–but I HAVE had “pre-medical examinations” (off the record) with physicians and my regular AME regarding medical questions and pro-active regular testing. That’s too bad–pilots reluctant to get medical exams for fear of losing their ability to fly–that is MORE than “too bad”–it’s just plain WRONG!

    When the time comes that I no longer need a second class medical, I’ll go BasicMed–and probably get BETTER health care advice since I won’t have to feel that I’m jeopardizing not only my livelihood, but my very IDENTITY by seeking medical care.

    It says a lot about our lack of trust in government (the FAA) that we would rather AVOID MEDICAL CARE and take a risk than we would submitting to the vagaries of the FAA medical system.

  8. One of the things that has been very helpful for me is that I will not use an AME unless he/she is a pilot and or airplane owner themselves. These docs seem to be a lot better at dealing with OK city on any medical issues that have come up for me including treating high blood pressure.

  9. Pilot, aircraft owner & AME and I find myself with the same debate, personally. I carry a second, but did the Basic Med when I couldn’t get another AME in time to keep my certificate current. I later renewed by Cl II. I think there is no reason not to go with Basic MED, if you can get someone to do them. I do basic med in some states where I’m licensed but not others due to the differing med-malpractice rules and laws. They make it dicey, and even though there is no apparent liability, my advisors are not so sure and in that particular state, a hospital system advised its entire physician group not to do them because of the liability.

    I do not advocate avoiding medical care because you can’t fly if you aren’t breathing. But, as Matt W indicated, pilots who are also AMEs do want to keep pilots flying and will ask the questions and get the paperwork lined up to get an SI if that is required. We do have to be concerned that the FAA and its twin sister the NTSB doesn’t continue to push expensive and hard to get secondary testing which contribute little to nothing in terms of aviation safety. If the FAA mandates something expensive, even if a few pilots will require it, it adds costs to everyone to cover the costs of the equipment. And that is a big problem.

    As for a phone call that could result in grounding at the whim of the phone answerer, there is not one pilot I know of who would take that chance. Neither would I.

  10. I took Larry Stancel’s advice last year. I dropped an MD who wouldn’t do Basic Med. Interestingly enough, it wasn’t liability that was his problem. I was in a crash where I was severely burned. When I asked him, he didn’t know anything about it (he was a former AME and just retired this month). I explained and he said said he didn’t think it was a good idea for me to fly again. I asked why. He said I had just been in a crash that almost killed me. He knew I wanted to get back on the horse, but he didn’t think it was a good idea. It later occurred to me that his analogy was wrong. You get back on the horse to overcome your fear (reluctance), not somebody else’s. I didn’t think that should be his decision, so I dumped him. The new doctor was initially reluctant. We had a discussion about people’s different perceptions of airplane vs. auto accidents and he admitted that he had that prejudice and eventually signed off. I found another plane and am currently working toward a flight review after five years.

  11. I am a former Senior AME, and have also worked as a pilot flying large jet aircraft and also helicopters at times. I do not have a medical certificate at the moment due to a head injury a few years ago. Complications, but no seizures, and on no meds. I have tried 3 times to get a Third Class certificate, and was denied twice. Waiting to see what happens with number 3. If no medical, I WILL fly, legally, in both airplanes and helicopters, because I will use the FAA’s own regs against them. 1. Fixed wing. I can fly a motorglider, which is an airplane licensed as a glider with an engine. Essentially an airplane with long wings. No limit on HP of engine installed. MTOGW 1870 lbs for a TWO place motorglider, and NO MEDICAL REQUIRED. 2. Helicopter. FAR Part 103. I can operated a single place helicopter with one hour of fuel, max empty wt 254 lbs, WITH EXCEPTIONS, meaning the MTOGW can be as much as 620 lbs. Can only fly in Class G airspace, but so what? Where do helicopters fly anyway? Below 700/1200 feet won’t make any difference. Avoiding Class B, C, D, and E airspace below 700/1200 ft still leaves about 85-90% of the surface of the USA available to me. So, tell me, what has the FAA gained? NOTHING. And if they deny me again, they are actually creating an anathema to aviation safety, because in an “ultralight vehicle” per FAR 103, the aircraft has NO certification of design or construction, NO certification of inspection or maintenance, NO certification of operator competence or maintenance of skills, NO medical certification. That means if I am flying an ultralight vehicle helicopter, it is just a LAWN MOWER in their eyes… while it flies over YOUR head….

  12. I am 57 year old ATP, flying for a major air carrier and I just took the survey as well.. Having had a few medical bumps along the way, I see they’re interested in getting the “skeletons out of the closet” via medical adviser over the phone. Before anybody medically “comes to Jesus” on the phone, one should always keep in mind, this is still a government driven agency.. Use your buddies cell phone..!!

  13. Pilots are supposed to evaluate their health each and every time they enter the cockpit. Likewise, the pilot assumes the ultimate responsibility for the airworthiness of their airplane at the time of the intended flight.

    Statistically, the US population is very unhealthy. 72% are overweight with 40%+ obese. According to the CDC, hypertension stats are climbing at record levels. “The prevalence was 22.4% among adults aged 18–39 and increased to 54.5% among those aged 40–59, and 74.5% among those aged 60 and over.” 11% already are diabetic with another 35% pre-diabetic. However, most folks have lived with these conditions as their respective “normal”. Many have said to me, ” I am healthy as a horse, except for my weight, blood sugar levels, and blood pressure.” Since many have been accustomed to managing their disease(s) by meds they view themselves as “healthy”.

    A large percentage have no idea that they have elevated blood pressure and glucose levels being used to what they feel like on a daily basis. Most know they should exercise, “eat their fruits and veggies”, stay properly hydrated, and get plenty of sleep. But that is not the lifestyle of the majority. Pilots have a little more interest in reasonably good health mainly to be able to continue flying. However, the FAA medical requirements are at the low ring of the health ladder. Passing an FAA physical is not a panacea of health. However, the FAA is known for its long, lengthy, expensive, and challenging process of getting a special issuance if one cannot pass this low health bar.

    Naturally, most pilots sweat this FAA medical evaluation every two to four years. Fortunately, few accidents have resulted from pilot medical incapacitation. However, the more sinister aspect of poor or compromised health is good decision-making. If one has cardiovascular issues, even though it may be mild enough not to fail the medical, our brains are compromised blood flow just as the heart and other organs. That diminished blood flow carries less oxygen, less glucose, impairing in varying degrees cognitive function. Now we have a perfect storm for marginal judgement under pressure, forgetfulness in normal operations, and simple lack of good judgement.

    For example, if one notices his or hers lips are dry due to normal thirst derived from a few hours cruising at 6500 to 10,000 ft…you have lost 15% of your brain function. Add to that any blood flow issues such as pre-hypertension, plus roller coaster glucose levels of per-diabetics, there is serious thinking impairment. But like when we drive our car with the front end knocked out of alignment after an encounter with a pothole, we get used to the pull and a couple of weeks later, we don’t even notice the pull. Likewise when we have marginally compromised health that officially is not bad enough for an official diagnosis of a particular disease, we get used to living life daily with our failing health, making enough good decisions overall to function at our own personal normal. But is that enough for consistent good decision making? That is the elephant in the room we don’t want to deal with. Yet, we are legally bound to self evaluate before every flight.

    As a result, in my opinion, our present system promotes avoiding medical intervention or even basic investigations because once in the SI spiral, very few come out wings level health wise. Plus, even if we have a valid FAA medical, that is a very minimal true health standard. And poor health to any degree impairs brain function sometime fractionally, other times quite dramatic. When we get behind in good decision making is when an accident is waiting to happen.

    • And THAT is the beauty of Basic Med. I feel SO much more comfortable discussing my medical issues with my GP doctor … the same doctor who signs the form. Your description, however, Jim, portends that unless you’re 20 years old, 10 feet tall and bullet proof, you shouldn’t be flying. Flying a recreational day VFR flight in a simple non-complex Class I airplane doesn’t require one to be a NASA space qualified astronaut … and we all know that … except for Uncle AME.