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NATIONAL BUSINESS AVIATION ASSOCIATION • focusHow Pilots Should View the Special-Issuance Medical ProcessPilot apprehension over a required visit to documentation. So, it goes to Oklahoma City,where the case may languish for one to three months. In the meantime, the pilot isn’t flying when they probably could be.”As in many other aspects of aviation, proper documentation minimizes the risks. “Rather than any particular medical condition, it’s the reporting terminology and lack of documentation that most often leads to deferrals,” Snyder noted. “AMEs have greater latitude to issue a certificate, but they are also under greater scrutiny to ensure they have made an aero-medically appropriate decision.”A pilot must also be forthright and honest with an AME, while mindful of the correct terminology.“Should an airman experience chest discomfort leading to an emergency room visit, where testing shows it to be a simple case of reflux properly treated by an antacid, that’s fine,” Snyder explained. “When they later tell their AME they visited the ER for ‘chest pain,’ though, that sets off warning bells. The airman must be ready to provide documentation showing the issue was treated and resolved.”Both physicians stressed the importance of seeking appropriate medical care, regardless of any apprehension about their medical certificate. “Overall, the process works,” Cowl concluded. “It’s important to remember that a flight physical is not a comprehensive medical evaluation, though.“We want pilots to get screening that isn’t required by the FAA, so they not only have healthy careers in the industry, but also healthy lives well into retirement.”This piece appeared as a feature story in the July-August 2014 issue of Business Aviation Insider, NBAA’s bi-monthly Member publication. Business Aviation Insider is provided as a complimentary benefit of Membership with the association. man aviation medical examiner (AME) maylead to unnecessary delays in receiving an otherwise standard waiver for an underlying medical condition.“There’s a paranoia in the pilot community that any condition is cause for disqualification,” said Dr. Quay Snyder, a former AME and president/ CEO of Aviation Medicine Advisory Service. “When someone goes into a medical exam, the AME has three options: issue or deny the certificate, or the intermediate option of deferral, which leads to certification delays when the pilot provides inadequate information regarding a medical encounter that occurred since the last exam.”Among the most common conditions leading to a deferral are cardiovascular disease, cancer and other “dynamic” illnesses requiring scheduled check-ups following treatment. In situations where the AME cannot grant approval during the initial visit, the case is deferred either to the FAA’s regional medical authority, or to the agency’s primary aeromedical office in Oklahoma City, OK.Dr. Clayton Cowl, senior AME and chief of aerospace & transportation medicine at the Mayo Clinic, cites a “fear of the unknown, or the need to stand down for purely bureaucratic reasons” for much of the reluctance among pilots to reveal their complete medical history.“The pilot/AME interaction is truly a trust relationship,” he added. “In reality, very few pilots out there - a 10th of 1 percent - are actually denied a medical certificate. Of the approximately 375,000 pilots who visit their AME each year, roughly 10 to 20 percent will have a medical issue leading to a period of time in which they’ll need to stand down to establish medical stability.”“In many cases, the medical condition is not disqualifying, or is easily waiverable,” Snyder added, “but the AME cannot do that without26 • TWIN & TURBINE OCTOBER 2014