AOPA calls on CASA for private pilot medical reform

[Icarus]

Like this?

 

My recommendation is to support the AOPA proposal which is closely aligned with the UK CAA medical rule brought in last August. Basically you make a declaration ONCE before age 70 that you are not restricted from driving ordinary private motor vehicle and every three years thereafter. The onus on you is to report if and when you would be unable to make this declaration at any time

[Super Cub]

OK I'm about to post mine. I've done my bit. It is up to you people to make a pile of paper on the Minister's desk and jam CASA Avmed's inbox with comments.How many will bother. If you don't you cease to have bitching rights about CASA Avmed screwing you over.

Totally agree Mike.

 

If pilots cant be bothered printing the letter out and mailing it, you have no right bitching on the subject in a couple of years when you lose your Class 2.

 

I don't know if it will change things but at least I did my bit.

 

I posted to one Casa and one to The Hon Darren Chester MP, Minister for Infrastructure and Transport, today.

 

I hate this ridiculous bureaucracy by civil servants who have no idea about flying, or aviation.

 

 

[Yenn]

I doubt your letter to Darren Chester will do any good. My wxperience is that he will not even acknowledge receipt, let alone read it.

 

 

[Super Cub]

I doubt your letter to Darren Chester will do any good. My wxperience is that he will not even acknowledge receipt, let alone read it.

Quite so.

 

Should I have attached a brown envelope to the front of the letter?

 

Lets hope the letter (along with a letter from every other pilot in Australia) to casa, does some good.

 

Even Class1 medical holders should be writing in now.

 

Perhaps they may want to fly privately when they retire, but by then, they may not be able to get a Class 2.

 

Some people have no foresight. Its all about their situation now, rather than how it may affect them in a few years time.

 

 

[craigL]

I've just re-read the report mentioned in the OPs letter - UK CAA CAP 1397 APR16And to be honest I still think my point is valid - and please don't think I'm saying this because I'm super fit and pass a class 2 with ease....I don't...my class 2 picked up hypertension a few weeks ago which has meant a long list of further testing that's still not over, but has this stopped a potential ticking time bomb of a pilot from flying...absolutely...did I know I was a ticking time bomb before the medical...no way.

 

...

 

.

I passed the Class 2 AVMED and during the examination the DAME told me that the average or typical systolic blood pressure for a 50 year walking in off the street is 150. He might have been exaggerating a bit, but there is an overall trending increase with age. People also frequently have an increase of10 points or more just due to entering a DAME's practice. So it's a good idea to record your blood pressure at home for a month or two before going in and show the record to the DAME. Also, if it's high, see a GP well beforehand so you can get it medicated before the DAME examination, otherwise you'll only be starting treatment at that point and it will greatly delay the process.

 

I had to go through this because there were no local RAAus trainers and GA was the only option. Now moving to Brisbane where there are plenty of RAAus trainers, I'm sure if I'll do it again unless CASA can show some concrete empirical data justifying the need.

 

There is a general problem in Australia of far too much bureaucracy and emphasis upon regulation and compliance. At the same time in CASA's case, reductions of staff mean increasing regulations with less people to implement them and it feels like the whole system is in danger of grinding to a halt. The greater problem is that bureaucracy becomes an end in itself - bureaucrats achieve success by having more junior bureaucrats under them, which is achieved by increasing rules and regulations that need more people to refine and implement them. If the regulations increase but the staff do not, then everything slows down and the life gets sucked out of us.

 

This is really endemic in our culture these days. We need to return to a culture where people take responsibility for their own behaviour and can choose their levels of risk based upon good information. Bureaucracy is about control and limiting our freedoms, including our choices of risks that we accept or not. CASA should focus on information and minimise regulation.

 

 

[facthunter]

RAAus should be active in this area. Are they doing anything? The rest of the world are ahead of us now, where once we were leading the pack. When a certain person became CEO of CASA I predicted a change for the worse. We got it. Nev

 

 

[aplund]

I passed the Class 2 AVMED and during the examination the DAME told me that the average or typical systolic blood pressure for a 50 year walking in off the street is 150. He might have been exaggerating a bit, but there is an overall trending increase with age. People also frequently have an increase of10 points or more just due to entering a DAME's practice. So it's a good idea to record your blood pressure at home for a month or two before going in and show the record to the DAME. Also, if it's high, see a GP well beforehand so you can get it medicated before the DAME examination, otherwise you'll only be starting treatment at that point and it will greatly delay the process.

In terms of the Class 2, it is unclear to me why a DAME is in a better position to fill in these forms than your regular GP. The whole medical profession is based on reputation and competency. The new US basic medical which gets your regular family doctor to oversee the tests seems to be a bloody good idea to me.

 

In my case, I had a condition in 2012 which I brought up with the DAME when I first had the medical done. He listed it on the form (as he should have), but didn't have the full information so I had to go to my GP to get a few pages printed out. AVMED granted me the Class 2 medical but only for 12 months. I have to get a medical done every year even though I have my GP and specialists giving me written evidence with pathology that I am remiss of my condition and that it is unlikely to return. This now annual class 2 medical exaimation was decided by someone at CASA who is 3 steps removed from the process. When I rang AVMED, they could not give me any advice as to when the audit requirement will be lifted.

 

The issue I have with this is that I cannot see any tangible benefit from getting me to do a complete class 2 medical with all of the tests unrelated to the condition which has not affected me for years. If it really did return, it would be because I declare something to the DAME. Which, when you think about it, is really pretty silly as it gives one an incentive _not_ to declare a full medical history.

 

 

[facthunter]

Yes it is counter intuitive. They have no reason to hurry up with a determination entailing some degree of risk so they delay, covering their Ar$e, as public servants often do. Nev

 

 

[djpacro]

Unfortunately there is a new electronic system.

Have you ever? seen a doctor, had an x-ray, osteopath

 

questions about your family members too

 

"answer them to the best of your ability including everything , even if you broke your leg when you were 7 years old"

[aplund]

Unfortunately there is a new electronic system.[ATTACH]49570[/ATTACH]

Have you ever? seen a doctor, had an x-ray, osteopath

 

questions about your family members too

 

"answer them to the best of your ability including everything , even if you broke your leg when you were 7 years old"

That's pretty much crazy. Particularly when you consider that this is _not_ your regular family doctor (if you have one of those) doing this. Good luck with this system detecting pathological liars.

 

I had a chest X-ray checking for TB 15 years ago which was negative (there was an international student at uni who tested positive). I'm meant to report this? What purpose does it serve? What about dental x-rays? I've had a bucket load of them.

 

[Jaba-who]

Unfortunately there is a new electronic system.[ATTACH]49570[/ATTACH]

Have you ever? seen a doctor, had an x-ray, osteopath

 

questions about your family members too

 

"answer them to the best of your ability including everything , even if you broke your leg when you were 7 years old"

 

I can see lots of people will have dodgy memories of what illnesses they have ever had.

 

I can see the standard approach will be - don't put down anything that could be incriminating then only if somehow it gets found out - then response will be " Oh yes! I forgot about that! It happened so long ago. Sorry"

 

Hardly an ideal way to approach it but as we all know a system which included such faulty memory medicals will be no less safe than one where a drivers licence medical applies.

 

 

[facthunter]

Don't tell them you fell asleep once in the afternoon watching the TV. You THEN have sleep apnea. Nev

 

 

[Jaba-who]

Don't tell them you fell asleep once in the afternoon watching the TV. You THEN have sleep apnea. Nev

A couple of medicals ago this question and a bunch of others relating to sleep patterns appeared.

This recent medical ( class 2) I did the sleep questions seemed to have disappeared. They were not in the on line section and I assumed they would emerge in the extra questions the DAME would ask. But they didn't get asked.

 

Don't know if he just assumed I'd answer 'correctly' so didn't ask or if they've truly been dropped.

 

 

[Icarus]

A few snippets from the discussion paper of interest:.......[bold is from the discussion paper]

 

The implementation of the ‘accredited medical conclusion’ in this sector as cited in the ICAO manual is not defined. This may be appropriate given the different risks involved in this sector, as reflected in the current licensing and administrative arrangements that apply. However, CASA has received approaches from the recreational sector to allow pilots to have greater access to controlled airspace and to increase the maximum take-off weight of aircraft able to be operated in that sector to 1500 kg maximum take-off weight. CASA is considering these proposals but may also need to weigh up the aeromedical consequences of such an expansion and its possible consequences for other airspace users and third parties not associated with the operation of the aircraft

 

There is inconsistency between the different approaches to medical certification in Australia. Both the medical standards and the flying privileges are different. For example, pilots who are refused a class 2 medical certificate often still fly RA-Aus registered aircraft. There have been several recent medically related fatalities in the latter group. The processes in place in this sector that follow the reporting of a safety-relevant condition to a doctor may need further clarification. The ICAO manual of aviation medicine describes what should happen in these circumstances, as follows:

 

Does anybody know of the incidents cited above?

 

CASA will like this one:

 

In the USA, the US Aircraft Owners and Pilots Association has argued that:

 

An equivalent level of safety regarding aeromedical factors exists between those operations that currently require a medical certificate and those operations that do not currently require a medical certificate (sport aviation).

 

 There is an extremely low incidence of medically related accidents across both factions, supporting the conclusion that a medical certificate may not always be required in order to maintain a lower incidence of medically related aviation accidents.

 

 Seven years of statistical evidence to support the petition with an AOPA Air Safety Institute study of light sport aircraft accidents from 2004–2011 claiming there have been no accidents attributable to pilot medical deficiency.

 

The US Aerospace Medical Association has contested this claim advising the FAA that data was extracted for 1084 individuals involved in fatal accidents from January 2011 to April 2014. Subjects included 68 sport pilots flying legally without a medical certificate and 403 pilots flying with an FAA Third class medical certificate. Moderate to severe medical hazards identified by autopsy were found in 25% of medically certified pilots but in 60% of uncertified pilots.3

 

One would then have to ask , did the medical conditions cause the accidents ,or were merely present as would be expected from a lower class medical?

 

The UK changes were supported by statistical analysis of relevant medical risks correlated to the age distribution spread of PPL holders to determine the probability of an inflight incapacitation. The assessment assumed an average of 30 hours flight per pilot annually. The UK assessment bases many of its assertions on a premise which supports the outcome, namely, the assumption that people who feel unwell will not fly. The probability of an incapacitating medical event occurring during the stress of aviation is equal to the probability it will occur during any other activity including sleeping, and the assumption of 30 hours flying per year as the average flying rate of a PPL holder.

 

The risk assessment also identifies a very low accident rate attributed to medical incapacitation however this accident rate occurs within an environment where more stringent entry control medical conditions are in effect.

 

More courses /exams anyone?

 

Pilot training and education

 

Relaxation of the existing requirements will rely more heavily on the integrity and professionalism of the pilot ensuring that they are medically fit for the planned activity.

 

Deregulation of medical certification requirements for the general and sport/recreational aviation sectors may need to be supported by extensive pilot education and training. As the UK position is the most liberal amongst the jurisdictions, pilot education would seem to be a requirement to support such a system; however, it is not mandated as such. In the USA, the proposal is for pilots to undertake an online, free of charge, FAA developed medical education course within the two years prior to application. As part of the successful completion of the course, a declaration is required by the pilot certifying compliance to the medical requirement.

 

 

Can anybody confirm how these numbers were calculated.

 

Advice from the industry is that there have been only 3–4 cases of medical incapacitation in over 450,000 landings by RA-Aus members, although it is not clear on what basis this claim is made

 

 

If the AOPA want to push this through , they better have some good arguments and numbers. they better have all their ducks in a row because it looks like CASA has done their homework . I don't think the argument " the UK has done it " will wash with CASA here.

 

They seem to think the UK research was designed to fit the desired outcome.

 

I support the Uk or NZ model , simply because there is no evidence to say there is more accidents per anything ,with a drivers equivalent self certifiying model.

 

CASA will probably argue that under reporting is the reason , although they do state that RAA reporting has increased 10 fold recently, So maybe they are starting to trust RAA and RAA pilots more!!!!!!!!!!!!! did I just type that!?

 

Flame resistant overalls are on.

 

 

[dsam]

RA-Aus members can now log in to our website and download the official RA-Aus response to CASA regarding pilot medical standards.

 

Their response to CASA is well researched, and quite forthright, with references to numerous studies, citing statistical evidence both here and abroad. They strongly refute misleading inaccuracies made in the CASA discussion paper, and draw attention to the conflict of interest that CASA has in certain respects.

 

I recommend RA-Aus members have a good look at this response to CASA on their behalf. I think RA-Aus have done a good job supporting and representing members interests against the regulator. The more motivated members among us should still write to our local member, as well as The Hon Darren Chester MP, Minister for Infrastructure and Transport, and voice our individual support for our organisation's response to the regulator. It may not help, but it can't hurt either...

 

 

[dutchroll]

Hopefully it won't be too long before I, as an ATPL holder flying high capacity jet transports, can self-certify my medical category and do away with the CASA medical too.

 

Our risk is quantifiably less as we fly with two equally qualified pilots at the controls, as well as statistically flying thousands more hours per year without incapacitation events. There's not been an accident in high capacity air transport where pilot medical incapacitation (excluding hypoxia due to pilot error) was a suspected factor for at least 40 years as far as I know.

 

You would all fully support this position of course, as it is based on the same argument used by AOPA and RA-Aus to reduce the medical certification burden on private pilots.

 

 

 

[Jaba-who]

Hopefully it won't be too long before I, as an ATPL holder flying high capacity jet transports, can self-certify my medical category and do away with the CASA medical too.Our risk is quantifiably less as we fly with two equally qualified pilots at the controls, as well as statistically flying thousands more hours per year without incapacitation events. There's not been an accident in high capacity air transport where pilot medical incapacitation (excluding hypoxia due to pilot error) was a suspected factor for at least 40 years as far as I know.

 

You would all fully support this position of course, as it is based on the same argument used by AOPA and RA-Aus to reduce the medical certification burden on private pilots.

 

I would.

For exactly the reasons you quoted.

 

Humans are very good at jumping to emotive conclusions about many things - because it just feels like it should be done that way and/or because that's the way we have always done it. That doesn't make it logically or factually correct.

 

I might be drawn to some form of medical on single pilot ops carrying passengers in less sophisticated aircraft. But even probably less stringent then we have.

 

But of course there is the issue that commercial pilots are far more likely to keep flying if they develop an illness (and hide it) because of the income requirement. There probably needs to be some net to catch that phenomenon.

 

 

[rrogerramjet]

All this seems to be is preposition CASA to claim that no change is required to the current methodology, indeed possibly to raise the bar for RA and RPL.

 

As an open minded discussion paper it seems to be unequivocally telegraphing CASA bias towards greater regulations in many statements.

 

I have only just begun to read the paper (2 days after submissions closed...bugger) but, besides at least another year or two of review, I can't envisage many/any changes coming.

 

Indeed I am increasingly of the belief that CASAs catchphrase of 'Safe skies for all' is merely truncated, '...all RPT' and everyone else can they please get out of the sky.

 

The avmed model does two things:

 

a) is part of this hidden mission statement to ground GA and keep them out of RPT flightpath, easier than providing flight tracking or any situational awareness by Airservices.

 

b) setup over years by the medical fraternity to drive up their business model. Highly paid medical bureaucrats (eg Navanthe) simply supporting their mates incomes.

 

Let's look at some of these statements in isolation, I am going to read the whole document today, so I may yet come back with a modified opinion, but these excerpts don't look encouraging.

 

.....may also need to weigh up the aeromedical consequences of such an expansion and its possible consequences for other airspace users and third parties not associated with the operation of the aircraft...

 

(Aeromedical? Is that even a word?)

 

....For example, pilots who are refused a class 2 medical certificate often still fly RA-Aus registered aircraft. There have been several recent medically related fatalities in the latter group.....

 

(but no evidence provided)

 

The US Aerospace Medical Association has contested this claim........Moderate to severe medical hazards identified by autopsy were found in 25% of medically certified pilots but in 60% of uncertified pilots....

 

(Here's some actual data, which supports our predisposed view, however we are scant on any other data and challenge everyone else's as unreliable)

 

.....UK assessment bases many of its assertions on a premise which supports the outcome, namely, the assumption that people who feel unwell will not fly....

 

(Claiming 'assertions' and 'presumptions' on a 'premise', none of which can be trusted)

 

....The risk assessment also identifies a very low accident rate attributed to medical incapacitation however this accident rate occurs within an environment where more stringent entry control medical conditions are in effect.....

 

(Ie There are statistics and statistics, and we prefer our own deductions on these ones)

 

Relaxation of the existing requirements will rely more heavily on the integrity and professionalism of the pilot ensuring that they are medically fit for the planned activity.....

 

(Ie. We don't trust any of you pilots, you all lie about medical conditions, based on the blatant evidence in numerous online forums such as this one)

 

Deregulation of medical certification requirements for the general and sport/recreational aviation sectors may need to be supported by extensive pilot education

 

(Ie If we go this direction our 'extensive' education will be so bureaucratic and onerous you will wish you had Class2 avmed back)

 

Advice from the industry is that there have been only 3–4 cases of medical incapacitation in over 450,000 landings by RA-Aus members, although it is not clear on what basis this claim is made....

 

(Questioning others data without presenting any of their own to refute)

 

 

[dutchroll]

But of course there is the issue that commercial pilots are far more likely to keep flying if they develop an illness (and hide it) because of the income requirement. There probably needs to be some net to catch that phenomenon.

But are they necessarily? When you're an airline employee, you have paid sick leave available. My accumulated balance is currently over 6 months. Some guys have 12 months accumulated. Costs me only the meal allowances to call in sick for a day, or a week, or a month.

Also we have a company loss-of-licence insurance policy. That may not be the case with all companies, but it is with some.

 

 

[Bennyboy320]

CASA=Empire building, you just have to look at the medical & ASIC threads on this site, reminds of that classic tv series Yes Minister.

 

 

[Jaba-who]

a

b) setup over years by the medical fraternity to drive up their business model. Highly paid medical bureaucrats (eg Navanthe) simply supporting their mates incomes.

 

)

I think the reality is that this is a complete myth. In private medicine ( all DAME s are in the private medical arena) medicals for licenses, insurances, proefessional positions etc are not economically viable and are a pain in the butt. I rarely do them in my specialty but I have done some and they are annoyance we would all rather be without.

 

They are not covered by any Medicare or insurance so they must be paid for by the patient fully ( which is surprisingly expensive because everyone forgets that when you see the doctor for a half hour you also have to pay for the receptionist, practice nurse, electricity, equipment used, stationary - everything. No one is helping pay for it.

 

So patients pay a lot and whinge about the cost. They take a long time compared to seeing several patients with coughs or colds with less remuneration. They result in patients being unhappy if they fail the medical but results of the test are not up to the doctor - they are dictated by casa but the dame wears the unhappy complaint.

 

If they give a glowing report to casa and the patient then has a bad event it can come back to bite the dame.

 

And lastly most of us disagree entirely with the CASA doctors who think that somehow the rest of us know nothing about how flying and health interact and override our medical knowledge with what is obviously casa clap-trap. They are NOT our mates!

 

 

[Jaba-who]

But are they necessarily? When you're an airline employee, you have paid sick leave available. My accumulated balance is currently over 6 months. Some guys have 12 months accumulated. Costs me only the meal allowances to call in sick for a day, or a week, or a month.Also we have a company loss-of-licence insurance policy. That may not be the case with all companies, but it is with some.

True for the pilot employed in a decent sized airline or aviation company.

I suspect ( without a lot of evidence) that it might not be so good for say a young guy just got his first job in a small company flogging freight and a few pax around the outback.

 

May also be a problem in the self employed guy with single aircraft doing charters. I speak from experience on that one.

 

Have a mate now retired, who had a single aircraft ( small twin shuffling charters around north Queensland ) never looked healthy to me but assumed he must have been ok. He came for an operation and I did his anaesthetic. He surprised me with what background illnesses he had and I now doubt he actually passed a proper medical. I suspect he had a friendly dame somewhere who ticked boxes and buffed him up for his medicals.

 

So that drags me back to my comment about medicals ( and the complexity of factual decision making on them) for the less complex commercial ops.

 

 

[rrogerramjet]

Dont forget the CASA demanded specialist referrals. And the revisitations to update simple detaills. I went back to my DAME who charged me $130 for a specialist referral. Apparently that requires a visit and an hour... can't do it via phone call or email?

 

The system is broken.

 

 

[dutchroll]

b) setup over years by the medical fraternity to drive up their business model. Highly paid medical bureaucrats (eg Navanthe) simply supporting their mates incomes.

I showed this statement to my wife, currently a specialist doctor and formerly an aviation medicine doctor and a GP.

She stated "I wouldn't even dignify that with a response". So I'm going to write one anyway.

 

The reason she has said this, is because it shows no understanding of the practice costs to DAMEs. They do not do it for the money. DAMEs would be far, far better off seeing a two or three "normal" everyday patients in that time. Then they wouldn't need the extra equipment to do the aviation medicals, wouldn't need to screw around with constant resubmission requirements and changes directed by CASA, wouldn't need to pay the practice nurse who has to do all the ancillary testing for aviation medicals, and so on.

 

My wife knows an anaesthetist who is a DAME. You honestly and truly believe an anaesthetist does DAME work for the money? Lol!

 

I went back to my DAME who charged me $130 for a specialist referral. Apparently that requires a visit and an hour... can't do it via phone call or email?

Her response to this statement was: "Why is there a community expectation that a doctor should work for free?"

 

 

[ave8rr]

Dont forget the CASA demanded specialist referrals. And the revisitations to update simple detaills. I went back to my DAME who charged me $130 for a specialist referral. Apparently that requires a visit and an hour... can't do it via phone call or email?The system is broken.

I wouldn't expect a DAME to do a referral for nothing. I am sure if you had to go back to your GP to have a referral to a specialist he/she would charge another consultation fee. My wife works in General practice as a Practice Nurse and tells me that the Doctors hate doing medicals due the time it takes of both them and the Nurses beforehand.