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#22
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Senate and House have Approved Third-Class Medical Reform
On Saturday, July 23, 2016 at 12:31:04 AM UTC-4, wrote:
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. Off topic. Aviators need a healthy cardiac report. 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. Your entire argument here is mute, as it is predicated on the assumption that people who fly balloons, light sport, and gliders prove that 3rd class medicals are unnecessary. Captain Obvious says that we don't know what percentage of that community WOULD HAVE PASSED their 3RD class medical anyway. I'm telling you that this is a minority community, and the folks in that community who can't pass a 3rd class medical, are a minority of a minority, and the folks in that minority of a minority who end up in an *FAA report*, are a minority, of a minority, of a minority. Even with ALL THAT, you still have glider, ballonists, and light sport pilots in FAA reports due to medical reasons. 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. Irrelevant. 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. Again, fails on the logical fallacy of assumption, and false analogy. You failed to consider the second group which would have passed the 3rd class medical. 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. There is a HUGE DIFFERENCE. The 3rd class medical has professional (albeit often manipulatable) oversight by a doctor. The other group is the HONOR SYSTEM. Big difference. 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. You can' plot statistics on that which goes unreported, like, when your little balloon lands in Martha's swimming pool. Very different than a Mooney missing the threshold. And there is STILL the requirement to get a phsical, just not all the extra time, expense, and paperwork required for a 3rd class. No there isn't. Light Sport medicals, and Glider medicals aren't required at all. 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. That is perfectly acceptable. You have a strange definition of "beat the system". Oh, I'm quite familiar with how it *actually* works, when the buddy system gives a guy a break. And frankly, most the time it's justified if proven as you say. And sometimes it's favoritism. 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. Ok. So given human nature, as it is, then you advocate oversight. Also I highly doubt there are very many people that have a heart attack and then go fly. No, they go fly, then they have the heart attack. 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. I agree. 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. Ok, fine. It isn't the only health issue that needs to be checked by a doctor before you qualify for certification. It's just the most important one. Up high on the list with it are Vertigo, Senility, and Anti-Behavior tendencies. 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. That's patently false. What about all the folks who can't pass a medical? Take a thousand of them and send them off flying and look at *those* statistics. Now look at the group who didn't take a medical. A high percentage of them COULD pass. And those who couldn't and end up in an FAA report... again, are a % of a % of a %. And again, there is nothing special physcially about Class C airspace, or Class B for that matter. Well, that isn't fully correct either. There is much more interaction, squawking, and memorization with these classes (I've landed Cessnas in Jetports) and it's done at higher speeds. Way different than throwing peanuts out of a balloon, or spiraling in circles over the bluff. You can't be larking in Class B and C. You do know light sport pilots can fly in both, don't you? In limited capacity. 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. Oh, well you snipped the entire FAR requirements for mental standards and called it boring, so... I thought I'd keep it on your level. 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? Mental. -- Jim Pennino |
#23
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Senate and House have Approved Third-Class Medical Reform
On Saturday, July 23, 2016 at 6:32:38 AM UTC-4, wrote:
We've beat this one to death so I'm not going to rehash it yet again. Ok, fine. It isn't the only health issue that needs to be checked by a doctor before you qualify for certification. It's just the most important one. Up high on the list with it are Vertigo, Senility, and Anti-Behavior tendencies. Typo. Should be, Anti-Social Behavior. As in, doesn't play well with others. Or make transceivers a priority. We all know that guy. --- |
#24
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Senate and House have Approved Third-Class Medical Reform
wrote:
On Saturday, July 23, 2016 at 12:31:04 AM UTC-4, wrote: 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. Off topic. Aviators need a healthy cardiac report. Yeah, a standard report, not every test that 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. Your entire argument here is mute, as it is predicated on the assumption that people who fly balloons, light sport, and gliders prove that 3rd class medicals are unnecessary. Captain Obvious says that we don't know what percentage of that community WOULD HAVE PASSED their 3RD class medical anyway. I'm telling you that this is a minority community, and the folks in that community who can't pass a 3rd class medical, are a minority of a minority, and the folks in that minority of a minority who end up in an *FAA report*, are a minority, of a minority, of a minority. Even with ALL THAT, you still have glider, ballonists, and light sport pilots in FAA reports due to medical reasons. What happens to non-pilots is irrelevant to what happens to pilots. The big push for 3rd class reform was higly motivated by the fact that the RATE of medical incidents for light sport pilots, as well as glider and balloon pilots, with no medical is not statistically different from the RATE of medical incidents for pilots with a 3rd class medical. Do you understand the difference between rate and absolute numbers? Do you understand that the FAA investigates ALL aviation incidents irrespective of medical, certification, of even if the pilot was never certified? 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. Irrelevant. What it means is 100% detection of 100% of potential medical problems is a fantasy. 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. Again, fails on the logical fallacy of assumption, and false analogy. You failed to consider the second group which would have passed the 3rd class medical. Whether of not some group who did not take a 3rd class medical could or could not pass it is irrelevant to the accident data for pilots. The accident data is the accident data and that data shows that for PILOTS, having a 3rd class medical makes no difference in the accident rate. One could assume that with the training ALL pilots receive, most people are smart enough to not fly when they are not well. 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. There is a HUGE DIFFERENCE. The 3rd class medical has professional (albeit often manipulatable) oversight by a doctor. The other group is the HONOR SYSTEM. Big difference. Point totally missed. The physical requirements on a pilot to operate an aircarft are not different for any type of private civil aviation, except maybe acrobatics. This has NOTHING to do with doctors. 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. You can' plot statistics on that which goes unreported, like, when your little balloon lands in Martha's swimming pool. Very different than a Mooney missing the threshold. All ACCIDENTS are investigated. Your remark of "little balloon" is childish nonsense. And there is STILL the requirement to get a phsical, just not all the extra time, expense, and paperwork required for a 3rd class. No there isn't. Light Sport medicals, and Glider medicals aren't required at all. We are discussing, well, at least I am, 3rd class medical reform. And after the 3rd class medical is eliminated, there is STILL the requirement to get a phsical and document it. 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. That is perfectly acceptable. You have a strange definition of "beat the system". Oh, I'm quite familiar with how it *actually* works, when the buddy system gives a guy a break. And frankly, most the time it's justified if proven as you say. And sometimes it's favoritism. Getting signed off on the most minor of discrepancies is a major effort, getting waivered is a HUGE effort. And since getting a waiver usually takes the agreement of several private doctors as well as FAA doctors, I don't see where you are coming from with your snarky remark about "the buddy 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. Ok. So given human nature, as it is, then you advocate oversight. Yeah, every pilot should have a physical before each flight and be connected to an EKG machine during flight, all of which should be streamed in real time to the FAA. Since most people do have a survival instinct, education appears to be sufficient as has been shown by the accident history for light sport pilots/ Also I highly doubt there are very many people that have a heart attack and then go fly. No, they go fly, then they have the heart attack. If they haven't had a history, there is no teason not to. 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. I agree. 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. Ok, fine. It isn't the only health issue that needs to be checked by a doctor before you qualify for certification. It's just the most important one. Up high on the list with it are Vertigo, Senility, and Anti-Behavior tendencies. There has never been any test for Vertigo, Senility, or Anti-Behavior tendencies in the 3rd class medical. The only thing even close is the inner ear exam and basic balance test. Where do you get this stuff? 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. That's patently false. What about all the folks who can't pass a medical? They never flew in the first place so they never had an aviation accident. Take a thousand of them and send them off flying and look at *those* statistics. Now look at the group who didn't take a medical. A high percentage of them COULD pass. And those who couldn't and end up in an FAA report... again, are a % of a % of a %. Just another red herring. And again, there is nothing special physcially about Class C airspace, or Class B for that matter. Well, that isn't fully correct either. There is much more interaction, squawking, and memorization with these classes (I've landed Cessnas in Jetports) and it's done at higher speeds. Way different than throwing peanuts out of a balloon, or spiraling in circles over the bluff. You can't be larking in Class B and C. Utter nonsense and I'm beginng to doubt you are a pilot at all. The physical requirements are no different. The control forces don't magically change when you fly into controlled airspace. The approach speed for an airplane is the approach speed. Squawk codes are seldom changed in flight. You don't memorize anything, you jot it down on your kneepad. Throwing peanuts out of a balloon is illegal. Busy uncontrolled airports are much more intense than any Class C or B airport as you never know when some yahoo is going to appear out of nowhere without having bothered to announce his presense. You do know light sport pilots can fly in both, don't you? In limited capacity. Nope, no different. The ONLY diffenece is that the training for flying in Class B is part of the private curriculum while for light sport it is additional training. 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. Oh, well you snipped the entire FAR requirements for mental standards and called it boring, so... I thought I'd keep it on your level. Yes, posting in the entire FAR requirements for mental standards IS boring; a link would have been much more appropriate. 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? Mental. And the appropriate objective medical test is? -- Jim Pennino |
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Senate and House have Approved Third-Class Medical Reform
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Senate and House have Approved Third-Class Medical Reform
S N I P Ooops! LOL! Just a well. We all know you can't pass your medical. |
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Senate and House have Approved Third-Class Medical Reform
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Senate and House have Approved Third-Class Medical Reform
On Monday, July 25, 2016 at 3:07:02 PM UTC-4, Larry Dighera wrote:
The legislation specifically lists three medical areas of concern: cardiac, mental health and neurological conditions. Equally important should be diabetes, so... endocrinological. Hypoglycemia is ubiquitous, and commonly results in mass confusion and or black-outs. --- |
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Senate and House have Approved Third-Class Medical Reform
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