AOPA calls on CASA for private pilot medical reform

[rrogerramjet]

Ok, maybe I havent been abundantly clear here, it seems others are demonstrating some cognitive bias suggesting I want free medical services, especially from those hardworking DAMEs.....so I'll write slowly and carefully...in dot points for simplicity.

 

- avmed team are Dr's (apparently)

 

- avmed assessment says 'go and see a specialist'

 

- not the DAME.

 

....still with me folks...?

 

-so avmed should be providing the referral letter. They're the referring Doctor.

 

- or allow the DAME to do it simply and easily.

 

- I dont need to waste 2hrs of my time and 1hr of a GPs to get a letter saying 'go see someone else', that is disgustingly inefficient.

 

- Anyone who says that is a good business model or an efficient methodology, probably works on a fully unionised council roadworks crew. (apologies in advance to all unionised road crew members)

 

- The system is broken.

 

So where did I say in this or any previous post I wanted free medical services??

 

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.

[aplund]

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!

 

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

I think it's abundantly clear that DAMEs aren't doing it to be rolling in cash. I've had to change because one I was seeing got jack of it all and thought he'd be better off being an "normal" doctor exclusively.

 

The question should always be is the cost worth the benefit. And by cost, I don't mean monetary costs alone. For a class 2 medical, why is it better to have someone removed from your personal doctor, that most people have to made special arrangements and time to see?

 

The list of tests and examinations performed doesn't seem to need medical training outside of the ordinary. For class 1 medicals, there certainly might be an argument for some kind of specialist knowledge, though I haven't looked into it. But for class 2, I don't see the need. Particularly given that AV Med, also someone removed from the medical history of the person, seems to order extra tests and have the final decision anyway.

 

If it is an issue of trust, then you are going after the wrong profession. As I stated above, the whole thing is based on reputation and competence. Sure the media have stories of rogue operators, but what exactly is it about CASA's system that ensures there won't be rogue DAMEs?

 

The thing is, I'm arguing that there be less demand for DAMEs, which is likely to cause some people grief if they have set themselves up in such as way as to rely on having this custom. This is a situation I fully understand.

 

Back on the CASA discussion paper though, the quantitative statements made without reference to quantitative evidence is of enormous concern. Anyone who find the scientific method appealing will see this as an obvious oversight. Easily fixed though. Give us the citations to substantiate the "several recent medically related fatalities in the latter group" claim. Then the role of the lack of a Class 2 medical can be examined more closely. Without this, it's just an argument based on 'truthiness'.

 

 

[Jaba-who]

I think it's abundantly clear that DAMEs aren't doing it to be rolling in cash. I've had to change because one I was seeing got jack of it all and thought he'd be better off being an "normal" doctor exclusively.The question should always be is the cost worth the benefit. And by cost, I don't mean monetary costs alone. For a class 2 medical, why is it better to have someone removed from your personal doctor, that most people have to made special arrangements and time to see?

 

The list of tests and examinations performed doesn't seem to need medical training outside of the ordinary. For class 1 medicals, there certainly might be an argument for some kind of specialist knowledge, though I haven't looked into it. But for class 2, I don't see the need. Particularly given that AV Med, also someone removed from the medical history of the person, seems to order extra tests and have the final decision anyway.

 

If it is an issue of trust, then you are going after the wrong profession. As I stated above, the whole thing is based on reputation and competence. Sure the media have stories of rogue operators, but what exactly is it about CASA's system that ensures there won't be rogue DAMEs?

 

The thing is, I'm arguing that there be less demand for DAMEs, which is likely to cause some people grief if they have set themselves up in such as way as to rely on having this custom. This is a situation I fully understand.

 

Back on the CASA discussion paper though, the quantitative statements made without reference to quantitative evidence is of enormous concern. Anyone who find the scientific method appealing will see this as an obvious oversight. Easily fixed though. Give us the citations to substantiate the "several recent medically related fatalities in the latter group" claim. Then the role of the lack of a Class 2 medical can be examined more closely. Without this, it's just an argument based on 'truthiness'.

Lots of points worthy of comment in the above post but the one that is probably the most concerning to us is that you are suggesting that CASA will have evidence or have a factual basis for having a policy or regulation.

 

If you were around during the jabiru debacle you would recall that casa don't need facts to crucify part of the industry. Casa used dubious data collected from a source who were unaware of what casa were going to use it for, so did not really scrutinise or verify it first, and then casa included irrelevant events and stated they were all relevant.

 

Absolute dishonesty to establish a rationale for bringing our hobby down.

 

 

[aplund]

Lots of points worthy of comment in the above post but the one that is probably the most concerning to us is that you are suggesting that CASA will have evidence or have a factual basis for having a policy or regulation.If you were around during the jabiru debacle you would recall that casa don't need facts to crucify part of the industry. Casa used dubious data collected from a source who were unaware of what casa were going to use it for, so did not really scrutinise or verify it first, and then casa included irrelevant events and stated they were all relevant.

Absolute dishonesty to establish a rationale for bringing our hobby down.

Just out of interest, I tried to see if the ATSB data is consistent with the claim in the discussion paper.

 

I went to ATSB National Aviation Occurrence Database: Detailed Data Search. I entered this search.

 

• Date range: From 04 Mar 2004 to 03 Mar 2017
   
   
  
• Location: All
   
   
  
• Occurrence Category: All
   
   
  
• Occurrence Type: All
   
   
  
• Aircraft and Airspace: Aircraft Type: Aeroplane. Operator Type: Sports Aviation - All
   
   
  
• Injury Level: Fatal
   
   
  

 

 

There were 28 results with 5 ATSB investigations. Each has a short summary in the data returned if there is an investigation or not. Most just say collided with terrain without giving a reason. Is it that the ATSB don't report reasons like incapacitation even if that information is known? Does "Sports Aviation" pick up all RA-Aus flights or am I missing lots of results here?

 

 

[turboplanner]

Just out of interest, I tried to see if the ATSB data is consistent with the claim in the discussion paper.I went to ATSB National Aviation Occurrence Database: Detailed Data Search. I entered this search.

 

• Date range: From 04 Mar 2004 to 03 Mar 2017
   
   
  
• Location: All
   
   
  
• Occurrence Category: All
   
   
  
• Occurrence Type: All
   
   
  
• Aircraft and Airspace: Aircraft Type: Aeroplane. Operator Type: Sports Aviation - All
   
   
  
• Injury Level: Fatal
   
   
  

 

 

There were 28 results with 5 ATSB investigations. Each has a short summary in the data returned if there is an investigation or not. Most just say collided with terrain without giving a reason. Is it that the ATSB don't report reasons like incapacitation even if that information is known? Does "Sports Aviation" pick up all RA-Aus flights or am I missing lots of results here?

You're missing lots of results.

 

 

[aplund]

You're missing lots of results.

Due to my choice of search parameters or the contents of the database?

 

 

[turboplanner]

Due to my choice of search parameters or the contents of the database?

Only a few RAA results are included in the ATSB report database.

 

 

[dutchroll]

Ok, maybe I havent been abundantly clear here, it seems others are demonstrating some cognitive bias suggesting I want free medical services, especially from those hardworking DAMEs.....so I'll write slowly and carefully...in dot points for simplicity.- avmed team are Dr's (apparently)

- avmed assessment says 'go and see a specialist'

 

- not the DAME.

 

....still with me folks...?

 

-so avmed should be providing the referral letter. They're the referring Doctor.

 

- or allow the DAME to do it simply and easily.

 

- I dont need to waste 2hrs of my time and 1hr of a GPs to get a letter saying 'go see someone else', that is disgustingly inefficient.

Not how the referral system works, and it is not governed by CASA, but by the Health Insurance Act 1973. Also Medicare billing is intricately bound into the referral system.

Avmed are not the referring doctor, they are the administrators. They did not examine you. They are simply requiring a specialist opinion. Your DAME may not even think you actually need one. Your DAME might think Avmed are being precious, or clueless, or ridiculous, or whatever (many do). Your specialist might totally agree with your DAME. Avmed are just saying "we demand a specialist opinion" (for better or worse) but Avmed aren't involved in providing the medical examination service so they have nothing to do with writing referrals. It would be pointless for Avmed to provide a referral.

 

As far as referrals go, you don't technically need one to see a specialist. However you cannot claim anything from Medicare if you don't have one (the main reason for them), and referrals are a bit like a short "briefing" for the specialist about your case from your examining doctor.

 

In any case, getting a specialist referral shouldn't take an hour of your GP's time. A standard consult should be plenty.

 

The bit about expecting medical services for free is because you seemed to be complaining about the cost and you pondered whether a referral could be done over the phone or by email. By default, anything done by phone or email from a doctor regarding provision of services to you is free. They're not like lawyers. They cannot charge anything for a phone call or an email. If you have a mate or relative who is a doctor, they might well write a referral for you from a phone call. If they do that, they're doing it for free.

 

None of this should be interpreted as a defence of CASA Avmed. I personally think they totally jumped the shark when the former avmed director was there, and a lot of doctors do too.

 

Edit.... no it's not a cognitive bias. It's just that you didn't seem to understand what referrals are all about, nor what the relative roles are (Avmed department versus DAME/GP).

 

 

[aplund]

Only a few RAA results are included in the ATSB report database.

This is not the report database. This includes results with no ATSB report. Those with a report have a report number associated with them.

I tried to find accidents listed on the RAAus report available on the website and those in this detailed database and they can all be found. The problem is that it doesn't list registration. And the Operation Type seems to be somewhat oddly assigned. Many in the RAAus report are listed as Private.

 

Never-the-less, about 1/2 of the overall (22 out of 38) seem to be findable by the "Sports Aviation" operation type. That's compared with the numbers in this report:

 

https://www.atsb.gov.au/media/5743306/AR-2015-082%20FINAL.pdf

 

Still not found any evidence of most of these, and particularly the recent ones, being due to medical incapacitation, which was the original claim. Still could be true, but it's not totally clear from what I've found.

 

 

[MichaelMVr]

-AVMed (and "DAME'S" system) is a pure nonsense, that country, and the strength of our dollar can do without.

 

(DAME's have no chance in a freaking moon to know (properly) about you - what your GP does, and

 

DAME's will definitely mis-diagnose you, on almost every step of the exam).

 

-I'd share my example here on my current medical, on the stupidity of CASA and DAME's: for few months i used my own made diet for vision improvement, so it improved, and DAME logged my results, so CASA sent me an additional form "from that reason" for a "complete ophthalmic review" (another $160 on my own pockets damage). Is this reason you'd ever send anyone for extra complete ophthalmic review ? Duhh.

 

-During the same exam with DAM'E, i answered few mobile calls to my staff, who call me very often, so DAME logged "from that reason" that i have "displayed some signs of preoccupation and disordered thinking" and CASA now emailed me another "extra" exam request for full Psych assessment (another $1600 +900 suggested out my own pocket, these exams are not even bulk billed, people :). Show me a single person who is not preoccupied these days, and does not answer mobile calls ? Duhh.

 

-Also my current blood pressure is inside of the normal limits, and they also emailed me another "extra" Diabetes test request form, just because i'm 50 now, and i'm also called "pre diabetic" by them, though i don't have that, and no one in my family never had one. Duhh.

 

-We should have all pilots (and i mean ALL) joined one day for not flying at all, for as long as necessary, until AVMEd, and DAME, and Class 1 Medical bullshit is abolished, from the reason that (as evident): DAME's and CASA can't do anything right, other than weakening our aviation more, increasing it's operational costs to ASTRONOMIC now, , and our: dollar down.

 

-This country is a world champion of tolerating stupidities, and outdated nanny state laws, like no other, we even tolerate nonsense's like: DAME system, CASA, AVMed, and useless ASICS - airport security is an expensive JOKE, mate, everyone knows that. We RAAus members are now charged $100 every year to access our own aircraft, a darn passport costs $200, and you can use it for 10 yrs, or so. All this only further damages our economy, aviation, and making our dollar strength: down.

 

-If there is still (any) sanity in our govt left - they should put someone like RAAus in charge of CASA, for them, and not the other way, and do away with all that unnecessary (billion-dollar-cost) outdated red tape system. We are not that rich anymore to keep it, so i'd suggest that madness has to stop one day, and we do what makes our dollar STRONG and not the other way.

 

 

[Happyflyer]

-AVMed (and "DAME'S" system)-During the same exam with DAM'E, i answered few mobile calls to my staff, who call me very often, so DAME logged "from that reason" that i have "displayed some signs of preoccupation and disordered thinking" and CASA now emailed me another "extra" exam request for full Psych assessment (another $1600 +900 suggested out my own pocket, these exams are not even bulk billed, people :). Show me a single person who is not preoccupied these days, and does not answer mobile calls ? Duhh.

 

.

I agree with a lot of your points, but isn't it just common courtesy to turn your phone off for the time you are with the doctor?

 

 

[MichaelMVr]

I agree with a lot of your points, but isn't it just common courtesy to turn your phone off for the time you are with the doctor?

Not on my business dollar, my number of staff, and the way is organized, it's just no go, thanks for that, i appreciate it. (i don't answer for more than 10 min - someone is injured or dead). Wish i could do the other way :)

[Bruce Tuncks]

I'm looking for a ( probably illegal ) jammer so that phones don't work under my roof when its turned on. Guests will be informed before accepting any invitation that their phone will not work in my house.

 

 

[Geoff13]

I'm looking for a ( probably illegal ) jammer so that phones don't work under my roof when its turned on. Guests will be informed before accepting any invitation that their phone will not work in my house.

Should be fitted to every motor vehicle on the roads as well.

 

 

[MichaelMVr]

I'm looking for a ( probably illegal ) jammer so that phones don't work under my roof when its turned on. Guests will be informed before accepting any invitation that their phone will not work in my house.

There is an app for that, called 'Jammer', i believe, or you can find one on GooglePlay that does exactly that :)

 

 

[Jaba-who]

Not on my business dollar, my number of staff, and the way is organized, it's just no go, thanks for that, i appreciate it. (i don't answer for more than 10 min - someone is injured or dead). Wish i could do the other way :)

I think you need to turn your phone off, step away from it, take a deep breath and reassess your place in the world.

(And I'm talking from a position where people lives depended on me too, where I was working a rostered 56 hour week but actually working over a hundred. I am in a field where (especially when we are younger my colleagues And I were so convinced the world needed us. .....

 

But fortunately I managed to actually see that if i dropped dead tomorrow the world would carry on, that someone one else could do the job and if they couldn't It was not my concern. It's not your job to carry the world.

 

Does having your phone on and talking on it, while other people who are trying to do for you what you need them to do mean you are preoccupied and disoordered?

 

Yep, sorry to inform you but it does and you should not be flying if you can't think of anything except when the next phone call comes in.

 

I'm sorry to say this, and it is not meant to be nasty. But as flying colleagues we should be doing the right thing by our flying fellows and pointing out the obvious.

 

Best of wishes.

 

 

[Bruce Tuncks]

When I googled up jammers, I found they are illegal for sure with a 2 year jail sentence threat. So in the meantime I will stick with my current policy of never again inviting a person who uses his/her phone rudely during a dinner party. So far there are 2 people in that category and I wish I could think of a way to tell them what they did wrong.

 

To be fair, I can imagine somebody who is on call needing to have their phone on. Sometimes my daughter is like this from her work, where she could be called in if there was an emergency.

 

 

[facthunter]

People ring you up expecting that you are always ready to drop everything and just listen to them, right then. Rude and totally an outrageous expectation. You could be on another call , speaking with a visitor, welding something (having sex) holding a ladder (more likely). I always ask "is it convenient now"? Why would you assume it's ok to interrupt? Nev

 

 

[kgwilson]

Voice mail was invented so you could reject calls, have your phone turned off or whatever. If it is that important to have your phone on cancel the appointment for another time when it is not.

 

 

[Mike Borgelt]

Well, that was a spectacular example of thread drift. Pick on one small point mentioned by a poster and go completely off the rails.

 

We should be asking what has happened to the CASA discussion paper on aviation medical reform. Comments closed at the end of March, there were 160 submissions (how many of you bothered?), overwhelmingly in favour of reform and now we've heard no more.

 

 

[Yenn]

If someone cannot miss answering their phone for ten minutes without someone dieing, they should get another job. Nobody should be so important to safety that they cannot have an offsider. We only have to wait for CASA now.

 

 

[MichaelMVr]

If someone cannot miss answering their phone for ten minutes without someone dieing, they should get another job. Nobody should be so important to safety that they cannot have an offsider. We only have to wait for CASA now.

It's one way to see it, but, again, for my flight times there is an aircraft mode it has, that i always put on, so that side is not an issue, and no - i don't use my mobile or allow the calls while i am around the airfield, or aircraft in general. Sadly, in the other (non flying) life anyone claiming not to do (or answer) a lot mobile calls around will be a hypocrite, knowing our need to communicate more as the technology and business develops. Point of view, really, for my vote here, and - as we just now train more staff that problem will probably decrease in frequency soon, allowing more free time for me, etc, which seems like a nice solution in the view, regardless non flying times. After this i enjoy to see that some other people have a lot of free time off their aviation duties, which i assume will always be the goal, when possible.

 

 

[facthunter]

CASA Avmed, have interpreted your behaviour on the phone and put it on files in the past. Example dispute anything and be classed as psychologically disturbed . I became aware of some doctor's comment that appeared on my file, so challenged it. Later asking for more file information I was told my files were LOST. BS. I also passed a flying standard eye test EASILY 6 years after my licence had "Must wear Glasses) Put on it. My eyes had improved with general health and many eye exercises BUT must still wear glasses. I could go on for pages but they only get away with this stuff because they are a law unto themselves, and the system lets them get away with it. Support any moves to change this unsatisfactory situation. Juts because YOU might be OK now doesn't mean tomorrow won't come for YOU. Nev

 

 

[MichaelMVr]

CASA Avmed, have interpreted your behaviour on the phone and put it on files in the past. Example dispute anything and be classed as psychologically disturbed . I became aware of some doctor's comment that appeared on my file, so challenged it. Later asking for more file information I was told my files were LOST. BS. I also passed a flying standard eye test EASILY 6 years after my licence had "Must wear Glasses) Put on it. My eyes had improved with general health and many eye exercises BUT must still wear glasses. I could go on for pages but they only get away with this stuff because they are a law unto themselves, and the system lets them get away with it. Support any moves to change this unsatisfactory situation. Juts because YOU might be OK now doesn't mean tomorrow won't come for YOU. Nev

i agree: they are looping without much control and - they know that as well.

 

It only proves the point again that you can never expect any fair (realistic) approach form the people who are not aviators and are govt red tape bookies, basically, CASA is not the only example, take for an instance the newest Frank's attack on disability pensioners where he is now going around the files and disconnects them form their pensions by the click of the button. For such people that equals to murder, as - DSP is their only support their lives depend on, of course he knows very well they can't represent them selves properly against something like that, and the money will go into the pockets of his govt cowboy gang, like every 5 yrs they invent some new strategy to: steal. there is no any control of what red tape people think they can do, and that is the main problem, per say, and can be improved, so they can't act above the law, destroying anyone's careers or lives, and damaging the value of our dollar any further. We need to speak clearly and openly about such things, as we are basically electing these guys. "law unto them selves" correct ... and we all know that anything above the law has only one name: criminal.

 

 

[MichaelMVr]

Ha, ha, just like Benjamin said here "Because of the above, thousands of general aviation private pilots across Australia have had no other option, than to move across to recreational sport flying to continue. The absurdity of course is that CASA AVMED deem these pilots unfit to fly, then in the same breath CASA approves them to fly with a recreational license! Go figure."

 

So, you's brothers pilots out there who are still not RAAus pilots - join the future, and the club of much safer flying, otherwise - you are not helping, and only prolonging the agony of our stalled aviation. And, in the answer to mike_perth above post - the answer is: none, mate, there is no medical incapacitation events/accidents have occurred in RAA with the lower medical standard. So ? How many under the AVMed ? You tell me. This means that the entire criteria system, adopted for AVMed and itself, (from some yester-war-year military standard for flying above 10 000 ft only) was a mistake from day one, to have at the first place in GA and recreational. (it has costed us billions by now) For the good and safety of this country: AVMed and Medical 1 should go, since it produces every [other-than-safety ] effect, in reality, and unneeded astronomical aviation extra costs, ha, ha ...