Senate and House have Approved Third-Class Medical Reform

wrote:
On Friday, July 22, 2016 at 10:34:17 PM UTC-4, wrote:
wrote:
On Friday, July 22, 2016 at 5:01:05 PM UTC-4, wrote:
wrote:
On Friday, July 22, 2016 at 12:46:03 PM UTC-4, wrote:
Um, the plaque test should pretty much do it for a read on
arterial calcification. An MRI wouldn't be a bad idea if one
has a family history of Intracranial Aneurysm Rupture, but
otherwise it's a waste of money. The former is worth paying
the deductible as it answers a lot of questions.

The average cost of a MRI in the US is $2,600. How often do you
recommend doing this?

If you can't afford medical insurance, you can't afford to fly.

Medical insurance will not pay for a MRI "just because"; there would
have to be some indication of an issue to justify insurance paying.

Mine does. And without referrals.

Aren't you lucky; very few do.

That isn't the point. The point is... if you're responsible and
cognizant of it's importance, then you'll do it for yourself and
everyone around you. Any doctor will refer a plaque score.

There is a word for people that take tests just because the test exists.

And the point here was hidden condtions that don't show up in any but
the most extensive of physicals and certainly not in a 3rd class physical.

No, my original point was that the efficacy of 3rd class medicals is
such that you cannot quantify how many airplane crashes they prevented
because data on non-pilots isn't tracked, and speculation as to what
may have happened is just that, speculation. So, MANY candidates have
failed their 3rd class medicals, and if that made us all safer cannot
be proven.

You mean other than the data for balloon, glider, and light sport pilots
which don't require a medical?

The number of people flying balloons, gliders, and light sport pilots
are in the minority, are susceptible to prosecution for hiding medical
problems, and yet... they die from lack of detecting medical issues.
The numbers are just much smaller, the missions are different, i.e...
floating and farting around as opposed to Class C traffic. The reporting
from this group too, is small to non-existent.

Nonsense.

There is nothing special about the physical requirments to fly in Class C
and the same investigative system investigates all aviation accidents
whether it is one guy in a hot air balloon or an airliner with hundreds
of people.

While the absolute number of flight hours for balloon, glider, and light
sport pilots are smaller than for private pilots, the percentage of
medically caused accidents is not statistically different.

My plaque test after deductible was about 35 bucks. As they said
there wasn't even a hint of any, I figure check again in about
10 years. Unlike most Americans I'm not overweight, don't smoke,
don't drink, exercise daily, and eat very healthy.

And a fair number of people who are not overweight, don't smoke, don't drink,
exercise daily, and eat very healthy drop dead every day from something
that did not show up in a routine physical.

Hardly. Unless you're counting old age, which is 100% fatal.

No, not in droves, but it does happen.

And your point is what? Since a tiny minority of people with no
obvious problems keel over dead, then 3rd class medicals have
no benefit?

**** happens.

Since the percentage of medically caused accidents are not statistically
different for those with a 3rd class medical and those without, the 3rd
class medical appears to serve no usefull purpose.

So what does that have to do with 3rd class physicals?

What it has to do with 3rd class physicals is CFR Part 67.311 which
states the following, and any individuals who failed their medicals
for these reasons, and then died of cardio problems as non-pilots,
never appeared on a statistical review of medical wash-outs.

But would appear in the statistical records for alloon, glider, and
light sport pilots if it actually were happening.

Apples, Oranges. Balloons, gliders, light sport...daytime, low elevation,
slow speed, farting and floating. And yet, they're crashing too due to
medical problems. Just no so many, not so published. Again, I'm not
necessarily advocating the status quo of 3rd class medicals. Just
saying it has served some good, and certain tests are a great idea.

No, there is no difference in the physical requirements for any type of
private civil aviation, except maybe acrobatics.

And again, the same investigation applies to ALL accidents and the percentage
of medically related accidents is not statistically different for those
with a 3rd class physical and those without it.

And there is STILL the requirement to get a phsical, just not all the
extra time, expense, and paperwork required for a 3rd class.

Cardiovascular standards for a third-class airman medical certificate are no established medical history or clinical diagnosis of any of the following:

(a) Myocardial infarction;

(b) Angina pectoris;

(c) Coronary heart disease that has required treatment or, if untreated, that has been symptomatic or clinically significant;

(d) Cardiac valve replacement;

(e) Permanent cardiac pacemaker implantation; or

(f) Heart replacement.

A clinical diagnosis can be an E.K.G. in any doctor's office.

All of which can be waivered with lots of tests and lots of time and money.

Waivered? So if you can beat the system, do?

Waivered means, after extensive tests, lots of time, lots of money, and
lots of paperwork, a bunch of doctors have decided you are fit to fly.

You have a strange definition of "beat the system".

And you keep seeming to forget you still have to get a physical and
self certify.

Like one fellow said:

"All of this is to say I think pilot incapacitation is a slightly
larger safety issue than it's made out to be, but not so large as to
justify the large bureaucracy and expense necessary to maintain the
Third Class, at least to current standards. Because of the way some
maybe most pilots self-certify, it's just not clear to me that the
Third Class exam makes much difference. You can hide stuff from your
AME, but you can't hide it from yourself. And you fly anyway. So what's
the point?"

And doing so is both stupid and illegal.

Also I highly doubt there are very many people that have a heart attack
and then go fly.

So, individual choice I guess. I think I've already mentioned that
I don't even fly when feeling a little "flat", or tired. Wouldn't
take the chance if sharpness isn't there. Operative word, responsibility.
Problem is, a lot of folks aren't good self regulators.

I highly doubt there are very many people that have bypass surgery or
a pace maker implanted and then go fly.

You can save a loved one or yourself by finding out if you're
afflicted with atherosclerosis and/or vascular plaque, as this
is what causes a sudden myocardial infarction which has caused
numerous plane crashes.

As there has never been any test for such things in a 3rd class physical,
it is irrelevant to the issue.

My understanding is that it is the responsibility of an AME to establish
that part 67.311 is carried out, often by a simple, in office EKG if
the candidate reports or presents any reason to be concerned.

And usually there has been no reason to be concerned until something
happens.

Don't know where you get that. A good doctor knows how to detect or
suspect circulatory issues. They come with age and have to be quantified.
These days most middle aged people have cholesterol problems, and heart
disease is the number one killer.

We've beat this one to death so I'm not going to rehash it yet again.


There never has been any test of mental stability for civilian pilots.

Well, not directly. But if their history of prior diagnosis by another
doctor gave indications or prognoses of such, then it may be an
insurmountable hurdle. And might should be.

If what history?

Very few people go to mental health professionals unless there is a
big problem.

Then they've probably not been hospitalized or incarcerated,
and aren't a known risk. This doesn't mean unstable people don't
quietly walk among us. The problem in this category seems to be
a lack of identification. (most "terrorists" lately may actually
be psychotically disturbed folks wearing that label.) My GP knows
very little about mental health beyond a Wikipedia education.
Addressing this gap is something that could solve several problems.

So how many crazy GA pilots are crashing their airplanes per year?

Attention deficit and lack of concentration go with depression, and
cognitive rigidity. You don't have to be suicidal like that
commercial pilot that intentionally nose grounded a passenger jet.
I'm not saying it's statistically a big problem today. Substance
abuse is a mental issue, including flying intoxicated.

And the relevance to a 3rd class physical is?

The relevance to a 3rd class medical is that as per CFR Part 67.307,
it is the responsibility of the AME to assure the following, and any
individuals who failed their medicals for these reasons and didn't
crash a plane, have not been tallied. Therefore it isn't established
that the 3rd class medical is ineffective.

You mean other than the history of balloon, glider, and sport pilots which
have NO medical requirements?

No, the handful of pilots who float and fart around, don't
enter class C, and don't report squat to the FAA. Yeah, them too.
Apples, oranges, hidden data.

You seem to forget we are talking about the probability of medically
caused accidents and the same investigation happens for both people
without medicals and 3rd class holders.

And again, there is nothing special physcially about Class C airspace, or
Class B for that matter.

You do know light sport pilots can fly in both, don't you?

Mental standards for a third-class airman medical certificate a

Long, boring, and irrelevant to anything.

Sure. Drunks and psychos are fun to fly with.

A childish appeal to emotion.

Most crashes are pilot error. Most errors are mental lapses. Why?

Lots of reasons and well documented such as "Hey, guys, watch this",
get home-itis, lack of proper planning, etc.

So, then, mental.

As opposed to what, gastrointestinal?

Only if the "hey guys watch this" is "hey guys watch me crap my pants
and crash".

Then it would be gastrointestinal.

So how does one medically diagnose get home-itis?

--
Jim Pennino