The FAA Throws AMEs a Curve

Doctor Warren Silberman took on a big job last year when heassumed the reins of the Civil Aeromedical Institute (CAMI), which is responsible forall FAA Airman Medical Certification. The place was a mess of paperwork with over 50,000medical certificate applications caught up in the quagmire. Silberman quickly reduced thatbacklog to 10,000 medicals, and began to computerize the entire process so that everymedical certificate application would be in the computer, and any medical records sent toCAMI 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 theInternet to transmit medical applications to Oke City. He told AMEs that the newAeromedical Certification System (AMCS) Internet software program will be up and runningby October 1, 1999 — considered a drop-dead date because the old software currently inuse is not Y2K-compliant — and its use will be mandatory for all AMEs from that dateforward. This news was pretty much in line with what AMEs expected, and most are happy tosee CAMI's continued efforts to streamline the processing of medical certificates.

However, Silberman's announcement contained an unexpected curveball that AMEs were notexpecting, and that has many of them alarmed. It seems that not only will each medicalcertificate application (FAA Form 8500-8) have to be entered online by the AME into CAMI'scomputer system, but the AME will have to receive electronic approval online beforeissuing the certificate to the airman! Uh oh!

In the past, AMEs would typically check over the applicant's 8500-8 for accuracy, givethe exam, type up the new medical certificate, hand it to the airman, and send him happilyon his way. Later on, the information would be entered into the computer and sent toOklahoma City by modem. If the CAMI computer was down, or if it didn't like one or moredata 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 thecertificate until the data has been entered into the CAMI computer and an approvalreturned online. Under the best of circumstances, this will mean the airman will have towait 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, ora whole host of other potential problems arise, it could mean a long delay for theapplicant. In some cases, the applicant would have to return later to pick up thecertificate, 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 nohassle for the physician. I do not know about the other guys, but I do about 100 physicalsa year and I enter all the data myself. Since 80% of AMEs in the U.S. do 30 or fewer examsper 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 createdis 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 inspite of the "problem" with the application. For the past three years, theresponse 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 oneever has ever contacted me.

Now, call me a doubting Thomas, but if I have to submit a medical in real time on theInternet and the approval has to come from Oklahoma City electronically prior to myprinting 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 thatis Internet-based, I am the Medical Editor for AVweb, and I have been an AssistantSysop on Compuserve's AVSIG forum for years. If I'm having this much trouble with the CAMIcomputer 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 pilotcommunity to make this leap of faith to a compulsory real-time Internet-based approvalprocess, especially considering that the FAA has not gotten the worms out of the currentmodem-based program that we've been using for years.

The new system will also drive some computer-phobic AMEs out of the system, which isboth good and bad. On one hand, it certainly will encourage some of the less interestedones to drop their AME status. At the same time, it may also discourage some rural AMEswho only perform the medicals as a service for geographically challenged pilots.

Currently, all AMEs are "supposed" to submit medical applications and EKGselectronically by modem to Oklahoma City. The fact remains that only about half of AMEs doso, in spite of an absolute requirement that ALL EKGs be submitted via modem, and that allrecently-appointed AMEs must submit the 8500 exam form electronically.

Don't get me wrong: There is nothing wrong with online submission. It's basically agood idea. The only part of CAMI's plan that's a bad idea is the new requirement thatprevents an AME from printing a medical certificate until all the data on the Form 85800-8has been entered online and an approval received from Oke City. No longer will the AMEhave the option of issuing the certificate first and entering the data later. So if theonline 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 AMEsup-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-timeapproval. Leave the immediate approval, referral, or denial in the hands of the AMEs whereit is now. The present system can work with some minor modifications, but raising thestakes when the AMEs are not ready may be a step backward for an agency that is trying tomove forward.