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BitterlichMG(at)cherrypoi
Guest

Posted: Wed Mar 22, 2006 6:21 pm Post subject: Commercial and Compensation

The only real difference between 2md and 3rd class medicals is with your eyesight.  I could only get a 3rd ... changed my glasses, and POOF... got a 2nd.  Your points makes sense Tim, but the reality of the differences between 2nd and 3rd class do not seem to.    

Mark Bitterlich  

  

--

HawkerPilot2015

Joined: 10 Jan 2006
Posts: 503

Posted: Wed Mar 22, 2006 6:39 pm Post subject: Re: Commercial and Compensation

 	  BitterlichMG(at)cherrypoi wrote: 	
		  The only real difference between 2md and 3rd class medicals is with your eyesight.? I could only get a 3rd ... changed my glasses, and POOF... got a 2nd.? Your points makes sense Tim, but the reality of the differences between 2nd and 3rd class do not seem to.?   

Mark Bitterlich  

  

-- 	




I have had all three and currently maintain a First Class because I have to, to be a Captain. I have been through more stringent Third Class physicals than some First Class. The biggest difference you will see between the physicals is the cost!!



I agree with your statement by the way.

brian

Joined: 02 Jan 2006
Posts: 643
Location: Sacramento, California, USA

Posted: Wed Mar 22, 2006 9:21 pm Post subject: Commercial and Compensation

 	  Quote: 	
		   There has to be some medical requirement for commercial operations or their  would be some folks out there flying airplanes that probably should not even be driving a car! 

   

That is a laudable goal but the fact is, it just doesn't work that way. 
	


The problem with the system of medical examinations in use today is that 

they do nothing to either determine the current medical status of the 

pilot nor do they do anything to determine the future medical state of 

the pilot.



Simply stated, the third and second class aviation flight physicals 

determine that the pilot was alive on the date of the exam, not that the 

pilot was in good health or would be in continuing good health. 

Therefore, the *purpose* of the aviation flight physical is not served 

by the aviation flight physical itself.



Case in point: my father got his aviation flight physical. Unbeknown to 

him and to the medical examiner he had 90% occlusion of the coronary 

arteries. He was issued a standard second-class medical certificate. 

Shortly thereafter the problem was discovered and rectified. He also 

lost his medical certificate. Problem exists -- certificate issued. 

Problem corrected -- certificate revoked. Yes, he eventually got a 

restricted third-class medical certificate but that isn't the point.



The point is, regardless of the *purpose* of requiring an aviation 

flight physical, it serves no real purpose in that it does not stop 

people from flying who are medically unfit to do so. All it does is make 

it difficult for people who are fit to fly.



Your tax dollars at work.



-- 

Brian Lloyd                         361 Catterline Way

brian-yak at lloyd dot com          Folsom, CA 95630

+1.916.367.2131 (voice)             +1.270.912.0788 (fax)



I fly because it releases my mind from the tyranny of petty things . . .

- Antoine de Saint-Exupery

_________________
Brian Lloyd
brian-yak at lloyd dot com
+1.916.367.2131 (voice) +1.270.912.0788 (fax)

I fly because it releases my mind from the tyranny of petty things . . .
- Antoine de Saint-Exupery

viperdoc(at)mindspring.co
Guest

Posted: Wed Mar 22, 2006 11:05 pm Post subject: Commercial and Compensation

 	  Quote: 	
		   That is a laudable goal but the fact is, it just doesn't work that way. 

 The problem with the system of medical examinations in use today is that 

 they do nothing to either determine the current medical status of the 

 pilot nor do they do anything to determine the future medical state of 

 the pilot.

Brian,
	


Tell that to the coorperate left seater that was in my office two weeks

ago. Found a precancerous rectal polpy with- in 1 inch of his anus on the

finger waive. It was removed the following Monday. He also was having

premature atrial contractions on his EKG that were caused by excess coffee

consumption. Left unchecked it could have lead to proxsymal atrial

tachycardia which carries a risk of syncopy. He was worked into the

Cardiologist office the following Tuesday for farther workup.

Feel like grabbing the yolk from this guy when he momentarily passes out?

Off caffiene for a week, and his 24 hour Holter monitor was back to normal.

He was returned to flying status even healther in two weeks time! Left

unchecked the colon polyp would have been poised to kill him 2 to 4 years.

This was a guy that rides his bike on average 20 miles a day on the

weekends participating in marithons. He was a healthy appearing 59 year old

(slim and inshape). Could have easily ignored the fact that he had not had

a complete exam for two years from his family MD. This was his first visit

to my office. He had had a colonoscopy 2 years before that was negative, so

according to the GI guys he was good for 5 years.

Granted some IME's are not the same, nor are some CF I's either. You get

what you ask for. Tell your IME you have not had a complete physical by

your family MD in the past 2-3 years and/or he has never done a prostate

exam or rectal exam and see what begrudingly happens. In my office, you

will get a finger stuck up your but. If you say you had a normal

colonoscopy in the last 2 years or your family doc does that annually, I

will give you the choice to be nice unless the review of sytems was

positive for something that really needs to be looked into. Your physical

exam is only as good as the answers you give on your review of systems part

of the exam sheet. It is a subjective and objective exam. 

The last time I checked, no one can predict the future. Your dad's coronary

stenosis could have been found on that exam. All that it would have taken

was a graded exercise treadmill (GXT). Which is not indicated in someone

without complaints or a history of none insulin dependent diabetes,

Hypertension, or symptomatic coronary arterty disease. Did your dad have

complains of chest pain symptoms at the time of his exam? If he did and the

IME ignored them then he screwed up. If he knew he was having funny chest

symptoms but was denying them which is what 85% of heart attach victims do,

there was nothing anyone could do. Short of doing a treadmill or the newer

more expensive CT Directed Coronary Artery Calcium assay, the pending heart

attach was not going to be diagnosed by a simple physical exam. An EKG is

on a snap shot of what your heart is doing at the 3 minutes it took to run

the analysis. True some things are found on the EKG but alot is missed

also. Does a photograph catch everything has happened in your life up to

that point?

Nothing in life is guarrenteed except death. I have not met anyone that got

out of this world alive. Sorry your dad had a heart attach, but it sounds

like you are blaming the IME for not finding it. Maybe the IME was a dumb

shit and missed it. Or maybe your dad was in denial and said nothing to

anyone about it until it happened. We pilots tend to be that way for fear

of losing something dear to us, flying. Problem is, we may lose something

even more dear to us, our lives by being in denial. In my humble opinion,

find the IME that is also an aviator. He understands how special the gift

of flying is. I want nothing to do with a flight doc that is a keewee. He

has never controlled an aircraft with his own fate in his hands so he has

no empathy for what maybe lost. Look for the one that really loves to fly

not the one who has never set foot in an aircraft except to go to a

convention sitting in the back of the bus reading a newspaper.

Doc

pilling.k(at)btconnect.co
Guest

Posted: Thu Mar 23, 2006 1:48 am Post subject: Commercial and Compensation

I'm suffering withdrawal symptoms....this current thread has wiped so much

familiar and comforting 'noise' off the List.



Whatever's happened to MMO, Yak-vs-CJ, Male-vs-Female, Nomex-vs-Cotton 

Flightsuits and all those other 'burning' issues that were the daily 

list-fodder...........Hell I cant even remember where we left 

off.........sic

HawkerPilot2015

Joined: 10 Jan 2006
Posts: 503

Posted: Thu Mar 23, 2006 4:30 am Post subject: Re: Commercial and Compensation

 	  pilling.k(at)btconnect.co wrote: 	
		  I'm suffering withdrawal symptoms....this current thread has wiped so much

familiar and comforting 'noise' off the List.



Whatever's happened to MMO, Yak-vs-CJ, Male-vs-Female, Nomex-vs-Cotton 

Flightsuits and all those other 'burning' issues that were the daily 

list-fodder...........Hell I cant even remember where we left 

off.........sic 	




Kevin,



This is what adults sound like discussing an issue!! Kind of refreshing. Its kind of like wearing noise cancelling headsets...you get to hear what is important instead of all the other crap that just gets in the way.



Tim

HawkerPilot2015

Joined: 10 Jan 2006
Posts: 503

Posted: Thu Mar 23, 2006 4:35 am Post subject: Re: Commercial and Compensation

My original (two years ago) flight doc flew B-17s in WWII. I think his deal is if you can see or hear better than him...you are good to go! 



I have switched recently and actually do not mind the thoroughness of a good physical...as Doc said..they may find something that will kill me!



Now, when I get my annual military flight physical and the doc dims the lights, lights a candle, puts on some Barry White, and gets out the latex glove, I know I am getting a more "probing" check under the hood. 



Three physicals a year...I hope if I had something, they would find during one of those!

brian

Joined: 02 Jan 2006
Posts: 643
Location: Sacramento, California, USA

Posted: Thu Mar 23, 2006 7:27 am Post subject: Commercial and Compensation

Roger Kemp wrote:



 	  Quote: 	
		   Tell that to the coorperate left seater that was in my office two weeks

 ago. Found a precancerous rectal polpy with- in 1 inch of his anus on the

 finger waive. It was removed the following Monday. He also was having

 premature atrial contractions on his EKG that were caused by excess coffee

 consumption. Left unchecked it could have lead to proxsymal atrial

 tachycardia which carries a risk of syncopy. He was worked into the

 Cardiologist office the following Tuesday for farther workup.


	


Right, because these guys had their prostate examined and had an ECG. 

But how many pilots going in for their second- or third-class aviation 

flight physical actually have that done? If I go to you I would not be 

surprised if you did it and I would be glad you did, but most AMEs 

don't. They aren't required and the procedures cost time and money anyway.



 	  Quote: 	
		   (slim and inshape). Could have easily ignored the fact that he had not had

 a complete exam for two years from his family MD. This was his first visit

 to my office. He had had a colonoscopy 2 years before that was negative, so

 according to the GI guys he was good for 5 years.

 Granted some IME's are not the same, nor are some CF I's either. You get

 what you ask for. Tell your IME you have not had a complete physical by

 your family MD in the past 2-3 years and/or he has never done a prostate

 exam or rectal exam and see what begrudingly happens. In my office, you

 will get a finger stuck up your but. If you say you had a normal

 colonoscopy in the last 2 years or your family doc does that annually, I

 will give you the choice to be nice unless the review of sytems was

 positive for something that really needs to be looked into. 


	


Thank you. You have just made my point for me. The point being, the exam 

tells you your status at the time of the exam. And if the FAA mandated 

physical examinations to the level and frequency to really ensure that 

the pilots are physically fit to fly, there would be screams of pain 

from all over because of the exorbitant cost.



 	  Quote: 	
		   Your physical

 exam is only as good as the answers you give on your review of systems part

 of the exam sheet. It is a subjective and objective exam. 


	


Bingo.



 	  Quote: 	
		   The last time I checked, no one can predict the future. Your dad's coronary

 stenosis could have been found on that exam. All that it would have taken

 was a graded exercise treadmill (GXT).


	


That was what caught it. It was a very small irregularity in the ECG 

taken during the treadmill stress-test. It was even within normal limits 

and in most cases he would have been dismissed but this happened to have 

been at the Bethesda Naval Medical Center and he is considered to be a 

VIP so they decided on a precautionary angiogram just in case because 

money is no object. That probably wouldn't have happened to most other 

people.



(BTW, he had no symptoms because his life-long love of playing 

basketball caused the heart to grow lots and lots of secondary paths for 

blood flow to the heart muscle.)



 	  Quote: 	
		   Which is not indicated in someone

 without complaints or a history of none insulin dependent diabetes,

 Hypertension, or symptomatic coronary arterty disease. Did your dad have

 complains of chest pain symptoms at the time of his exam? 


	


No, none. In fact, he had played several games of basketball the day 

before. He was *totally* asymptomatic.



 	  Quote: 	
		   If he did and the

 IME ignored them then he screwed up. If he knew he was having funny chest

 symptoms but was denying them which is what 85% of heart attach victims do,

 there was nothing anyone could do. Short of doing a treadmill or the newer

 more expensive CT Directed Coronary Artery Calcium assay, the pending heart

 attach was not going to be diagnosed by a simple physical exam. 


	


Right on bro! You just keep making my point for me.



 	  Quote: 	
		   An EKG is

 on a snap shot of what your heart is doing at the 3 minutes it took to run

 the analysis. True some things are found on the EKG but alot is missed

 also. Does a photograph catch everything has happened in your life up to

 that point?


	


Nope.



 	  Quote: 	
		   Nothing in life is guarrenteed except death. I have not met anyone that got

 out of this world alive. Sorry your dad had a heart attach, 


	


He never did have a heart attack. Many years before he had Bell's palsy 

and after many years needed a face-lift because he has no muscle tone in 

the side of his face due to the paralysis. The cardiac problem was 

discovered in the preop screening. My point is that it would never have 

been discovered by an aviation flight physical and probably not even a 

first-class flight physical.



 	  Quote: 	
		   but it sounds like you are blaming the IME for not finding it. 


	




No no no no no no NO! I am saying that the procedures we have to go 

through for a medical certificate, which determines fly/no-fly for us, 

is virtually useless to determine actual state of health over and above 

alive/not-alive and sure as hell tells us nothing about our physical 

status even  one year down the road. The concept of the medical 

certificate, i.e. is this person should be healthy enough to fly a 

plane, is a good one. It is the implementation that is flawed in that a 

standard third- or second-class aviation flight physical doesn't 

determine anything. It tests for the wrong things because the wrong 

things are easy to test for and the right things are both hard and 

expensive to test for. So what do we test for?



You are on the right track -- people should really know the status of 

their bodies with regard to flying. But to really do it requires much 

greater participation on the part of the pilot and a lot more time, 

effort, and money spent on diagnostic procedures.



Doc, your view of this is skewed by the fact that you are in the 

military. A pilot in the military gets just about the best medical care 

available. You really know the status of the people under your care and 

you look for long-term trends. You can freely order a relatively 

expensive diagnostic routine on a hunch and not worry about cost or 

insurance pay-back. Those of us not in the military don't really have 

that luxury. I certainly wish I did. If so, I would have you poking and 

prodding me at least every year so I would know my own health status, 

FAA be damned.



So lets get on to the real issue here. If I am safe to fly with 20:40 

distance vision why am I not safe to be reimbursed for flying my 

airplane to an airshow? You will let me perform in the airshow because I 

am not being compensated but I thought the issue was one of SAFETY? The 

whole point is that the existing medical examination process as dictated 

by the FAA, is virtually useless to have any effect on the safety for 

people to operate airplanes.



The rest is just window dressing.



-- 

Brian Lloyd                         361 Catterline Way

brian-yak at lloyd dot com          Folsom, CA 95630

+1.916.367.2131 (voice)             +1.270.912.0788 (fax)



I fly because it releases my mind from the tyranny of petty things . . .

- Antoine de Saint-Exupery

viperdoc(at)mindspring.co
Guest

Posted: Thu Mar 23, 2006 7:58 am Post subject: Commercial and Compensation

Kevin,

We've mooooovvvveeeddd onnn totottttoooo riping wings off and having parts

sales for perfectly good airplanes ddddooiiiinngggg BBBBFFFMMMMM!

Doc

 	  Quote: 	
		   [Original Message]

 From: Kevin Pilling <pilling.k(at)btconnect.com>

 To: <yak-list(at)matronics.com>

 Date: 3/23/2006 3:58:14 AM

 Subject: Re: Commercial and Compensation



 



 I'm suffering withdrawal symptoms....this current thread has wiped so much

 familiar and comforting 'noise' off the List.



 Whatever's happened to MMO, Yak-vs-CJ, Male-vs-Female, Nomex-vs-Cotton 

 Flightsuits and all those other 'burning' issues that were the daily 

 list-fodder...........Hell I cant even remember where we left 

 off.........sic

viperdoc(at)mindspring.co
Guest

Posted: Thu Mar 23, 2006 8:02 am Post subject: Commercial and Compensation

Does he/she have a hand on both shoulders? If so, I'd worry!

Doc

 	  Quote: 	
		   [Original Message]

 From: Tim Gagnon <NiftyYak50(at)msn.com>

 To: <yak-list(at)matronics.com>

 Date: 3/23/2006 6:41:23 AM

 Subject: Re: Commercial and Compensation

 My original (two years ago) flight doc flew B-17s in WWII. I think his

deal is if you can see or hear better than him...you are good to go! 

 	  Quote: 	

 I have switched recently and actually do not mind the thoroughness of a

good physical...as Doc said..they may find something that will kill me!

 	  Quote: 	

 Now, when I get my annual military flight physical and the doc dims the

lights, lights a candle, puts on some Barry White, and gets out the latex

glove, I know I am getting a more "probing" check under the hood. 

 	  Quote: 	

 Three physicals a year...I hope if I had something, they would find

during one of those!

 	  Quote: 	

 Read this topic online here:

 http://forums.matronics.com/viewtopic.php?p=23662#23662

Valkyre1(at)comcast.net
Guest

Posted: Thu Mar 23, 2006 8:02 am Post subject: Commercial and Compensation

Just a thought here on who and what we're  dealing with when we put ourselves in a grey area of legalities and run  into an FAA employee who just may have gotten up on the wrong side of  bed;

  

 To make a long story ...not quite so long, nineteen  years ago I was flying as co-pilot on a 737 at the end of a four day trip. The  day was CAVU and not another aircraft was within 150 miles as we landed in  Casper, Wyo. enroute to SLC.

  

 In those days, we made quick turn arounds. ( Land,  unload baggage-passengers, reload all, and leave within about 15 minutes.) This  was a good trip and everyone seemed in a good mood. We were having fun. I  called for taxi clearance and received it, called for takeoff (captain was  flying/taxiing) and received the OK for that too. 

  

 As we departed and were told to switch frequencies  we thanked tower for the help and they cheerily told us to "have a nice  day."  

  

 When we landed in SLC our Chief Pilot was out to  meet us telling us that Casper had called him and filed a violation on us for  taxiing and taking off without a clearance. We were horrified and asked each  other "Did we DO that!?" We both concluded that we had not, and my Captain  said that he would talk to the tower Chief in CPR when he went through the next  day.

  

 The tower chief apologized to my captain and told  him that we had been dealing with a supervisor and a trainee who filed the  violation against us. They were the only personnel in the tower.  Evidently  the supervisor had "issues" because he had wanted to be an airline pilot and  been rejected. He also had "issues" with female voices coming out of the  cockpit. The tower chief said that he would have thrown out the complaint but he  could not because it had already been filed. They wanted to slap us with a  "minor" violation and 5 days off.

  

 I did not want a violation on my record.  Particularly one that I didn't feel we deserved. (Lets forget others that I may  have slipped through the net on in previous years.)

 I demanded the tower voice tapes and was relieved  to hear us ask for and receive all clearances...end of issue, or so I assumed.  They sent another letter informing us that the charges had been changed  since their initial complaint was proven false. Now we were accused of  moving an inch before they said that we could (in motion) in a "mother-may-I"  pissing contest. We had no witnesses other than the two accusing ATC tower  people themselves. Faced with something as apparently unjust as this, I refused  to go down without at least having our day in court and convinced my captain to  go to Seattle for an NTSB hearing which occurred a year  later. 

  

 The lesson that I learned and the facts that I was  reminded of is that a pilot's license is considered a privilege and not a right.  NTSB (FAA) courts admittedly function on the premise that you are considered  "guilty until proven innocent". The NTSB judge was a good buddy of and played  golf with the FAA lawyer. The judge, after hearing our opposing views of what  happened ( did we or didn't we start to move a few seconds before being given  permission?) asked me if I know of any reasons why the FAA controller would have  accused us of this if we hadn't done it. I said yes I did. (I hate playing the  gender card, even if it's true.) The judge didn't ask me to tell him the  reason, our ALPA attorney didn't  pick up on it, and I was too uncomfortable to push it thinking that surely  someone would ask. They didn't ask and we lost our only chance of being  vindicated.

  

 The prosecuting attorney said that since  the tower Supervisor had nothing to gain by unfairly violating us, and since we  had something to lose (our first and only violation) quote: "The pilots must be  lying and the controllers must be telling the truth." Of course I resented being  called "a liar" by default, no less, and turned to my Attorney."  He told  us "Look, I have a tennis match to get to, the violation is minor, and you  should just take it and drop it. You can't win in a case where it's the FAA's  word against yours, this is THEIR court and not a civil court. You don't  have the same rights here."

  

 That, my friends, is the story of my first and only  violation. it was a learning experience. At least I got the opportunity to meet  our accusers and to make them go all of the way to Seattle, endure the same  uncomfortable days in court that they subjected pilots to, and hopefully ask  themselves if violating their next pilot really had enough truth to it to  justify backing it up. It was rather disgusting to watch the Supervisor, Mr.  Short, slapping hands and high fiveing his buddies over his perceived victory.  It wasn't the trainees fault. He seemed like a decent guy, just caught in the  situation.

  

 I did get some sense of vindication when I walked  up behind Mr. Short (and he was short...about 5'  7") doing his victory  dance.  Everyone became quiet and my captain later told me "I just kept  thinking....Don't hit him Val!".  He turned and I looked him in the  eye and said "Mr. Short, up until now I have  always had the highest regard for Air Traffic Controllers. They're wonderful  people and have always done a fine job for me. You are the exception.  Regardless of this court ruling, both you and I know why you really did this to  us and it's a gross abuse of power. At this point I have no choice but to bid  around Casper Wyoming because I don't know when you're going to get up on the  wrong side of bed and decide to throw your weight around again.  Your  contemporaries deserve to be represented by better men than you."

  

 He had been sweating profusely and just kept the  same silly grin and blank look plastered on his face as he absently muttered  "thank you." I don't think that he even knew who I was, much  less registered what I said.  

  

 Point being, let's fight the good fight, knowing  well who we're dealing with and what we have to work with. Let's get a  regulation that we can defend in court firmly set in place BEFORE we have to  defend ourselves. Don't hope for nebulous solutions because it's hard enough to  defend even the best of your actions in an NTSB Court. Not the same rules and  rights and both the judge and the jury can also be your  accusers. This is definitely not meant to  discourage you guys. Quite the contrary. Just to give you good tools to fight  the good fight.

  

 Happy ending for me was that it was such a minor  violation and happened so long ago that I think it has long since left my record  (I hope). That's just my understanding of the law.

  

  

 Fly Safe, have fun, and don't go through Casper  Wyoming. At least not on Mr. Shorts watch. That's assuming he hasn't already  been pummeled into submission by another irate Amazon. (laugh)

  

 Fraternally, - Val

BitterlichMG(at)cherrypoi
Guest

Posted: Thu Mar 23, 2006 3:05 pm Post subject: Commercial and Compensation

That is no doubt absolutely true.    

Mark Bitterlich  

  

--

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