A new study has found that many pilots avoid medical professionals due to a fear that revealing health problems may lead to the loss of their pilot certificates.
According to the study, two-thirds of military and paid civilian pilots answered “yes” to at least one of four survey questions addressing their reluctance to seek formal medical advice about health problems.
Knowing they could be grounded, which “can have negative occupational, social, and financial repercussions,” pilots may see “disincentives to be truthful about their health care” if there is a chance their employers or the FAA could find out, said Dr. William R. Hoffman, a U.S. Air Force employee at Brooke Army Medical Center in Fort Sam Houston, Texas.
In a 2019 survey of pilots, Hoffman found that more than 75% of pilots “worried about seeking medical care due to concern for their career or hobby.”
The new survey expands on his previous research by asking about specific aspects of that reluctance to seek medical care.
Pilots were asked to agree or disagree with several statements such as:
- Sought informal medical advice for fear of certificate loss
- Flew despite experiencing a new symptom (physical or psychological) that warranted evaluation
- Did not disclose prescription medication use
- Misrepresented or withheld information on a written healthcare questionnaire for fear of certificate loss
The web-based survey was completed by 2,383 non-professional civilian pilots, 1,097 paid civilian pilots, and 261 military pilots.
Just over half of the unpaid civilian pilots denied ever hiding any of the four types of information, according to the survey’s findings. But that was true for only 33.6% of the paid civilian pilots and 32.2% of the military pilots.
The survey also found that only 6.8% of the pilots said they had not disclosed prescription drug use as required, while 16.8% acknowledged that they kept new symptoms secret.
It also found that 45.7% sought informal advice in place of seeing a professional, while 26.8% said they had withheld or misrepresented information on written forms.
A very few of the pilots — just 2.2% — admitted to all four types of reluctance.
The study also found that:
- Women were more likely than men to avoid disclosure in at least one way (62% of all female respondents vs 55.4% of men)
- Younger pilots, those between the ages of 25 to 40, also were more likely to avoid disclosure (69.1%) vs. pilots older than 60 (40.7%)
- Union membership was associated with high rates of avoidance (70.1%) vs. non-union pilots (51.8%)
- Active duty military status also was associated with high rates of avoidance at 75.8%
What can we learn from the new study?
First that healthcare professionals should recognize the “potential” for pilots to be reluctant to share their true health conditions.
“This might be mitigated through developing rapport with the pilot, asking questions about concerns related to their flying status, and clear communication about documentation and clinic course,” he suggested.
He also recommends that doctors order “only the necessary tests” for all patients, but especially pilots, to avoid the possibility of “false positives.”
But in the end, Hoffman notes that if a medical professional has concerns about a pilot’s health, they should share those concerns with the officials charged with evaluating that pilot’s fitness to fly.
The FAA is nothing but an outdated, organization that thrives on taking flyers livelihood away. It’s one thing finding a problem, but then it takes months to resolve .Some pilots are grounded for the most trivial problem and this still takes sometimes years to resolve.
It just needs to be done away with and get out clean paper and start over again. Why should an organization that is supposed to be helping polish instead of making them afraid to even contact them.
The best thing you can do is just try to avoid anything to due with the worlds worst organization .
Could you give us the name of the study and the source? Thank you very much!
“Aircraft pilot healthcare avoidance due to fear for aeromedical certificate loss and implications for neurology care of the pilot patient” American Academy of Neurology 2023 conference, Abstract 7-004.
I have to ask why pilots who feel they should not disclose information would participate in a survey regarding this subject in the first place. Even if guaranteed that the survey would ensure anonymity, a savvy person would not take the risk. (AKA–I put no faith in any poll regardless of subject matter)
Primary Care Physician sent me for a stress test “just as a precaution”, even though no symptoms or issues.
Cardiologist said well y’all getting old, son, we might want to do a stent. Asked if a stent would affect my medical. He answered no, it won’t.
He was absolutely 1,000% wrong – a stent is immediate grounding, period.
Second half of stress test (did treadmill first, then let a giant machine make me glow in the dark) found I am just fine thank you very much and can anticipate living to 150 years old. Cardiologist said the treadmill is an outdated and inaccurate test anyway, yet it risked my medical. If that had been reported to the FAA, I would have been in line for a series of expensive and totally unnecessary invasive tests, plus possibly a stent which I don’t even need.
The FAA’s medical standards are probably 80 years out of date. People are much healthier now, have much better medical care, are better nourished, and adult smoking is down to only 11% of the population (from 40 to 50% in the 1950s). The FAA’s “standard person” is 5’8″ tall and weighs 140 pounds. Heck, I’ll bet Twiggy weighs more than that . . .
Going through the process currently. Passed all required testing with flying colors, report submitted last September, finally received a denial last week and requesting more testing before I can reapply. If the process cannot be streamlined and Doctors findings be given greater consideration I understand the reluctance to disclose. As a professional Pilot I have missed a lot of paychecks waiting for the bureaucracy.
I’m curious how skewed the female data is because of a smaller data set. Females as a percentage of the pilot population are significantly smaller, so even a few more responses one way vs the other can have a larger impact on skewing the dataset for that gender.
Even still, interesting that more females admitted to not disclosing.
The FAA medical review group ONLY utilizing USPS written communications is another example of a bureaucracy without accountability to the people they serve.
I know of examples where 10 days passed between decision and notification. At today’s pilot pay rates, and the 30,000 special issuance medicals issued annually that is $150,000,000 (that’s million) in lost wages just in antiquated communication practices.
8 doctors make up the review group for 30,000 SI’s annually. If everybody reported everything, the system would buckle and the Air Transportation System would fall like dominos.
It needs to be said, so I will say it. The following are just a few examples I know about. And the comment at the end is the one we need to think about.
One reports something that is benign, for them. But someone put something dumb in their medical record and the FAA happens to ask for a copy of that. And now the FAA wants a special test done. Let’s say it is a vision test for full visual “range” because they think you have a detached retina. $$$ to find out that one doesn’t, never did, have a detached retina.
What if “that something dumb” indicated you were in early stages of kidney failure… So the FAA denies your medical until you have certain tests run, to find out that comment was in your file in error.
Or, you put down that you had a migraine and what the doctor said the migraine type was. But that was a mis-diagnosis. Never the less, your medical is denied. Now you have to go to some neuro-doctor for some special tests $$$. Where you find out that what you had was a classic or standard migraine. Not a major big deal. But if that bad diagnosis hadn’t been shown to be wrong, this would have been medically grounding.
Meanwhile a pilot finds out they have cancer, so they go through Basic Med. Then they go through their cancer treatment. Had they reported it for an FAA medical, they would have been grounded for some period of time and had to go through a bunch of tests. But with Basic Med, their doctor signs them off as being good to fly or drive a car or truck after they finish their course of treatment.
Then there is A-Fib. You don’t qualify for any medications or other treatment, but you are now over 65. Assume you have had an irregular heart beat all your adult life, but because you had an urgent care visit because of it, you have just had your FAA medical denied. You could get an SI but it will cost. Had you been on Basic Med before this incident, your cardiac MD could sign you off and you Basic Med MD could have signed off, no problem. But now one has to get an SI to go off to Basic Med.
Now we can see why people don’t want to report stuff. And there is no oversight that I am aware of for the FAA’s medical group.
So how many medical issues are out there flying that are a “NO PROBLEM” situation, but if the FAA Med group was dealing with them, they would be medically grounded?
Following an Vitrectomy surgery on my eye, my AME requested additional tests he knew the FAA would need for review. Those tests confirmed my class 2 medical could be approved. However, it took 4 months for the FAA to review and approve my medical. No wonder some pilots are hesitant to get or report treatment if their profession will be put on hold for months.
It seems to me that the local AME should have more authority on approving some conditions, or at least the FAA medical review be more responsive. One would improve the other as well.
shocking.
In other news, water is wet.
You don’t say. You mean we dont’t volunteer information to a heavy handed authoritarian bureaucracy?
“What can we learn from the new study?” From the findings, older male private pilots are the most honest. No surprise really. When people become dependent on government or union approval to continue their occupation, they will often lie and cheat to maintain what they believe is job security. Private pilots fly because they want to. Solution – don’t work for the government and don’t join a union. Stay healthy or don’t fly. Women will have to answer why they are more likely to lie, I am not going there….
I’ve taken a few flight physicals from different AME’s. And, even though I was just going for a 3rd class, my experience was that all of these AME’s offered merely a cursory check of my health. The exam was nothing like the thorough physical my primary care physician provides.
Exactly my experience as well.
Your AME isn’t really supposed to do a thorough physical. The problem people usually face is those sweepingly broad questions on the application, which you may not have read carefully. By the time you reach middle age, your chances of being able to check “no” on every single one of them are declining really quickly. Most of these checks reflect a completely benign situation, but every one of them will generate an FAA review and if you have more than a few of them the FAA will start viewing you as a health risk even if you pass each individual review. If you don’t check the box for the condition you know is benign (and possibly ancient history), to avoid generating a review, you are committing a crime – and FAA administrative law judges have very much taken a “which part of ‘ever, in your life’ did you not understand?” attitude.
But if you’re either a) young and healthy enough or b) willing to take your chances committing a crime, and you check “no” on all those questions, the AME is going to take you at your word and do a relatively quick review before signing you off and sending you on your way.
Attacking the symptom, not the underlying problem of the Aeromedical department’s “lifestyle”.
That’s healthcare all over, isn’t it?
How many pilots have essentially gave up flying because of the fear of not passing the medical or of lying on the med form? Isn’t it ironic that the medical exam might be keeping unfit pilots from flying because of this fear.
Maybe this is also the reason that AOPA could not get the FAA to go along with letting pilots fly on their motor vehicle license.
The very sad irony is that pilots probably suffer worse health and earlier death (including, albeit extremely rarely, at the controls) precisely because they know that if they try to proactively take care of their health, the FAA’s bureaucracy will very likely ground them – and do it often – even if that’s entirely unnecessary and inappropriate, as judged by the specialist they saw.
The FAA’s response to specialist opinions, by the way, is that a specialist knows nothing about aeromedical considerations (a claim I’d like to see probed). The specialist responds that it’s clear the FAA’s aeromedical group knows nothing about the specialty (a claim also worth testing). But, one of them holds the key to people’s livelihoods and assumes the worst unless proven otherwise – and pilots know it.