BasicMed Survey: Disappointed Resignation

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After a month on simmer, what do AVweb readers think about the FAA’s new BasicMed Third-Class medical exemption rule? Our recently completed survey provides a glimpse and if I could characterize the overall mood, I’d call it disappointed resignation.

Why the disappointment? If there’s any common theme in the responses we received on the survey it’s that readers expected and wanted a driver’s license medical standard similar to the sport pilot rule. The fact that BasicMed falls short of this this drew a steady stream of ire. “Third-Class medical exemption using a driver’s license was very important. This BasicMed turkey is irrelevant," wrote reader David Dean in one of dozens of unvarnished, blunt comments we received.

To summarize, we published the survey on AVweb in early January and received 1966 responses, a fairly large number for this sort of thing. The vast majority of respondents had active Third-Class medicals and some 20 percent were flying on special issuances. An unknown number were flying under the sport rule on driver’s license certs. That pilots were interested in medical reform is shown in the graphic at left. More than 90 percent of respondents followed the Third-Class exemption closely or very closely.

Similarly, a large number of pilots told us that having this medical exemption is important to their personal flying. Forty-five percent called it very important and another 32 percent said it was somewhat important. But having read over the proposed rule—it doesn’t go into effect until May 1, 2017—pilots seem less thrilled with the results. “I see no difference between a Third Class and the BasicMed, other than four years and somewhat less FAA involvement, and ultimately more costs,” commented one reader. (Not all readers agreed to our request to use their names for this report.)

Related to this was our question about how readers think BasicMed will stimulate aviation activity. Here, the opinions may be a little more encouraging as shown in the graph summary at right. It suggests a majority think BasicMed will help and 15 percent think it will be very effective. But those who left comments on this question weren’t expecting much. “It won’t slow the decline any. This legislation is useless,” wrote James Koper. We would say his comment was in the majority. But at least some readers think BasicMed can’t help but stimulate some activity, by either keeping owners in airplanes they might have otherwise sold or by breaking loose some sales. “The used airplane market will explode upward,” commented another reader.

When readers were asked if BasicMed would make them consider keeping an airplane they might otherwise not, a third said yes and nearly a third said no. However, many of our readers and respondents to the survey already own airplanes so it’s biased toward owners. That may explain why only 17 percent of respondents said BasicMed would make them consider buying an airplane, new or used. More than half said BasicMed will have no bearing on that decision, but again, it may be because they’re already owners.

One thing we hadn’t figured on is that BasicMed may have an effect on owner decisions to equip with ADS-B. “It removes the financial risk from an avionics (WAAS GPS, ADS-B Out GPSS, navcomm et al.) upgrade, so instead of postponing, now I'm scheduling to begin soon,” one commenter told us. We also asked if any light sport owners would consider moving into a certified airplane now that medical certification worries are off the table. Surprisingly, there weren’t enough LSA owners in the sample to make any sense of the question. I think this suggests that light sport pilots have crossed the divide on medical worry and just don’t even think about it enough to answer a survey.

Clearly, the chief worry among pilots is finding a doctor who will sign the BasicMed checklist, a draft of which appears in AC 68-1. (We don’t know if it will change in the final form, but it’s not likely to, since the draft reflects the legislative direction from Congress.) I noticed a dichotomy in the responses. As the graph shows, not quite a third of respondents thought it will be easy to find a doc while more than a third thought it would be a little difficult. Fourteen percent said impossible.

But in the comment fields, the remarks were more strongly negative; not universally so, but the majority of commenters said liability concerns will keep doctors from participating in BasicMed. “I can't believe that the FAA wants everyone to believe that it took six months to make a copy of the 8500-8 form. I personally don't see much benefit in the whole dog-and-pony show program. If you presently have a valid state driver’s license, there is no reason that you cannot pilot a aircraft. The medical profession is not going to want intrusion by another government agency,” wrote one commenter.

“My doctor already said no, and all the other doctors at my medical plaza said the same. The reason is obvious: Liability. FAA knew this, that's why it passed so easily,” commented Michael Livote. To be fair, a number of readers said their doctors had already agreed to sign off on BasicMed and others said their docs would.

On a personal note, I saw my own doctor—non-AME—this week and brought along the AC 68-1 checklist. The news isn’t good. He said the medical group doesn’t sign such declarations when they are asked for driving permits and I doubt if they’re going to make an exception for aviation. He promised to hand it off to the group’s legal counsel. I’m sure mine won’t be the only such request.

AOPA and EAA say they’re both aware of this potential problem and are developing educational programs for non-AME doctors. For now, as the survey indicated, the entire success of the program remains unknown if doctors won’t participate. On the other hand, AMEs may step into the breach and scoop up some new business. Or at least reduce the erosion of pilots abandoning traditional medicals.

Last speaking of AOPA, readers recognize that the alphabets were instrumental in lobbying the BasicMed enabling legislation. But that’s not the same as saying they think the advocates did a good job. The survey was full of complaints like this one: “The compromise they reached was a huge failure. It is bad policy. AOPA was more concerned with getting a win than with getting it right,” wrote one reader. “AOPA was started by a doc. Do I need to say more?” added Melvin Freedman. Still, despite these negatives, less than 5 percent of readers said AOPA and/or EAA made no difference. “They helped get it passed, but could not prevent poison pill inclusion,” added reader Mark Foringer.

Additional Comments:

"I can't believe that the FAA wants everyone to believe that it took six months to make a copy of the 8500-8 form. I personally don't see much benefit in the whole dog-and-pony show program. If you presently have a valid state driver's license there is no reason that you cannot pilot an aircraft. The medical profession is not going to want intrusion by another government agency."

“Can't see where BasicMed did much except going from two to four years to get a medical. With most of the same requirements it looks like FAA got a little vindictive after we/congress went around them. I was expecting/hoping it would be fairly easy for your family doc to do the medical but the way it looks, I doubt if many non-AMEs will want to go to the trouble or take the risk.”—Dennis R.

“I think it will get increasingly difficult to find a doctor who will sign the checklist. As non-AME doctors become more aware of the liability concerns, fewer will be willing to sign. At the same time, fewer doctors will become AMEs due to the reduced demand for services. It will become more of an issue to find an AME within a reasonable travel distance.” —John McNerney

“I am excited that it will be implemented! May 1, 2017.” —Wylie M. Smith

“I feel let down. I see this as an attempt by the FAA to keep the regulations in their favor as opposed to what was laid out in the Pilot's Bill of Rights.”

“This new rule did nothing more than appease ALPA and the FAA. It will be more difficult to get a medical because the general physician will be reluctant to accept the liability. Additionally, there is no physical exam requirement to drive a car, which is what was originally sold to the flying public. The checklist of the BasicMed medical exam is quite detailed. It will be simpler and cheaper to go to an AME. Furthermore, even though the FAA says that the medical findings by your private physician will be confidential, all bets will be off if there is an accident or incident that requires an FAA or NTSB investigation.”

“It' about time this happened. Now we just need the training and test to be published and available to everyone ... quickly and not at the last minute.” —Frederick Williamson

“A reasonable solution to the problem. Took about 20 years too long.”

“Having a special issuance cert, I am relieved to have the BasicMed opportunity. I don't mind the weight/pax restrictions because I don't do that kind of flying. I will be getting with the AOPA medical experts because I have questions relating to my special issuance cert.”

“I will be recommending some of my students pursue the BasicMed program. The biggest frustration to me is the FL180 limitation. I'm not sure what makes FL180 a big deal when pilots can fly under IFR with the BasicMed program. I could understand FL280 to stay below airline traffic in RVSM airspace. For pilots with a turbocharged piston airplane, it can be a fairly significant limitation to be required to stay below FL180.” —David Richardson

“BasicMed is a good first step, but it should not be considered a complete solution. AOPA and EAA should continue to push for refinements to streamline the process and work towards a true driver’s-license medical for Third Class, as per the original goal.” Dean DeRosia

“No doctor is going to sign this ... AME is the only option. I know my doctor that I get a yearly physical--and I am in great condition--will not be allowed to sign by his group and he would not sign this if he was on his own. They will get strong recommendations by their insurers and their organizations to not sign. This is a waste of time and effort since this inability to get a signed form will kill the program. Also, why do you think this makes it more likely that people will buy aircraft ... no relationship. What you should have done is get the Third Class medical to be every four to five years after 40 with an AME.” Manthou Tsiouris

Comments (21)

Kudos to AvWeb for conducting this survey. One conclusion seems unassailable: the Alphabets' party line about puppies, candy, and widespread joy is a crock of something brown.

Posted by: Tom Yarsley | February 10, 2017 4:38 AM    Report this comment

The FAA could have gotten the same thing "BasicMed" gets us by just getting rid of the "once you start the exam you're committed" part. But as long as BM still has doctors certifying that our anuses and genitals are in good shape, and that we don't have hernias, being able to stop and reassess if things aren't looking good is the only benefit.

Posted by: Robert Gatlin-Martin | February 10, 2017 5:45 AM    Report this comment

"Kudos to AvWeb for conducting this survey. One conclusion seems unassailable: the Alphabets' party line about puppies, candy, and widespread joy is a crock of something brown."

Well said, and my heartfelt thanks to AvWeb for not jumping on the sugar coated train of delusional happiness that the alphabets have been riding, it's refreshing to have a voice of reason in a den of lies.

Posted by: Michael Livote | February 10, 2017 6:48 AM    Report this comment

The sweet spot in all this commotion seems to be going to an AME you've never been to before. Every single time.

Posted by: Peter Kuhns | February 10, 2017 7:27 AM    Report this comment

Wow!!. I just looked at the checklist. This is only marginally better than what we had before. They didn't get rd of the medical requirement at all.

Posted by: STEPHEN EGOLF | February 10, 2017 9:00 AM    Report this comment

My initial thought when I first saw the checklist last month was "If I was a doctor, I sure as heck wouldn't sign this open liability risk. Never in a million years..." What a massive waste of resources expended for nothing.

FAA and ALPA just told Congress to go stick it, and they dutifully skulked away with their tail between their legs. Stay tuned, we are about to see the same song verse 2 on ATC privatization.

Posted by: A Richie | February 10, 2017 9:52 AM    Report this comment

The only marginal improvement is that you have a path to get back flying even if you've been denied an FAA medical. For everyone else, it's actually worse than nothing, since now the alphabets can all pat each other on the back, give themselves an Attaboy, and declare mission accomplished.

If this had actually cratered, there would still be some hope for a drivers license in lieu of a third class for all uncompensated ops, but now that's pretty much doomed.

Posted by: Joshua Levinson | February 10, 2017 9:52 AM    Report this comment

Prima facie evidence of bad faith on the FAA's part, imho. Like the debate from years ago -- which to require, seat belts or air bags? -- we got both. With this answer to PBR2, we get BOTH a requirement that we carry a valid drivers license as evidence we have met the medical requirements AND that we carry a signed statement that a doctor has given us a third class medical examination [equivalent] within the past four years, rather than the first being acceptable in lieu of the other. I'm an independent; I voted for my Republican congressperson because she supported PBR2, and I voted for my Democratic senator because he did the same. The new administration is making noises that might at least aim in the right direction on this matter if it ends up in their sights. I plan to give BasicMed a try at least once before moving permanently to something else. But very disappointed.

Posted by: Terry Bolls | February 10, 2017 10:30 AM    Report this comment

Should have just polled John Dunkin for the opinion that matters.

Posted by: Robert Davison | February 10, 2017 11:09 AM    Report this comment

The results of Third Class Medical Reform sound like a case of the Law of Unintended Consequences: if you make a big change to something, you may get the results you expect, but you're also likely to get results that you didn't expect and probably don't like.

If I recall correctly (and maybe I don't) the biggest issues that aging pilots had with the Third Class Medical were the nightmarish Special Issuance and the ultimate penalty of denial of issuance. Now these issues are gone; so far gone that nobody even remembers being so upset about them.

But, as an unintended consequence, we ended up with competing private interests getting their nose in our business. The ALPA didn't want us flying without medical cert, so we ended up basically with watered-down privatized medical certification. From the sound of things, pilots are now upset that we've exchanged faceless bureaucrats in OK City with their publicized regulations, for faceless insurance companies and law firms with their own standards & practices and laws to back them up. And they have at least some physicians in their grip over liability concerns. We thought the appeals process with FAA was bad; there's no appealing a physician's decision to avoid signing the form.

The good news is that a) we don't know yet how BasicMed will play out in practice, b) we can always shop around for a physician who will sign off, and c) we can take personal responsibility for influencing how our physicians view the Basic Med forms.

The bad news is that the private sector includes people and organizations that don't have personal GA's best interests at heart. And the big guys in the private sector can control us just as much as the government bureaucrats can, even more.

Posted by: Rollin Olson | February 10, 2017 2:25 PM    Report this comment

Good survey and analysis. It states that much of the general aviation community is NOT ecstatic about BasicMed.

Posted by: Rafael Sierra | February 10, 2017 5:47 PM    Report this comment

Rollin ... your item C is great advice for anyone intending to use BasicMed. I just did it myself.

I visited a new physician two days ago to begin laying the ground work for a May BasicMed exam. Before I showed up, I figured he'd want me to explain what BasicMed was so I wrote a one page compendium and attached to the tentative forms for him. When I was signing in, he happened to be standing there and asked if I had anything on "it." I immediately handed him my packet of documents. They're now scanned into their electronic system. In the exam room, we also discussed it all. He didn't say if he'd be willing to sign off on it, or not, but I'm feeling more positive than negative at this time. Lets see if I'm smiling after May 1 or chopping up my airplanes?

I would recommend that anyone who intends to use BasicMed as their method of compliance do the same. School the doctor, negotiate with them and -- if necessary -- snivel. It can't hurt and might just get ya "four more years" if you find a doctor who isn't afraid of lawyers.

As for the liability issue, I explained to him how every pilot takes personal medical responsibility before each and every flight between AME exams. And I can think of a way to solidify liability concerns for all ... make a Federal law that parallels that of liability relief for good Samaritans who stop to help a roadside victim. And, I wonder if AME's are somehow similarly indemnified?

Off topic ... I read the article about the President meeting with the airline execs and was GREATLY buoyed by his words about the FAA Administrator position needing to be filled with a pilot (duh!). Here's a Politico title from two days ago, "Trump slams 'out of whack' FAA in meeting with airlines." John Dunkin for Administrator !!

Posted by: Larry Stencel | February 11, 2017 9:54 AM    Report this comment

I'm getting depressed that I'm even taking this seriously enough to comment. AMEs have a more favorable liability posture because it's the FAA doing the approval, not the doc.

Under BasicMed, the signing doctor assumes all the liability.

Posted by: Paul Bertorelli | February 11, 2017 3:18 PM    Report this comment

Out of wack FAA? Wag the dog in process gentlemen.

Posted by: Rafael Sierra | February 11, 2017 10:34 PM    Report this comment

This and many more reasons is why I let my AOPA membership laspe. I foolishly belived their hype, I should have known better. What it comes down to is the do nothing FAA is not going to do anything to jepardize their over paid high 6 digit salaries. Mean while our do nothing Congree will do nothing to make the FAA stooges do their job. Why should Congree do anything, they will still have GOOD healthcare, GOOD paychecks and a fabulous pension... Basically AC 68 1 aka Basic Med shows we pilots have no rights. The alphabets should call their fiasco the "Pilots Bill of NO Rights". What a waste of everyones time!

Posted by: Tom Alldridge | February 12, 2017 1:31 PM    Report this comment

"Under BasicMed, the signing doctor assumes all the liability."

Paul, with that and all of the rules and regulations pilots live by, the medical exam is one of the most subjective, non sequitur regulations out there.

1. Head, face, neck, and scalp.

Is dandruff a non-qualifying condition? An anomaly that should be placed in the check block?

9. Anus (not including digital examination).

How about Hemorrhoids?

Given the liability, you have to wonder. And under the third class medical, going to an AME that's having a bad day might provide the same poor results.

Posted by: Robert Ore | February 13, 2017 9:45 AM    Report this comment

Well, about as many fatal crashes have been caused by dandruff as by un-diagnosed sleep apnea. And who among us hasn't been suddenly incapacitated by a hemorrhoid? Or by skin cancer?

Posted by: Tom Yarsley | February 13, 2017 11:55 AM    Report this comment

About 3.5 million.

Posted by: Rafael Sierra | February 13, 2017 9:36 PM    Report this comment

I have to admit, I spoke too soon about BASIC MED. Many pilots are flying TODAY!

Posted by: Tom Alldridge | May 30, 2017 7:11 AM    Report this comment

My experience is one of not finding a BasicMed doctor. They are worried about liability. BasicMed probably increases liability of a family doctor compared to that of an AME physician. When one goes for a 3rd Class, the exam by the AME does not create a physician/patient relationship unless the examining physician and the pilot want a physician-patient relationship. Some medical examiners unwittingly create tort liability for themselves by having patients do paperwork as if they are new patients instead of just sticking to the FAA forms completed by the pilot and examiner. Going outside of the forms means going outside of the system, and that would probably be tort liability territory. Staying within the forms is the safe place to be for an AME. Normally, all the AME is doing when performing a 3rd Class physical (or any other aviation physical) is certifying to the FAA that the examinee meets FAA criteria for that physical classification at the time of the examination.

With family docs doing BasicMed, the situation is different. The "patient/pilot" is seeking a physician sign-off on liability regarding health instead of making a certification response to the FAA. The results of the physical are not transferred to the FAA by the physician, so the physician is not performing a FAA function as a designated examiner, but is performing a medical function for the examinee, the pilot, who just carries the results in the flight bag to produce to the FAA if the need ever arises. That is a big liability difference.

Many AME doctors are already confused about their liability when performing FAA physicals. When they perform medicals for the FAA, the relationship is primarily one of examiner to the FAA which then certifies the pilot who must hold the medical certificate. When the docs perform BasicMed for the pilot, it is the pilot who certifies to the FAA on demand, with the doc certifying primarily to the pilot, not to the FAA. That one-step removal may create liability for the doctor signing off, since the examination and sign off are now probably classified as the provision of medical services to the patient/pilot instead of a certifying activity of the doctor to the FAA as an AME. BasicMed may create tort liability for the doctor that did not/does not exist under the FAA medical examiner programs.

Posted by: Ted Stacy | July 16, 2017 7:07 PM    Report this comment

My PCP can not sign off... legal department opinion regarding liability... He is an employee of a large health care system and none of their physicians will sign off.

Posted by: Gordon Young | August 20, 2017 9:29 AM    Report this comment

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