Director of Aviation Medicine resigns

[kaz3g]

Dr Pooshan Navathe has announced his resignation as CASA's head of aviation medicine.

 

A lot of pilots will be relieved and hope this bodes well for a more reasonably inclined future appointee under the new DAS .

 

In the last few years CASA has tried it implement a strict ICAO regime, effectively turning back the clock on issues such as colour vision defectiveness and age of retirement where changes were brought about by legal action in Australia.

 

The link below is informative.

 

http://proaviation.com.au/2014/02/23/dr-liddell-speaks-out-for-australian-pilots/

 

Kaz

 

 

[facthunter]

I hope funds are available to encourage people of the right level of qualification to apply for this position in the future. Then we might get somewhere. What a waste of time the last five years or so have been. Nev

 

 

[old man emu]

It seems to me that Dr Navathe exhibited a common failure of non-Western peoples, which is the inability to apply Discretion. To them, the Rule is the Rule and must never be questioned.

 

I'm at the other end of the scale of pilots that Dr Liddell refers to. I want to be able to fly "on occasion". You can appreciate my delight when CASA introduced the Class 3 Medical a short while ago. Basically, if a pilot was medically fit enough to drive a motor vehicle, he/she was fit enough to fly an airplane (albeit with not too onerous restriction).

 

I recently had to undergo a Heavy Vehicle Driver's medical, during which the doctor found that I had a slight heart murmur. I was examined by a cardiologist, and after a Stress Test, was passed as OK. The stupid thing is that my CASA licence is suspended pending a Class 2 medical, BUT

 

1. I am considered medically sound enough to drive a road train up

 

2. I am considered medically sound enough to fly an RAA registered airplane over provided I remain clear of any CTAs.

 

3. I cannot lift the suspension on my CASA licence until I am examined by a DAME, to whom I will give a copy of the cardiologist's report, plus copies of the ECG records.

 

The DAME ( being of Western origin) will no doubt forward this information onto CASA Medicals, who will clip my wings.

 

If you have ever done one of these Stress Test you will know that they stick a lot of electrodes to you chest to obtain the data they need. My test showed that I have an "inverted T-wave at lead 3". According to this article : http://content.onlinejacc.org/article.aspx?articleid=1119521 from the American College of Cardiologists, " Isolated T wave inversion in asymptomatic adults is usually a normal variant. "

 

I wonder if CASA's Medical section would accept that, and apply discretion, or if they will be automatons and stick to the rule that any ECG change is a failure?

 

Old Man Emu

 

 

[motzartmerv]

Maybe they might start taking accepting the recommendations of some of the countries leading specialists over that of the GP who asses the reports.

 

I was sitting at the desk recently with one a professor in cardilology from RPA, when he read a letter from the GP at CASA that they were not letting a young lady fly due to some minor heart thing that the professor had tested and reported on as being "no issue".

 

He was...very disappointed (to say the least) that his recommendations had been over turned by a GP.lol..

 

ps, apparently professors in cardiology swear aswel:)

 

 

[Chird65]

...a professor in cardilology from RPA, when he read a letter from the GP at CASA that they were not letting a young lady fly due to some minor heart thing that the professor had tested and reported on as being "no issue"....

I still have to wonder why the AMA do not stamp on this type of behaviour from Non Specialist Doctors, when a specialist has made a diagnosis?

 

 

[peter]

How are you defining "specialist"? A specialist cardiologist may know very little about aviation and be less informed than a GP who has a specific interest in aviation. I work as an expedition medical officer and have at times had to listen to "specialist" opinions that have been given with little or no understanding of the environment I work in.

 

Do not take this to mean I support the current CASA medical policies. I have seen many examples of what I would consider bizarre decisions. I feel the whole system needs to be overhauled as it does not take into account modern research. There are so many anomalies it is laughable. For example how anybody could believe that someone with early prostate cancer is at increased risk of sudden incapacitation is mind boggling.

 

I sincerely hope that the system moves to one which is based on actual rather than perceived (by who?) risk, but I'm sure not holding my breath waiting!

 

Peter

 

 

[rhysmcc]

Just to clarify, the AvMed (aviation medical based on the Heavy drivers license) is not the same as the Class 3 Medical. The Class 3 is similar to a Class 2 Medical, however is only valid for 2 years and is required by Air Traffic Controllers.

 

I don't see why a head of medical should be required. They have a DAME system and should rely on that.

 

 

[facthunter]

You need a review process available or the decision be comes conservative. Dame's won't risk litigation. Some might be very easy but they get into strife (Hempel case) and then we are all worse off. Medicine is certainly NOT black or white only when it relates to safety. The more is known about someone's condition the better the decision(s) made. Nev

 

 

[rhysmcc]

I've seen a few medicals this year which have resulted in restrictions/suspensions on the medical even though the specialist have given a clean bill of health. Such specialist were even upset that their time is being wasted doing these tests which are not required (in their opinion)

 

 

[facthunter]

They still get paid. The pilot may lose his job or have to sell his aircraft, and is therefore really affected. Liddell did an excellent job in the past. It can be done again. Nev

 

 

[rhysmcc]

Indeed, but it generally means someone else misses out on the appointment. Most specialists have a decent sized waiting list. In these cases it was a waste of resources and in the end CASA Medical overruled the tests anyway.

 

 

[facthunter]

I'm with you but it is the pilot being most affected. The current system is broke. These people don't have the knowledge to over-rule those who are expert in their respective field. There's no justice to the people adversely affected at all and no redress, at the moment. Totally unsatisfactory. Another nail in the aviation coffin. Nev

 

 

[dazza 38]

I take it by going by the name that Dr Pooshan Navathe was Indian ?

 

 

[Guest Andys@coffs]

How are you defining "specialist"? A specialist cardiologist may know very little about aviation and be less informed than a GP who has a specific interest in aviation. I work as an expedition medical officer and have at times had to listen to "specialist" opinions that have been given with little or no understanding of the environment I work in.Do not take this to mean I support the current CASA medical policies. I have seen many examples of what I would consider bizarre decisions. I feel the whole system needs to be overhauled as it does not take into account modern research. There are so many anomalies it is laughable. For example how anybody could believe that someone with early prostate cancer is at increased risk of sudden incapacitation is mind boggling.

I sincerely hope that the system moves to one which is based on actual rather than perceived (by who?) risk, but I'm sure not holding my breath waiting!

 

Peter

My Cousin is in the ADF specifically Army and is a GP. As part of his defence training he undertook a stint at AvMed section at RAAF Based Edinburgh in SA. I believe that it was about 6 months or so and can remember him telling me that there are a number of aviation unique things he had to learn.... So ADF medico's go through AvMed, where do DAME's do their aviation training?

 

Andy

 

 

[rhysmcc]

when you say go through AvMed, i'm assuming you mean Aviation Medicine, rather then the division in CASA? CASA does not oversea ADF licensing or medical.

 

From all hoops pilots and ATC have to jump through to get a medical and licence, i'm sure the DAME's have a strict certification process as well

 

 

[old man emu]

. Some might be very easy but they get into strife (Hempel case) and then we are all worse off. Nev

That's a valid comment, but a side issue to my point.

 

My point is this - if the data which are obtained are the results of accepted procedures and suitably calibrated instrumentation, then they indicate the same thing to a specialist in the particular field, the general practitioner, or the informed layman. ECG data are not something that are open to widely diverse (subjective) interpretation.

 

On the point of a GP over-riding a specialist, why then would a GP refer a patient to a specialist if the GP was going to ignore the results of the specialist's examinations?

 

Old Man Emu

 

[Gee it's hard to correctly match the plural word 'data' with the plural form of the associated verb, or when using a pronoun, without making the sentence sound wrong!]

 

 

[peter]

You may refer a patient for an opinion on one but not all aspects of their care. You can have any number of LAME's who specialise in specific systems tell a pilot that the plane is safe to fly but who should make the final decision that pulls all the combined opinions together? The pilot.

 

Cardiologists may understand the heart, but do they understand heart function in a rarefied atmosphere at altitude and how that may interact with say, a respiratory problem.Some will, some won't. The aviation qualified medico "should" be bringing all the opinions together and evaluating them in an aviation context. They should be the aviation "specialists". From my perspective the problem is not with the rationale behind who has the final say but rather the actual implementation by the current decision makers.

 

Peter

 

 

[rhysmcc]

That person should be the DAME, not someone behind a desk at CASA

 

 

[DonRamsay]

This resignation could not have been one day too soon. Choke riddance. Hopefully this is the beginning of a clean out of the deadwood from CASA. McCormick was. Good start and this one is very welcome. He completely defeated the concept of a Drivers Licence medical and made it more expensive and onerous than a Class 2. Long may be rot in obscurity.

 

Anyone like to know how deep down I really feel about Av Med?

 

 

[coljones]

That person should be the DAME, not someone behind a desk at CASA

for most DAMEs it appears to be a, very, part time job. I am not betting on the AVMED people but AVMED is their full time day job and they have opinions which should be respected as much as those of narrow Specialists or broad based GPs.

 

 

[old man emu]

Cardiologists may understand the heart, but do they understand heart function in a rarefied atmosphere at altitude and how that may interact with say, a respiratory problem.

Peter

Oh come on! Get real!

 

"rarefied atmosphere" All I wanted to do was potter around in a basic two-seater, below 10,000 in Day VMC.

 

OME

 

 

[old man emu]

I wonder what would happen if someone referred a CASA doctor's decision to the Administrative Appeals Tribunal.

 

OME

 

 

[Camel]

This resignation could not have been one day too soon. Choke riddance. Hopefully this is the beginning of a clean out of the deadwood from CASA. McCormick was. Good start and this one is very welcome. He completely defeated the concept of a Drivers Licence medical and made it more expensive and onerous than a Class 2. Long may be rot in obscurity.Anyone like to know how deep down I really feel about Av Med?

Yes I would like to know what you think of the STUPID people CASA has bullying and screwing the public, I think they should throw a few more out of CASA, like a few hundred more !

 

 

[rhysmcc]

for most DAMEs it appears to be a, very, part time job. I am not betting on the AVMED people but AVMED is their full time day job and they have opinions which should be respected as much as those of narrow Specialists or broad based GPs.

Yet they see zero patients a year and your happy to call them experts in the field? No your DAME is the person in the best position to determine your health and fitness. If they aren't up to the task then they shouldn't have been given the qualification. Too many examples recently of both the DAME and referred specialist both saying the results are okay, only to be overturned by 'someone' at CASA who can't give you any details or let alone actually examine you.

 

 

[dazza 38]

This resignation could not have been one day too soon. Choke riddance. Hopefully this is the beginning of a clean out of the deadwood from CASA. McCormick was. Good start and this one is very welcome. He completely defeated the concept of a Drivers Licence medical and made it more expensive and onerous than a Class 2. Long may be rot in obscurity.Anyone like to know how deep down I really feel about Av Med?

It is interesting that old mate resigns not long after Skid is announced as the new CASA boss. Coincidence ?