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Well there I was again, sitting in the doctor’s office waiting to get my over 40 years of age aviaton medical exam First Class Medical done. Since I’m an airline pilot and over 40, I have to do one every six months and an EKG once-a-year.

And I have to say, I think they are a bit of scam!

Though the FAA provides a guide for the doctor, via the “Guide for Aviation Medical Examiners,” in all my years of getting physical exams, only a handful have ever followed it and most seem to make it up as they go. On top of that, the doctor’s fees are getting out of hand. These exams are not covered under medical insurance, usually. Furthermore, why is it that over 40 have to do physicals twice a year? How did they come up with the magical number?

Anyway, here’s the deal.

The medical tech takes my pulse, checks my blood pressure, checks color vision and urine. The hearing test, I discover, is optional and the tech asks if I want to do it. Hey, if it’s optional, why would I want to do it? OK, so far, easy enough. Then I sit in the exam room for 15 minutes and I thumb through the magazines to my left.

Then the doctor(?) comes in.

Now I’ve gone through both extremes as far a FAA doctors are concerned.

Some doctors are cavalier and some are thorough. Basically, the easy ones come in, vaguely check a few things, sign your medical certificate and then they are gone and you are out $90+. One doctor’s hearing test is him saying, “Can you hear me now?” Other doctors, well, you would think that this physical determines the future safety of the airline industry. This time it was a kind of a mix of the two. 

The doctor asked me about the skin cancer (basal cell carcinoma) that I reported the last time I did my physical. I am happy to report that all is great. Then he asks me about the last time I went to the doctor about a swollen testicle. I know…TMI. I told him no problem on that either. I’m thinking…end of story. See ya!

He says, “I guess I better do a physical.” He (very) quickly looks in my ears and mouth and listens to my lungs and heart. That’s it! Then he gets back to this swollen testicle thing. I tell him that the doctor is sure that it was a just a twisted cord and that the testicle got inflamed. I tell him that an ultrasound was done with no significant findings and that I went to a urologist, as a follow-up, who confirmed the findings of the previous doctor. I tell him that I’ve had no other issues since then.

Again, I’m thinking, end of story. See ya! Wrong! The doctor says he has to call the FAA and see what they say. I’m screaming in my head, “WHAT?!” Doesn’t this guy know that you don’t call the FAA? I ask why he has to call the FAA and he says that the FAA is really coming down on Aviation Medical Examiners (AME) and they need to know about this. Again, I’m screaming in my head, “WHAT THE HELL?!”

So, the doctor does a piss-poor physical exam, but he has to call the FAA about this?

A few minutes later he comes back and tells me that the FAA says that he can go ahead and issue the First Class Medical Certificate but that they want the paperwork from the examing doctor(s) concerning my “condition.” Ugh…Great!

So I call my primary doctor’s office and ask for the notes from the exam. Ironically enough, the doctor’s office doesn’t even ask to see my ID when I go to pick up the paperwork and just hands over the reports. So much for patient privacy!

Once I get home I call the FAA…not the friendliest of sorts…and say that I’ve just been to the doctor for said First Class Medical exam and that he (stupidly; I didn’t say that!) called the FAA and now I have to send in supporting documention about a condition that no longer exists. Again, not that this surprised me, but this FAA person wasn’t very helpful, seemed quite unpleasant, and was a bit condescending. I guess that’s the FAA for you. I can’t really imagine working there. Must be horrible. No wonder they get a bad rap.

So now I end a long day of having to worry about this but I learned a few things.

1. First of all, go back and read my post on Surviving a First Class Medical.

2. Ask around and find out about the FAA Aviation Medical Examiners (AME) in your area. Talk to other pilots and make a list. Call their office, ask about their fees and availability.

3. Document everything! Did you hear me? Document everything! If you are thinking about getting into flying, or are currently in flying, document ALL medical issues. Go back and write down every medical issue that you can think of. Include the date, doctor’s name, address, telephone number, reason for visit, and condition/result/prescriptions. Take this with you when you go for the physical.

4. Start getting copies of the doctor’s reports. After a few days of visiting the doctor, the doctor’s notes will be transcribed and placed in your medical records. Ask for a copy of the report and then put them in a folder. I’ve started taking the additional step of scanning in the report and putting them in my computer and offline storage. Take copies of these with you when you go for your physical but don’t offer them unless you need to support something. For instance, after the episode with the basal cell carcinoma, I took a note from my doctor saying I was all clear.

5. When filling out the FAA Form 8500-8, which is the application for a medical certificate, make all your entries, throughout the years, consistent. Don’t say you have “hay fever” one year but not the next. What people have told me is that this could raise a red flag with the FAA.

6. Take ALL previous copies of your FAA Form 8500-8’s with you to the next physical exam for reference.

7. Don’t offer, per se, any extra information to the doctor…even if you totally trust the doctor. Let them look over your application and ask YOU the questions. That’s not to say that you can’t build a honest relationship with your doctor or that you need to be rude or ambigious, just be cautions on what you say. It’s an interview and just remember the old saying, “It’s easy to open a can of worms, but hard to put them back in.” Let the doctor ask you the questions and you provide short answers. Above all, be respectful and be professional.

8. If you have a question that you think may compromise your medical exam, contact your AME before you visit the office and start the exam, or contact the AOPA medical services and ask them.

9. Finally, as you leave the doctor’s office make SURE you have a copy of the front AND the back of the 8500-8. The back is where the doctor makes their notes that the FAA is going to so. You have a right to this information but it is not typically given to you unless you ask for it.

So, I hope that helps.

One thing I’m learning as time goes on in this industry is you have to watch out for yourself. There are rules and you have to play by their rules. The FAA is there for you but they can also be against you if you let them. The more paranoid you are, or I should say proactive, about your career, the better of you are going to be.

To Your Flying Success and Health…

Jeffrey

PS - Here some addition reading for you concerning aviation medicine:

Basic Flight Physiology – This readable, updated textbook by a flight surgeon comprehensively covers the factors that affect “medical airworthiness.”

 

 

 

Pilot Medical Handbook – Discusses the effects of flying on the human body.

 

 

 

Related posts:

• How to Survive an FAA Aviation First Class Medical
• Medical Illness on an Airplane
• Flying as a Career: What to Expect and What Your Choices Are
• I M SAFE! Are You?
• Double Check Your FMS and the GPS Waypoints