Beginning May 1, people who fly certain small private planes may ask their family physicians to complete a new alternative medical qualification form legislated by Congress and administered by the Federal Aviation Administration (FAA).
The "FAA BasicMed"(www.faa.gov) pathway was created to ease the medical certification process for aviators participating in not-for-hire activities.
The Academy was made aware of the coming availability of this exam via a March 16 letter from Civil Aviation Medical Association (CAMA) President Clayton Cowl, M.D., M.S.
Section 2307 of the FAA Extension, Safety and Security Act,(www.congress.gov) which became law in July 2016, gives certain aviators the option to choose any state-licensed physician to provide a comprehensive physical exam and medication review.
By contrast, the usual aeromedical certification pathway requires evaluation by an FAA-designated medical examiner. These examiners are required to attend a week-long training course at the Civil Aerospace Medical Institute in Oklahoma City, and renew training every three years.
- Beginning May 1, some family physicians may get patient requests to complete a new medical exam for certain small-plane pilots.
- The new certification pathway for these pilots is called "FAA BasicMed" and is part of a Federal Aviation Administration (FAA) law passed in July 2016.
- The president of the Civil Aviation Medication Association cautioned physicians who are unfamiliar with FAA regulations to fully understand their responsibilities and the associated liability before agreeing to a patient's request to complete the exam.
According to CAMA, family physicians across the country should be aware of the upcoming changes because more than 100,000 pilots each year will be eligible for the alternative pathway and it is likely that some "will be asking your members to perform and sign off on the physical examination checklist."
In addition to that sign-off, a physician must certify that he or she discussed all items on the checklist with the patient and talked about any medications currently being taken that could interfere with the patient's ability to safely operate an aircraft or motor vehicle.
Furthermore, the physician must attest to performing an exam that covers all items on the checklist -- including visual acuity and color vision -- and that he or she is not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft.
CAMA provided other key points for physicians to consider:
- The law prohibits advance practice providers such as nurse practitioners or physician assistants from signing off on these forms.
- Medical history, physical examination and medication review findings should be documented in the patient's medical record.
- Physicians participating in these exams should be familiar with FAA regulations including the FAA Guide for Aviation Medical Examiners.(www.faa.gov)
- Physicians performing the examinations should order any testing or diagnostic studies necessary to establish clinical stability for the requesting pilot.
Pilots with specific cardiac, neurological or psychiatric conditions must be under the care of a state-licensed medical specialist as noted in Chapter 8 of the FAA advisory circular on the alternative pilot physical examination and education requirements.(www.faa.gov)
In an interview with AAFP News, Cowl stressed that physicians should understand FAA medical guidelines as they pertain to potential liability.
"There is the potential for liability to physicians, in part because the pilots most likely to use the alternative qualification pathway may be the very people who need the standard flight physical," said Cowl.
"Pilots with multiple and complex medical issues may have a perception that FAA BasicMed will simplify the exam process. Some may think they will not undergo the same level of scrutiny from their personal physician as they would if examined by an FAA aviation medical examiner," he added.
Pilots who qualify medically under FAA BasicMed are limited to flying aircraft of up to 6,000 pounds that carry a maximum of six occupants. The maximum allowed altitude is 18,000 feet with speeds of up to 250 knots, said Cowl. Pilots must be able to fly in instrument-required weather.
"At that altitude and type of airframe, these planes are sharing the airspace with paying commercial passengers. As physicians, we need to maximize the health of our patients and promote aviation safety," he said.
Simply put, "This comprehensive medical checklist is not a summer camp physical," said Cowl. Physicians should familiarize themselves with FAA guidelines, communicate with aviation medical examiners in their communities and understand the liability they take on when they put their medical license number on the FAA form.
Cowl acknowledged that some family physicians may already perform commercial truck and bus driver examinations that are similar in nature to pilot exams. For those physicians, a certain comfort level may already exist.
However, he added, "Physicians who do these exams need to be cognizant of the 'ask' -- and that is to perform a comprehensive exam and then sign an attestation statement that says, 'Based on my comprehensive exam, this person is safe to fly.'"
Federal Aviation Administration BasicMed FAQ(www.faa.gov)