By Jim Posner, Poulsbo, Wash.
I have long thought that the FAA should NOT be in the medical certification business, at least for Part 91 operations. Ever since my denial – despite letters from my doctors specifically stating that I am good to go – I have tried to understand why they should consider themselves more qualified to determine my fitness to fly than my own experts. I am not a doctor nor do I have any medical training. My primary care physician is a former AME-equivalent in the military so is very familiar with “fitness to fly” criteria.
The newly introduced legislation by Congressman Todd Rokita (H.R. 3708) goes a long way toward solving this problem by eliminating the FAA-issued medical certificate requirement for piloting most types of light (under 6,000 pounds gross weight) GA singles and twins VFR below 14,000 feet and should be supported by us all. I do have some concerns about its ability to be passed, however.
The FAA wastes huge amounts of money duplicating the medical community, maintains a very inefficient bureaucracy that costs us over $55 million per year just for the medical group, is entirely unnecessary and counterproductive, compromises public safety, and is a major impediment to the growth and health of general aviation.
My concern about the Rokita bill is that if it doesn’t have some sort of oversight component, it won’t have a ghost of a chance of passing.
Clearly, there are some people who have health issues that make it unsafe for them to act as pilot in command (or drive a car for that matter). If we rely solely on them to self-determine their fitness to fly and they don’t ground themselves when they should, we could have some safety issues. There needs to be a basic requirement for us to consult with our medical professional and get him/her to agree generally and as issues come up that we’re OK to fly. They are the only ones in a position to accurately know, on a day-to-day basis, the pilot and his or her fitness to operate an aircraft safely. It should not be a government agency that knows nothing about our personal situation.
All pilots should be required to have their own physician’s permission to fly on a real-time basis to be legal. If a significant (or even minor) change in the pilot’s medical condition or medication (prescribed or OTC) makes him/her unsafe to fly, the pilot’s primary care physician will know as soon as he/she is consulted and a note would be put into the patient’s file admonishing him/her against flying (if that is the appropriate recommendation based on the diagnosis) until all re-fitness criteria are met.
Once the problem is solved, and this might be just a day or so later, the pilot is once again good to go. No longer would it take months of time, mountains of paperwork and huge costs to get certified again. If the problem can’t be solved (or until it can be solved) and the pilot’s doctor advises that he/she is risking his/her safety, the safety of his/her passengers and the public, he/she would most likely agree to stand down. When it is finally time to permanently hang up the headset, it will be a much more mutually agreed upon course of action based on the pilot’s personal circumstances, prognoses and his/her personal physician’s opinion/advice.
The FAA’s current process jeopardizes public safety because it doesn’t track the pilot’s health for the two to five years (depending on age) between examinations and thus relies on an honor system where the pilot is depended upon to self-certify and ground him or herself if he/she is not, in their personal judgment, fit to fly that day or leg.
The FAA can be involved as a clearing house of accident investigation intelligence regarding the pilot in command’s medical condition at the time of an accident and how it might have contributed to the cause. In this capacity, they would limit their involvement to issuing GUIDELINES to the medical community for determining fitness to fly based on that experience and investigative results data. Such guidelines must, however, be based on documentable research into aviation incidents/accidents that were attributable, at least in part (by the NTSB) as being caused by some preventable, medically-related incapacitation of the pilot in command, not just opinion, theory or speculation.
For instance, if there is something about the three-dimensional aspects of aviation where the pilot in question’s medical situation requires supplemental oxygen at a lower altitude than most, his or her doctor would make it clear that he/she must use it while flying at or above that altitude. It would be the same as when glasses are required if the pilot needs correction to see properly.
Whatever other differences there are (that can be documented) can be explained in a briefing paper issued by the FAA to the medical community so that they can digest and integrate those differences into their general knowledge base. These guidelines can be updated periodically as pertinent new data becomes available.
The present setup also invites pilots to “game” the system; lie about or omit facts when filling out his/her medical application or even just fly without a medical certificate. Recommended tests that could lead to improved health might be refused on the basis of possibly discovering issues that would result in a long and costly investigation by the FAA and possible denial. Using one physician to do a pre-qualification exam and then another to act as the AME for the FAA paperwork so that he/she knows what to conceal is a common tactic. Hesitance to seek advice about a medical issue because it might lead to disqualification is particularly dangerous to both the pilot and the public.
On the other hand, if he/she knew that by discussing a concern and dealing with it pro-actively, it would probably result in a relatively quick solution and re-certification, he/she would be more willing to take action. Of course, it’s possible that some might just shop around for a doctor willing to sign off on his/her fitness to fly without even examining him/her, but that puts the doctor at risk of having to answer to the NTSB if an accident occurs, making this scenario unlikely.
So, if the Rokita bill were to include a requirement for pilots to get and have his/her doctor’s continuing opinion that they are fit to fly and make that the “certification,” we should be good to go. Without such a requirement, those opposed to the bill will try to instill fear into congressional voters by suggesting that all of a sudden unfit pilots will be taking to the air jeopardizing their safety as well as their passengers and the general public. That message will ring true if there is no oversight component to the bill at all.
We must, therefore, persuade the authors of the bill to include an oversight component and then elicit the support of our congressmen/women and senators to get their affirmative vote.