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Senate and House have Approved Third-Class Medical Reform



 
 
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  #11  
Old July 22nd 16, 12:51 AM posted to rec.aviation.piloting
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Posts: 58
Default Senate and House have Approved Third-Class Medical Reform

On Thursday, July 21, 2016 at 1:31:03 PM UTC-4, wrote:
wrote:
On Thursday, July 21, 2016 at 9:24:56 AM UTC-4, Vaughn Simon wrote:
On 7/20/2016 8:44 PM,
wrote:
There is no data showing having all GA pilots take a 3rd class medical
has accomplished anything.

That's the real take-away point. After doing this for (what? a half
century?) there is no data that shows that the third class physical does
anything to reduce accidents. At the same time, we have parallel
populations of pilots, glider pilots in particular, that have long
operated perfectly well without any requirement for physicals.


People who got turned down due to medical reasons, and then later
dropped dead at the grocery store, aren't statistically charted
by someone who follows their lives and makes an FAA report after
the fact. Same for mentally unstable. If they commit suicide, no
one calls the FAA about a non-pilot. In flight medical emergencies
being a small percentage anyway, would appear to be a non-issue
among a smaller population of flyers. Should that population
significantly increase, and should there be no oversight, then
logically it will become an issue.


I watched a guy in his 40's drop dead while sipping a cup of coffee
the day after an extensive physical; a physical in general is no
guarantee of much of anything, and particularly a 3rd class physical.


Then maybe under the new rules there should be a few *specific*
tests relevant to piloting. The first one being a "plaque test",
and then a focus on possible hypertension.

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.

A lot of peiple are missing the point that you do still need to take
a physical, just not one with the FAA paperwork burden in front of an AME.


To tell you the truth, I'd rather go before an AME than a non-pilot
GP who's lack of familiarity with the experience would cause them to
flag non-issues off the "top of their head".

---

Mark



--
Jim Pennino


Ads
  #12  
Old July 22nd 16, 01:21 AM posted to rec.aviation.piloting
Vaughn Simon[_2_]
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Posts: 58
Default Senate and House have Approved Third-Class Medical Reform

On 7/21/2016 6:51 PM, Larry Dighera wrote:
On Thu, 21 Jul 2016 16:53:38 -0400, Vaughn Simon wrote:

On 7/21/2016 3:49 PM, Larry Dighera wrote:
Here's a case in point:

http://www.ntsb.gov/_layouts/ntsb.av...6-17b4751406da
National Transportation Safety Board Washington, DC 20594

OK, but what exactly IS your point?

Jim caught it. :-)


That pilot apparently had a valid medical certificate, which did NOTHING
to prevent the accident, because a cursory one-time physical exam simply
has little chance of predicting a sudden incapacitation event.

See. You got it too.


Excuse my confusion here, but weren't you the person who wrote:
"Personally, I thought the medical requirements were prudent and
acceptable, but then I'm healthy."???

You said "prudent and acceptable", I say ineffective, unacceptable, and
in some cases, actually counterproductive.

Vaughn
  #13  
Old July 22nd 16, 02:11 AM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 2,872
Default Senate and House have Approved Third-Class Medical Reform

wrote:
On Thursday, July 21, 2016 at 1:31:03 PM UTC-4, wrote:
wrote:
On Thursday, July 21, 2016 at 9:24:56 AM UTC-4, Vaughn Simon wrote:
On 7/20/2016 8:44 PM,
wrote:
There is no data showing having all GA pilots take a 3rd class medical
has accomplished anything.

That's the real take-away point. After doing this for (what? a half
century?) there is no data that shows that the third class physical does
anything to reduce accidents. At the same time, we have parallel
populations of pilots, glider pilots in particular, that have long
operated perfectly well without any requirement for physicals.

People who got turned down due to medical reasons, and then later
dropped dead at the grocery store, aren't statistically charted
by someone who follows their lives and makes an FAA report after
the fact. Same for mentally unstable. If they commit suicide, no
one calls the FAA about a non-pilot. In flight medical emergencies
being a small percentage anyway, would appear to be a non-issue
among a smaller population of flyers. Should that population
significantly increase, and should there be no oversight, then
logically it will become an issue.


I watched a guy in his 40's drop dead while sipping a cup of coffee
the day after an extensive physical; a physical in general is no
guarantee of much of anything, and particularly a 3rd class physical.


Then maybe under the new rules there should be a few *specific*
tests relevant to piloting. The first one being a "plaque test",
and then a focus on possible hypertension.


And the other 5 to 10 things that could cause one to keel over with
little to no previous symptoms?

Perhaps semi-annual MRI's and CT scans at about $4,000 a pop just to be
sure.

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.

A lot of peiple are missing the point that you do still need to take
a physical, just not one with the FAA paperwork burden in front of an AME.


To tell you the truth, I'd rather go before an AME than a non-pilot
GP who's lack of familiarity with the experience would cause them to
flag non-issues off the "top of their head".


1) The 3rd class physical is a joke and less extensive than the normal
physical my docotor gives.

2) There is a checklist of items for your doctor to check, it is just
not forwarded to the FAA.


--
Jim Pennino
  #14  
Old July 22nd 16, 02:35 PM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 58
Default Senate and House have Approved Third-Class Medical Reform

On Thursday, July 21, 2016 at 9:16:03 PM UTC-4, wrote:
wrote:
On Thursday, July 21, 2016 at 1:31:03 PM UTC-4, wrote:
wrote:
On Thursday, July 21, 2016 at 9:24:56 AM UTC-4, Vaughn Simon wrote:
On 7/20/2016 8:44 PM,
wrote:
There is no data showing having all GA pilots take a 3rd class medical
has accomplished anything.

That's the real take-away point. After doing this for (what? a half
century?) there is no data that shows that the third class physical does
anything to reduce accidents. At the same time, we have parallel
populations of pilots, glider pilots in particular, that have long
operated perfectly well without any requirement for physicals.

People who got turned down due to medical reasons, and then later
dropped dead at the grocery store, aren't statistically charted
by someone who follows their lives and makes an FAA report after
the fact. Same for mentally unstable. If they commit suicide, no
one calls the FAA about a non-pilot. In flight medical emergencies
being a small percentage anyway, would appear to be a non-issue
among a smaller population of flyers. Should that population
significantly increase, and should there be no oversight, then
logically it will become an issue.

I watched a guy in his 40's drop dead while sipping a cup of coffee
the day after an extensive physical; a physical in general is no
guarantee of much of anything, and particularly a 3rd class physical.


Then maybe under the new rules there should be a few *specific*
tests relevant to piloting. The first one being a "plaque test",
and then a focus on possible hypertension.


And the other 5 to 10 things that could cause one to keel over with
little to no previous symptoms?

Perhaps semi-annual MRI's and CT scans at about $4,000 a pop just to be
sure.


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.

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.

A lot of peiple are missing the point that you do still need to take
a physical, just not one with the FAA paperwork burden in front of an AME.


To tell you the truth, I'd rather go before an AME than a non-pilot
GP who's lack of familiarity with the experience would cause them to
flag non-issues off the "top of their head".


1) The 3rd class physical is a joke and less extensive than the normal
physical my docotor gives.


Ok.

2) There is a checklist of items for your doctor to check, it is just
not forwarded to the FAA.


A good doctor is hard to find.

I'm in favor of expediting the screening process, and making it
easier for me to fly.

This fellow seems to think it won't:

"This reform bill is going to be more trouble than it is worth. Think about it - you still have to see a doctor every four years. I can assure you that their physical will be a lot more intense - blood work, EKG - the works. Second, you still have to do something to qualify - take an online training class every two years. I'll bet it will take a lot longer than the 30 to 45 minutes that a Third Class Medical takes. What happened to being medically fit if you have a driver's license? This entire thing is a joke and politically driven by the AOPA and the EAA. Additionally, they could not get the original bill passed on its own so they had to follow the Pork process and stuff into another bill. This entire thing was written in such a way to appease the FAA and ALPA. It does not benefit the GA Private Pilot. You can be assured that if the doctor, who most likely has never done an FAA medical, is not happy with his findings, he or she will not sign you off. You are in no better shape. Remember you do not need a physical to drive a car!!"

---


--
Jim Pennino


  #15  
Old July 22nd 16, 05:37 PM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 2,872
Default Senate and House have Approved Third-Class Medical Reform

wrote:
On Thursday, July 21, 2016 at 9:16:03 PM UTC-4, wrote:
wrote:
On Thursday, July 21, 2016 at 1:31:03 PM UTC-4, wrote:
wrote:
On Thursday, July 21, 2016 at 9:24:56 AM UTC-4, Vaughn Simon wrote:
On 7/20/2016 8:44 PM,
wrote:
There is no data showing having all GA pilots take a 3rd class medical
has accomplished anything.

That's the real take-away point. After doing this for (what? a half
century?) there is no data that shows that the third class physical does
anything to reduce accidents. At the same time, we have parallel
populations of pilots, glider pilots in particular, that have long
operated perfectly well without any requirement for physicals.

People who got turned down due to medical reasons, and then later
dropped dead at the grocery store, aren't statistically charted
by someone who follows their lives and makes an FAA report after
the fact. Same for mentally unstable. If they commit suicide, no
one calls the FAA about a non-pilot. In flight medical emergencies
being a small percentage anyway, would appear to be a non-issue
among a smaller population of flyers. Should that population
significantly increase, and should there be no oversight, then
logically it will become an issue.

I watched a guy in his 40's drop dead while sipping a cup of coffee
the day after an extensive physical; a physical in general is no
guarantee of much of anything, and particularly a 3rd class physical.

Then maybe under the new rules there should be a few *specific*
tests relevant to piloting. The first one being a "plaque test",
and then a focus on possible hypertension.


And the other 5 to 10 things that could cause one to keel over with
little to no previous symptoms?

Perhaps semi-annual MRI's and CT scans at about $4,000 a pop just to be
sure.


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?

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?

A lot of peiple are missing the point that you do still need to take
a physical, just not one with the FAA paperwork burden in front of an AME.

To tell you the truth, I'd rather go before an AME than a non-pilot
GP who's lack of familiarity with the experience would cause them to
flag non-issues off the "top of their head".


1) The 3rd class physical is a joke and less extensive than the normal
physical my docotor gives.


Ok.

2) There is a checklist of items for your doctor to check, it is just
not forwarded to the FAA.


A good doctor is hard to find.

I'm in favor of expediting the screening process, and making it
easier for me to fly.

This fellow seems to think it won't:

"This reform bill is going to be more trouble than it is worth. Think
about it - you still have to see a doctor every four years. I can
assure you that their physical will be a lot more intense - blood work,
EKG - the works.


My doctor already does all this; if you are over 40 any decent doctor
should.

Second, you still have to do something to qualify - take an online
training class every two years. I'll bet it will take a lot longer
than the 30 to 45 minutes that a Third Class Medical takes.


Something that can be done at any time including the middle of the night
on a weekend, and it is free.

What happened to being medically fit if you have a driver's license?


You have to be able to see and hear; flying doesn't require much more.

This entire thing is a joke and politically driven by the AOPA and
the EAA. Additionally, they could not get the original bill passed
on its own so they had to follow the Pork process and stuff into
another bill. This entire thing was written in such a way to
appease the FAA and ALPA. It does not benefit the GA Private Pilot.
You can be assured that if the doctor, who most likely has never
done an FAA medical, is not happy with his findings, he or she
will not sign you off. You are in no better shape. Remember you
do not need a physical to drive a car!!"


Sounds like an AME who is about to lose his 3rd class gravey train.

I explained what happens in a 3rd class to my doctor and how much it
costs. He shook his head and asked how to get in on this.


--
Jim Pennino
  #16  
Old July 22nd 16, 09:24 PM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 58
Default Senate and House have Approved Third-Class Medical Reform

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.

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.

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.


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.

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

---
  #17  
Old July 22nd 16, 09:54 PM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 2,872
Default Senate and House have Approved Third-Class Medical Reform

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.

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.

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.

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

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.

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?

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.


--
Jim Pennino
  #18  
Old July 23rd 16, 02:06 AM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 58
Default Senate and House have Approved Third-Class Medical Reform

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.

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.

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.

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.

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.

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.

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.

Mental standards for a third-class airman medical certificate a

(a) No established medical history or clinical diagnosis of any of the following:

(1) A personality disorder that is severe enough to have repeatedly manifested itself by overt acts.

(2) A psychosis. As used in this section, “psychosis” refers to a mental disorder in which—

(i) The individual has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition; or

(ii) The individual may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition.

(3) A bipolar disorder.

(4) Substance dependence, except where there is established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section—

(i) “Substance” includes: alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and

(ii) “Substance dependence” means a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by—

(A) Increased tolerance;

(B) Manifestation of withdrawal symptoms;

(C) Impaired control of use; or

(D) Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.

(b) No substance abuse within the preceding 2 years defined as:

(1) Use of a substance in a situation in which that use was physically hazardous, if there has been at any other time an instance of the use of a substance also in a situation in which that use was physically hazardous;

(2) A verified positive drug test result, an alcohol test result of 0.04 or greater alcohol concentration, or a refusal to submit to a drug or alcohol test required by the U.S. Department of Transportation or an agency of the U.S. Department of Transportation; or

(3) Misuse of a substance that the Federal Air Surgeon, based on case history and appropriate, qualified medical judgment relating to the substance involved, finds—

(i) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

(ii) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

(c) No other personality disorder, neurosis, or other mental condition that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.


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.

---


--
Jim Pennino


  #19  
Old July 23rd 16, 03:00 AM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 2,872
Default Senate and House have Approved Third-Class Medical Reform

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.

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?

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.

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.

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.

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

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.


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?

Mental standards for a third-class airman medical certificate a


Long, boring, and irrelevant to anything.

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?



--
Jim Pennino
  #20  
Old July 23rd 16, 04:31 AM posted to rec.aviation.piloting
[email protected]
external usenet poster
 
Posts: 58
Default Senate and House have Approved Third-Class Medical Reform

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.

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.

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?


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.

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?

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?"

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.

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.


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.


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.

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.

---


--
Jim Pennino


 




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