Last month this column was full of low-skill derring-do; this month I’m back with another blood pressure raising potboiler, this time more of the bureaucratic bent.
My precious memory got things started by letting my BasicMed lapse, if only by two or three weeks. We had a Young Eagles rally coming up at my local airport, and while reviewing my paperwork as requested by the Supreme Eagle, I had that funny feeling it had been a long time since I had taken that online refresher. And yes, a close look at the paper revealed it had been a while and I needed the blessing of a medico, pronto.
Naturally this was Thursday night and the Young Eagle rally was Saturday. That left one day—Friday—to get close with the medical profession. I needed to impress my family doc’s stethoscope and tongue depressor, not so easy to do as a walk-in on a Friday. But I tried and didn’t impress the receptionist one bit. “You need an appointment.”
Reminding myself that a mistake on my part didn’t constitute an emergency for my doctor, I said thank you and wheeled over to the Urgent Care dugout. We used to have our own hospital in our village, but like the family-owned pharmacy, Ford dealership, bowling alley, movie theater, clothing stores and wonderful family-owned hardware store, the horse pistol is long gone, turned into a druggie’s halfway house. That’s all thanks to the overnight sprouting of 150,000 houses just over the hill by the great land developer machine. Traumatize your bod in my small town these days and you get a long ambulance ride in gridlocked SoCal traffic to the big hospital over the hill. Get bit by a dog—or overlook your medical—and you get Urgent Care.
Turns out the sole Urgent Care in town is staffed by pleasant people, none of whom, alas, is a “state licensed physician.” So, no possibilities there.
Retreating to the airport intending to talk my hangar partner into flying the Young Eagles and thus not abandoning the Supreme Eagle, it was suggested I go to the big city over the hill and see a certain AME. A brief finger trip on the cellphone revealed said AME had an opening that afternoon, so I took it. Sure, an AME is overkill for a BasicMed check, but at least I wouldn’t have to explain what BasicMed is.
It said in the fine print that I’d receive a confirming email. Never did, so I called four times to listen to the answering machine during office hours. Hmm, do I really have an appointment? No choice but to sit in the afternoon traffic and get to the big city to find out in person. Glad I don’t have a real job anymore and can devote so much time to such things.
“Why yes, you’re on for 3:30 p.m.,” was the answer upon arriving at the chrome-and-glass palace. Ah, some good news. “That’ll be $285.” Geez, life in the big city. Credit card returned to wallet, I got taken to the back for a vitals check, along with reading that ever-shrinking eye chart, looking for the red line through the musical note, reading the numbers in the colorblind dot-fest and all that. “Strip down to your shorts and sit on the exam table. The doctor will be right in.” Some basic exam.
The usual mind-wandering wait and then the door burst open and the doctor was present, all white lab coat, gray hair and clipboard. More erupting than speaking, his clipped, snarling opening was, and I quote, “Umm, yes, I’m Doctor XXXX and what the hell are you doing wasting my time on a Friday afternoon when I could be at home or doing something else instead of a stupid BasicMed?” He certainly has a command presence, I remember thinking while stumbling out why I was in for a quick BasicMed, but he cut me off. “Look, no one comes to me for a BasicMed unless they’ve got something to hide. And you’ve got something to hide and I’m going to find it.”
Are You for Real?
It had already been a long day and was definitely getting longer. I don’t enjoy being called a liar, particularly when it isn’t true, and if I had then fully understood how BasicMed works I would have put on my Levi’s and walked out. But Cub Scout that I am, my focus was upholding my Young Eagles obligation and naively thought by dint of my superior physical state I could push aside doubt and walk out with the coveted signature.
There followed some rapid interrogation regarding why was I there…then the cursory flashlight in the eyeball bit, followed by grilling on why I had gone to my regular physician twice in the last three years as I had noted on the form. Well, if you really have to explain a skin rash, then I guess you do. The other was for a pain that had gone away and an ultrasound that had shown nothing. But to Dr. X that was the sturdy peg to hang his weighty suspicions on. In the meantime he warmed his stethoscope on my back. “Nice and clear,” he mumbled. Then the heartbeat; no comment.
Again he asked why I was there, made another rude comment I won’t repeat here, and in what I thought seemed getting desperate told me to bend over and touch my toes with my fingers. Luckily I had been riding the dirt bike lately and was about as limber as I get anymore (not very), so I managed the task with the slightest of knee bend. Then he told me to squat down like a baseball catcher, then stand up again. At 67 that can be a lot to ask of a guy who’s been sitting at a desk for 40 years, but again the dirt biking did me proud and I made sure to not use my hands or arms at all when standing up. “Get dressed and see me out front.”
Out front he said he was going to hold my paperwork and I was to get a letter from my regular physician—on his letterhead—explaining that bit about the long gone pain. “When you can do that I’ll feel more comfortable about signing you off. Sorry you can’t fly tomorrow.” And I was out the door.
My hangar mate flew my Young Eagles and I was put on the PA system. On Monday I was back at my regular physician’s looking for a letter. No letter was forthcoming without an examination, said the receptionist. “We’ll call you after I talk to the doctor.” About four hours later I received a phone call and was told to get blood drawn for a panel and make an appointment with the doctor when I had that. The next possible date was two weeks out.
And BasicMed is all about making flying easier and less expensive, I mused. Here I am, grounded for at least two weeks if I’m lucky. Counting the driving I’m already $300 lighter and just getting started. Most troubling was the AME’s attitude. It was beyond obvious he had a burr under his blanket about BasicMed. In other remarks not repeated here, regarding how BasicMed had come to be, the doctor made it clear he thought BasicMed was a bad idea but never said why. He also had the bedside manner of a pissed off traffic cop. Certainly a disagreeable personality—which is unfortunately not a breach of the regs but would seem a liability for a doctor in a capitalist society—the AME was exceeding his mandate for a BasicMed exam in his zeal to find something wrong when all evidence was to the contrary.
The two weeks passed, I got the blood work, and after a brief exam my family physician gladly signed another BasicMed form I thought to bring with me, and the episode is behind me. That’s possible because, as I was reminded after the first exam, unlike Class l, ll or lll medical paperwork, BasicMed forms don’t go to the FAA; they stay with the pilot until the Feds want to see them. That’s one check against overzealous physicians—if you run into a stinker you can try again elsewhere.
I must say, experiences such as mine are what teach pilots to never mention anything to an examiner, as the punishment for honesty can be vexing. I can also advise avoiding any AME if wanting a BasicMed sign-off, a sentiment other AMEs have since confirmed. An AME represents the FAA during a Class I, II or III check; your physician represents you during a BasicMed exam. There’s a distinction, and some AMEs thus don’t do BasicMed exams. They don’t want to work both sides of the runway as it were. For a pilot there’s no upside in dealing with an AME for BasicMed, just the chance of meeting up with a prick, so don’t do it.
Then there is the whole thing about BasicMed not looking as good to the insurance industry as a Class III medical, but that’s another topic for another time.
In a larger context, the episode reminds of how dangerously close we are of drowning in practically unaccountable officialdom. Any number of administrative law types stand nearly unassailable in getting things done today. Pilots are one step away from a rogue AME, while elsewhere fire marshals, building inspectors, DMV clerks and so on have the power to impede. It’s all for buildings that don’t fall down or explode, pilots that don’t keel over at the stick and all that, which is a heck of a lot better than riding out an earthquake in some third-world paradise where a $100 bribe got the contractor past any inspection. But at some point there needs to be a check on those checking.
Ultimately, maintaining good health is easily the best medical policy. It’s attention-getting to contemplate not flying again, even over a paperwork scare, believe me. It’s also good to review the practicalities of how medicals and BasicMed work and understand your options. Being in a rush doesn’t help either.