THE OFFICIAL PUBLICATION FOR BONANZA, BARON & TRAVEl ...

SPECIAL ISSUANCE PROCESS
APiiot discovers he has a disqualifying condition and is
told he needs to provide more medical infonnationl
tests/documents for consideration by the Aerospace
Medical Certification Division (AMCD). Finding out what information
is needed and acquiring and preparing these documents is
one of the greatest challenges to obtaining the special issuance.
The ABS Aeromedical Committee often receives calls
from members who have been turned away from their AME
exam with a condition that requires deferral by the AME. In
many cases the pilot is told simply that a finding or condition
does not allow the AME to issue and that AMCD will send the
pilot infonnation concerning what is needed for further consideration
for a medical certificate. When this occurs we get
calls for more infonnation and of course seeking ways to
"speed up the process."
How to get ready for AME exa m
One step in speeding up the process can occur before the
AME exam. If you know something has happened that might
affect yo ur eligibility for a medical certificate, call your AME
or ABS, EAA or AOPA before you go to the exam.
Sometimes simply having your documentation in hand at
the time of the exam will allow the AME to issue. It also gives
the AME infonnation to call AMCD or the Regional Flight
Surgeon and perhaps get a verbal authorization to issue the
certificate, once he has explained your condition with the help
of the extra information you provided.
Not all AMEs can or will do this, but I obtain a phone number
for all my appeintments who are requesting AME exams. I
then call the pilot before the exam and ask if he/she has had any
changes or new findings since we last did an exam. Sure, it takes
a little extra time, but often saves time later.
It is frustrating to have an ainnan come for an exam and in
the midst of the exam relate something like "Oh yeah, I forgot to
mention that I had that LASIK surgery a couple of months
ago ... and I also had that colon test with the scope. They said it
was some little cancer, but not to worry ... just get another scope
in a year." This exam just landed with the gear up! ow we are
going to have to get documents, at least, for these issues.
I can 't totally blame the pilot for not being concerned. He
is seeing without difficulty, and the polyp that was removed
probably is not serious or he wou ld not have been released
without more testing. But AMCD wi ll want more information
from his eye doctor and the surgeon who performed the
colonoscopy. We can't complete the exam at this peint.
I usually try to help the airman by making calls and trying
to round up the needed information. The AMCD allows the
AME a few days to do this. but it would have been so much
simpler, better and faster if the information had been documented
before the exam.
One really great ally in the process is your family doctor.
Family Medicine as a medical specialty has met with some hard
times in the 21 st century. Fewer and fewer doctors are going into
the specialty. I was trained in the 1970s when Marcus Welby,
MD, ruled the television ratings and residencies training family
doctors were pepular. Many factors over the next 30 years turned
the newly graduated MDs toward other specialties: income,
hours, insurance reimbursements for primary care, prestige.
I am always amused by the inevitable question when
meeting someone new who asks, "Are you a specialist or just
a general practitioner?" I try to explain that my specialty
required three years of training after medical school, just like
an internist or pediatrician. That it is a specialty never seems
to register with the general public.
The expression on the questioner's face is somewhat similar
to that seen when learning that I am a pilot: "Oh, you're a
pilot! Do you fly for the airlines or just a little plane?" Well,
that usually leads into an explanation about the Bonanza not
being in a western TV series and that it has only four seats.
But back to the beleaguered pilot in distress with his medical.
Having a family doctor, whether he is trained as a fa mily
physician or intern ist can be of great help in gathering records
and tests fo r the AMCD because the fami ly doctor has or
should have all of your medical hi story and records from the
other specialists you have seen!
Ever notice when you go to a specialist or hospital or to
get an X-ray or test, that they ask who your family doctor is?
They follow up your treatment by sending information and test
results to your doctor. So when the AME needs the information
on your LASIK and the information about the colon test,
he has only one call to make. Often a brief chat with the family
doctor will clarify questions that the AME (and AMCD)
might have about a test result or other fi ndings. Easy!
If you have a good family doctor, hold on to himlher. The
system is not producing as many as in the past. Tell your fami ly
doctor you are a pilot and if any future medical issues arise, you
hope he/she will be an advocate for your case.
Let your family physician know that you are passionate
about your flying and how much it means to you. Then if andlor
when a call comes from the AME, the fami ly doctor will hopefully
be ready and willing to help you speed up the process.
Charles S. Davidson, M.D .. holds board certification in family
medicine and emergency medicine. He has been an aviation
medica l examine r since 1978 and se rves as a senior AME . He
holds a commercial pilot license with multiengine and instrument
rating. He is on active pilot using genera l aviation for busi·
ne ss and p leasure for 23 years a nd is a lso on the ASS board . He
flies on A36.
This column is intended as general information only for the ASS
membership; it should not be construed as providing medical advice
or creating a doctor-petient relationship. Consult your own doctor for
personal advice or your AME for aeromedical advice.