 Welcome everyone. My name is Fred Kaiser and I'm your host here at the fast team National Resource Center FAA production studios at the Sun and Fun complex at Lakeland, Florida An exciting week we're having so far at Sun and Fun and more to follow today's presenter is The deputy federal air surgeon he retired from the Navy as a captain after 30 years of service He holds several degrees from the University of Oklahoma including doctor of medicine He is an emeritus member of the Society of Naval Flight Surgeons where he was president from 2002 to 2003 His topic today is maintaining your medical and without any further delay. Let's welcome dr. James Frazier Well, good morning. It's great to be back at Sun and Fun. This is my Third year here to have the opportunity to speak in this venue today, I'd like to Do a couple things first of all, I'd like to tell you just a little bit about myself So you'll know where I'm coming from then I'd like to tell you about what the Office of Aerospace Medicine does and Then lastly, I'd like to get into current issues as it regards So how you can maintain your current medical things that I think you may be interested in So to start off with just to give you just a couple seconds about where I come from Just over five years ago. I was a happy sailor down in Norfolk, Virginia Still thinking I had four years to try to figure out what I wanted to be when I grew up When the Navy sent me a letter and told me that 30 years was all the time a sailor was allowed to have fun so After 30 years in the Navy, I was able to apply for my present position at the FAA and Made the move from Norfolk, Virginia to Alexandria, Virginia same-state different world. I Did spend My time in the Navy not all of it was as a flight surgeon I started life as a mark one mod zero family physician and after Residency and family practice and steep and sticking around as family practice teaching staff I I went with my family overseas and had tours in the Philippines and in Scotland I certainly enjoyed my time overseas and as a family physician Had some great experiences, but I had always wanted to be a naval flight surgeon So before I turned 40 and got too old to start training I was able to report to Pensacola, Florida the source of all things from which naval aviation comes and Did my training flight surgeon? They taught me how to fly an airplane and with flight pay. I got a pay raise and I've been in aerospace medicine ever since Following my time as a basic flight surgeon I was able to stick around Pensacola and do a second residency in aerospace medicine And then in the Navy if you do a residency in aerospace medicine It's pretty much a one-way ticket to an aircraft carrier So I had the opportunity to serve as the senior medical officer on the USS Theodore Roosevelt one of our national treasures one of our nine now nine nuclear aircraft carriers On the carrier I had a 67-bed hospital a Medical staff of 70 and we took care of the ship's company and the air wing that comprised 6,000 personnel on the Roosevelt and then the larger battle group with the destroyers and the amphibious Ships grown in were about 10,000 folks that we oversaw Well following my tour on the Roosevelt I was able to to fleet up and be what was called the force medical officer for the commander Naval Air Force's Atlantic fleet and as such I had oversight of what were then eight aircraft carriers on the East Coast All naval flight surgeons and physicians serving in the Atlantic fleet and then lastly I finished my career in the Navy at the Naval Safety Center Where I had the opportunity to provide oversight and train all naval flight surgeons I had the opportunity to be involved in safety initiatives at the very very highest levels of the Navy and I actually finished out my Navy career having the honor to serve on the Columbia accident investigation board So I feel very fortunate to have had a career in the Navy that I think has Served me well for my position as deputy federal air surgeon I'd like to tell you now a little bit about the office of aerospace medicine and What we what we do Certainly probably the most important thing we do is develop standards for airmen and air traffic controllers We serve as the gold standard for the rest of the world In terms of setting these kind of standards that the other medical Certificating authorities basically emulate With that I'll I'll tell you a quick story just to give you some some idea of Of the way that we are able to serve as the benchmark for the rest of the world In addition to setting standards We also determine what medications are safe for airmen and for air traffic controllers and and being the world gold standard We're relatively conservative. We we don't allow experimental drugs. We wait until the FDA approves of a given medication and then as lots and lots of people begin taking these medicines We actually wait an additional year to make sure that there's no air medically unacceptable side effects So a couple years ago there was a medication that came along named verenicline Verenicline was a smoking cessation medication and it showed great promise Verenicline was effective where other modalities of smoking cessation Had failed and this included hypnotism and nicotine patches nicotine gum Now in case you just dropped in from another planet smoking is bad for you So certainly we and aerospace medicine were interested in any medication that could help airmen and air traffic controllers Stop smoking. So when verenicline got approved by the FDA and then it went a year and it showed no evidence of No of side effects that would be incompatible with aviation. We allowed it to be used In both airmen and air traffic controllers However, as is not uncommonly the case there began to be reports that showed up in the medical literatures about a year after two years after approval and in these reports people taking verenicline Starting at having episodes of psychosis or suicidal ideation suicidal thinking Neither of these are good if you're in a cockpit or if you're a controller controlling traffic, so We we met as a group and we looked at the The literature that was coming out about these episodes of psychosis or suicidal ideation and in patients taking verenicline And we determined that that was a risk to the national airspace, so We very quickly identified those that those airmen or Controllers that had had stated on their last physical that they were taken Verenicline and we were able to notify them within 24 hours But as you know, you only report medicines at the time you do your physical Unlike the Navy or the military you don't go to a flight surgeon or to an aviation medical examiner every time you start a new medicine So to get the word out to these airmen and controllers we worked with the alphabet groups We worked with a opa we worked with with natka. We worked with ea a We had the word out on electronic bulletin boards and within the space of one week Not only did you see the word out in electronic bulletin boards, but in the Washington Post and the New York Times and various other Big publications it became known or it was being spread the word was being spread that The FAA had declared use of verenicline and airmen and air traffic controllers to be disqualifying so I thought this was pretty cool and within that same week we had some of the representatives from the medical Certificating authorities from around the world calling us and asking us why we had discontinued The approval of verenicline and we would tell them and then they too would do the same for their airmen and air traffic controllers So within a week within the span of one week we had identified a risk to the national air airspace and we had taken actions and Basically had very effectively made sure that verenicline wasn't only being used to the United States But throughout the world, so I went home on a Friday thinking Darn were good, you know within a week to identify a hazard and to be able to mitigate that risk Within such a short of period of time not only nationwide, but worldwide we did good work Then I came back to work on Monday and one of the first things that I was told was that we had that aviation safety had been notified by the American Medical Association and there was a statement that they wished us to respond to Basically the American Medical Association said we had caved to the pressures of the tobacco lobby. I was really angry not only Not only had I never spoke with nor would I know what a tobacco lobbyist looked like. I mean they don't deal with us Feds they go up to Congress up on the hill But not only would I not know what a tobacco lobbyist looked like for anyone without benefits of the facts and data to To suggest that we would discontinue a medicine for the sole purpose of allowing airmen and air traffic controllers to Continue smoking was just ludicrous. So I was I was really torched. So took a few deep breaths Went outside and had a cigarette. Just just just just kidding about cigarette so we we sent this member of the American Medical Association all the facts and data on which we had made our decision and We haven't heard anything since but I tell that quick story Just to point out the influence that we the office of aerospace medicine have not only in the nation But throughout the rest of the world So our first our first job is to keep the national airspace safe. That's why we develop standards That's why we look at new medications and things of that nature, but our secondary mission that I'm very proud of We look to get every airmen up that we think we can safely do so and in order to do that We authorize special issuances special issuances being a waiver for Medical conditions that were previously considered as disqualifying and I'm very proud of the fact that if You will work with us if you have a disqualifying medical condition But yet you're willing to work with us in the office of the aerospace medicine We ultimately final deny only about one tenth of one percent of all airmen So if you're willing to work with us and undergo the specified follow-up and testing that we may require The odds of you getting a medical certificate are very very good We'll talk more about that later We also develop standards for commercial air travel That's that's with us now And we develop standards for operations of UAS's unmanned aerial systems or unmanned aerial vehicles As it was once known certainly a part of our industry that is Quite interesting and evolving very rapidly in the office of aerospace medicine We give medical certificates. We give 450,000 odd medical certificates per year at headquarters. We are the appeals level So for those medicals that might have been denied by the regional flight surgeon or by AMCD in Oklahoma City the Aeromedical Certification Division in Oklahoma City those cases ultimately come to the federal air surgeon at headquarters and we We get involved in some of the most interesting medical and psychiatric issues and Certainly go through those cases with a fine-tooth comb because if we Final deny we have to defend before administrative law judge at the NTSB and those guys aren't physicians They just make sure that we've dotted every eye and crossed every T in terms of following all the statutes and all the rules That we have to go by We're very big in Occupational health in the sense that air travel Represents a very real risk to the introduction of serious diseases in this country You can look at the deepest darkest scariest places on earth and now with the advent of modern air travel you can get Bad things into the borders of the United States within 24 hours So I have found it very interesting to work with organizations like Homeland Security and CDC and NIH In in terms of making sure we work in a coordinated fashion for things such as infectious diseases like TB and SARS emerging illnesses like the avian flu or Ebola virus and Especially bio-terrorism agents like anthrax and I can tell you that that there's some Exciting and some scary stuff that goes on out there that you don't read about in your local newspaper We're also very much into substance abuse or dependence abatement We have our industry program where we're very active in terms of Testing our 121 and our 135 pilots. It doesn't affect most of you folks since your general aviation We also have our internal substance abuse program whereby we test our own FAA personnel that are in safety and security Sensitive positions and that's mostly our air traffic controllers I Tell you it's been it's been an interesting phenomenon to have The substance dependence Reinforced upon me as as a big issue. I I never cease to be amazed at the many thousands of 121 and 135 pilots that either try to go through TSA with Alcohol on their breath and you occasionally read about some of the most agrarious cases in your newspaper But we also test these folks randomly and most amazing of all to me is the Pre-employment testing that DOT requires if you're going to start work for an aviation entity 121 or a 135 entity. It's required that you're going to have a drug screen Now it's no surprise that that's going to happen. You're told that that's going to happen and yet the thousands of pilots that have had years of training and spent many Thousands of dollars that undergo this training that have this disease Such that they can't stay off of drugs prior to a pre-employment testing Just just amazes me. So the problems with substance abuse substance abatement is out there It's very real and I never cease to be amazed at how serious a problem that is One of the things that I'm very proud of or are proud to be a part of Is the programs at the FAA that we have developed many years ago To work with substance abusing or substance dependent pilots. We have a HEMS program HEMS is human interventional motivation study It's a program that was started 30 years ago in conjunction with the with the unions And with the air carriers and with the FAA and so with the three of us working together We have identified substance abusing pilots Or substance dependence pilots It was once a career ender and because it was a career ender it would not get mentioned people would not Would not Basically tell us when one of their cohorts had a problem and there was a risk to flight and a risk to passengers but We now fortunately have a system where You can either self report Or if you're concerned and once again, i'm talking 121 135 operations You can report a fellow crew member And after treatment and rehabilitation We are able to successfully get these pilots back to Active careers and and they once again are productive members of society We have returned many thousands Of substance abusing and substance dependent pilots to sobriety and to active productive Careers and and i'm proud that we now have a lot of AMEs that are specially trained That allow us to work with third class pilots general aviation pilots So if there are Uh third class pilots that have third class medicals We're now able to get them hooked up with the same kind of rehabilitation That we previously had for commercial pilots and get them a medical certificate sooner than the two years they'd have to wait If if they were just the routine third class We're very much involved in air medical education. We have some air medical education Occurring right outside in the hangar. We go to a number of air shows and have the opportunity to talk to airmen But certainly the the biggest thing we do Is train our aviation medical examiners. We have some 3800 aviation medical examiners scattered throughout the world and We train them initially at oklahoma city and then hold refresher courses throughout the country In order to make sure they stay up with f a a standards The office of aerospace medicine Is involved very much at research most of our research is done at cammy our civil aerospace medical institute in oklahoma city And there we do research In such things as survival and evacuation issues We have a huge human factors division that looks at Things like selection and training of air traffic controllers We look at the issue of fatigue in airmen and and flight attendants and air traffic controllers We we have the world's best forensic toxicology laboratory and following fatal mishaps We always get specimens and we were able to determine whatever medicine A pilot may have been taking that might show us if there was some medical reason for the crash We're we're also developing techniques where we can look at genomes and genetic markers and tell if a pilot was fatigued at the time of the crash So we have the the the gold standard Forensic toxicology lab there at oklahoma city and we learn lots of lots of things We also are looking into decontamination of aircraft following an infectious illness emerging illness or Bioterrorism event and we look at the more common Environmental issues associated with aircraft cockpits We look at the effects of Petroleum products that you might be found in the bleed air from our air carriers We look at the effect of pesticides that we're required to use as we move from country to country and what that residual effect may do to aircrew and passengers And we look at the more common environmental issues like the effects of Of hypoxia and low humidity and low barometric pressure and radiation and ozone So we're very much involved in research in the office of aerospace medicine So that's a few things about our office and what we do I'd uh, I'd now like to get into some some current issues um And talk about How these Pertain to you or might pertain to you in terms of maintenance of of your medical Now the first thing I have up there is the fair treatment of experienced pilots act better known as age 60 once again, we're talking about A a 121 135 operation But as many of you are aware This was certainly a major major issue with with With air transport pilots and commercial pilots Uh until december of 2007 when president bush finally signed into law The fair treatment for experience pilots act and I am so thankful I think all of us at the fAA are thankful that he did that Otherwise we would have spent years trying to justify the age 60 rule As you probably know Since december of 2007 We now allow pilots To fly up to the age of 65 if you fly outside the borders of the united states in order to be consistent with iKO One pilot can be up to age 65 as long as the other one is under the age of 60 If you fly within the continental united states both pilots can be up to the age of 65 And i'm just glad i'm not spending my life testifying as to why we should or shouldn't have changed that rule And i'm thankful the president did it with a stroke of a pin Now the age 60 rule served us well for many many years It was a rule that stems from 1959 And i don't know how they came up with the age of 60, but i think it was a pretty good stab At uh at a time when commercial pilots should no longer be allowed to carry ticket-carrying passengers Um not to bring up any depressing topic, but as we age we have Physiologic and perceptual motor skills that decline Our vision declines our hearing declines our sleep patterns decline There are other things that don't work as well when you age, but i'll stop there Well, could you could you save it till the end sir? Okay, and i'd be pleased to have your comment We've done sophisticated neuropsychological testing and as you age you have decrease in Attention you have decrease in memory you have decrease in speed of processing so basically Things don't Look well as you age all of that being said who would not want to fly home With captain sullenberger as their pilot in command So certainly experience makes up for many of the physiologic and the perceptual motor decrement That we all experience and as i mentioned earlier i for one Think that it's an idea whose time has come Now in terms of using best evidence-based medicine in order to determine what is a risk and what's not In july of last year the law changed the rule changed Uh, we now have increased the periodicity of medical certificates for those pilots under the age of 40 If if you are under the age of 40 And you have a first class medical it's now good for a year by what used to be six months If you're under the age of 40 and you have a third class medical certificate It's gone from three years to five years and that's simply because we now have good data we have good medical data That that basically tells you the same thing the actuary the life insurance actuary tables tell you if you're under the age of 40 The value of a physical in finding something wrong with you is it's pretty slim So we have increased the periodicity For those that are under the age of 40 what's really cool about this new law Is that it has a resurrection effect There are those that had a third class medical That have had their medical expire and as the passage of this law in july of last year Their medical is suddenly good again And I think that's uh, that's nice to have a law that resurrects something of that nature now. There are a few issues. I know the AMC 700 folks are here making yep, there they are keeping an eye on me as usual You know every time you sign your 8500 tack eight based on A requirement from 10 years ago a congressional requirement you give us permission to Look at the national driver registry to see if you have forgotten to tell us about a DUI so When you give us that authority by statute by law We are only able to look back three years. So as the people from AMC 700 will tell you There's a small window of opportunity now that we've increased the periodicity That that you could get by with a DUI. You'd forgotten to tell us about If you're under 40 and and you're in that certain time period But we're in the process of changing the law It just takes a long time to change the rules in washington You know, I've learned in my time in dc in the five years. I've been in in washington There's there's there's two things in life a man Shouldn't have to watch one is the making of sausage and the other is rulemaking in washington Lastly, I want to Tell you that we continue to leverage our aviation medical examiners We now have 35 medical conditions that once upon a time we expected to be deferred only to the fAA physicians for disposition We now encourage Uh, we now have programs whereby for anything from heart attack to cancer Once you're approved first time by the physicians by regional flight surgeon or amcd Then your ame can look at the specified follow-up and testing and give you your medical certificate I hope most of you are using fAA med express This was developed several years ago and it's been a huge huge success Basically, if you have a home email address you can sign up for ff a fAA med express You go online and you can fill out the 8500 tack eight In the middle of the night in your pajamas at home where you have all your medical records you get a confirmation number You know once you're completed with the front of your 8500 tack eight Basically your medical history You send that into the electronic netherworld you take your confirmation number to your ame. He's able to pull that up and Finish the backside the physical part of your 8500 tack eight and then send that off electronically Airmen love it ames love it if you haven't used fAA medical express. I encourage you to do so I will touch briefly on The hottest thing the latest thing going at headquarters and that's our Efforts to approve airmen and air traffic controllers that have been depressed and have taken antidepressants According to the medical statistics 16 of us some time in our lifetime are going to have a major depression A major depression that's going to require treatment. So i'm talking about something above and beyond reactive depression like for loss of a job or grieving or something of that nature but but major depression that will require medicine Now if as you're all aware major depression has some real side effects That preclude flying an aircraft or controlling aircraft In addition to the sadness and the mood You don't think well. You don't make good decisions. You're irritable Your thinking is slowed your processing is slow And certainly in the acute phase depression is incompatible with aviation duties However, that being said 85 of all depressions are treatable with antidepressants and we have good Antidepressants now that have much fewer side effects than the antidepressants of old So we are now Soon to be announcing How an airman first second or third class medical airman can Have had a diagnosis of depression received the appropriate treatment Take the appropriate medicine have the specified follow-up and testing and get back in the cockpit That's been a program that's been a long time in coming And uh, I tell you there's still some details to be worked out particularly with the air traffic controllers But soon you'll see published in the federal register A new benchmark in terms of a medical condition that we can work with you and get you back up in the air A part of my life at headquarters in dc is working with congress And certainly we work very closely with the house transportation and infrastructure committee The chair is is congressman over star congressman over star Is very concerned about falsification As a risk to aviation safety and as such he has sent the ig and the gao to help us the faa figure out how we're going to Improve upon this risk to aviation so congressman over star has looked at What the ig from Dot and the ig from social security did out in northern california a couple years ago Some of you are aware that that they did an operation out there called operation safe pilot whereby They looked at social security disability records and they compared that To airman medical certificates in the universe of 40 000 pilots in northern california And lo and behold they found a couple thousand out of that 40 000 Where people had not only a medical certificate, but they also were collecting social security disability And of that the u.s. Attorney's office Determined that they wanted to prosecute 50 of the most agrarious cases and they actually identified 48 of the most agrarious cases And of of those 48 We're talking about people that had such serious heart disease And really it was mostly psychiatric disease like schizophrenia and bipolar disorder But such serious disease that that they were collecting 100 social security at the same time They were either a first second or third class pilot Needless to say what showed up on the social security records and what showed up on the 8500 tac 8 were not one in the same So they prosecuted 48 people of the 48 people that they charged 45 were indicted Two died in the process and one was so mentally unstable that they dropped charges so Taking off from operation safe pilot Uh congressman overstar has asked the f a a to engage in a similar match in disability records We are Certainly we have made the initial movements to be able to do so Those of you that read the fine print and read the back of the 8500 tac 8 will now read that When you fill out your 8500 tac 8 you need to be aware that by law These records might be shared with other federal agencies You will all see also see a new block on the front of your form That ask if you're taking any if you're collecting any kind of disability Now this is not always an easy thing Being retired military i'm aware of many people that have a va disability And there are other kinds of disabilities other than va and social security And most of the disabilities that people receive compensation for Would allow them to be a pilot no problem But uh your your ame should be asking you about that if you put yes in your in your block for uh disability Certainly We we were also charged By the ig that that looked into the falsification issue As regards our f a a medical certification we were charged with educating pilots And aviation medical examiners so as part of what we were charged to do By congressman over star i'm telling you that there are very real penalties to Not being as completely honest and forthright on your 8500 tac 8 as we depend upon you to be You may or may not have read the fine print that says that you can be fined $250,000 or put in five year be put in prison for five years or both On these certificates That was that was rarely used in the past however with operation safe pilot in northern california and now more recent cases of Um Pilots that were instructor pilots that had insulin dependent diabetes up in this was up in new york That that basically passed out in hypoglycemic coma And and had an instructor pilot that successfully landed forgot to put the wheels down, but otherwise successfully landed and certainly He ended up in in jail for for failing to disclose accurate information So there's very real civil penalties if you're not honest and forthright and likewise Working with the world class toxicology laboratory that we have I will tell you that we Not uncommonly learn in fatal mishaps that pilots were on medications that would only be used for disqualifying medical conditions Or in some cases are drugs of abuse alcohol In general aviation We continue to learn that about eight percent of fatal mishaps involved the use of alcohol alcohol that can be detected That would indicate that that pilot was not at his peak in terms of where he needed to be and It's a significant issue that Has stayed stable at that percent of fatal mishaps for many many years So I say this because in the unlikely event that You were involved in the fatal mishap all those privacy rules that apply to you when you're alive Go away And I can tell you that your insurance company will certainly be interested in the forensic pathology studies That are done as as part of our Cooperative agreement by law with ntsb. You lose all privacy rights when you're dead and if you are are Either under the influence of something That is illegal or if you were taking medications that you should have reported on your 8500 tach 8 and did not do so certainly The insurance companies may not be forthcoming in terms of paying for your airplane or paying your life insurance and in those cases Where there might be other people involved If you hit a house on the way down and and there are other people killed and then you were found by forensic examination To have not been honest and forthright Certainly any estate you have is going to go to the Families of of those on the ground and not to your own family so You need to be truthful on your 8500 tach 8 And I will remind you again That there is very little reason not to be honest and truthful because we are perfectly Prepared and anxious to work with you and as I said earlier Only about one tenth of one percent of those airmen that are willing to work with us and get the specified follow-up and testing are ultimately final denied so There's no reason not to be honest and forthright And just very quickly because I want to leave time for some questions I'll touch on sport pilot because that's always a big issue at a venue like this Many of you are familiar with the operational Limits of light sport aircraft basically if if you are willing to fly low and slow You can fly a light sport aircraft and instead of an f a a medical you can fly with your driver's license in less in less Your last f a a medical was denied Suspended revoked or if for any reason you applied for an f a a medical and didn't get it You may not use a driver's license Now this has disappointed a lot of people and and this is dying down somewhat now, but when we first Enacted the light sport Rule a couple years ago It was a big issue because there were lots of older pilots that had been denied and f a a medical 10 or 12 or 15 years ago that had had heart disease or cancer or some medical problem For which they had been denied and they were chomping at the bit to go get their light sport aircraft and take their driver's license And go fly and then low and behold the law comes out and the rule says whoops if you've been denied You can't do that So these people were very vocal very disappointed A opa often Will bring up the issue as well And basically it's it's the typical american feeling of fairness to all And i i admit There there is a tiny bit of unfairness there if you take the example of Up two brothers They have the same seizure disorder one applies for an f a a medical and gets denied The other brother with a similar seizure disorder never applies for an f a a medical He buys his light sport aircraft He goes to his private physician who doesn't practice aviation medicine and his private physician says well joe You can drive your car. I guess you can fly an airplane. Well, you hadn't had a seizure in a year. Just take your anti seizure meds and Go have a good time And he can do so perfectly legally So one brother's denied and can't fly the other brother Goes and flies absolutely legally perhaps. That's a bit unfair, but nonetheless We as federal regulators Are charged with not allowing anyone to fly if we know they have a medical condition and would be unsafe to do so That being said Most folks with heart disease and cancer and things that they were denied 10 years ago We now look at those things and routinely Special issue almost every kind of cancer just as soon as it's controlled and we know you don't have active disease Same thing with heart disease. You have a heart attack a stent coronary artery bypass grafting A new valve you wait a couple of months to rehabilitate You do a stress test to make sure that there's no ongoing ischemia or lack of oxygen to the heart And you're going to get your special issuance. So the great majority of those folks that That were denied on their last medical need only reapply again Work with us. They'll get their special issuance and once they get their special issuance thereafter They can use their driver's license. So If you're if you're one of those folks, please don't be afraid to work with us And with that ladies and gentlemen, I thank you for your attention and I'll take any questions Yes, I'm martin sobel nine years and almost two months ago. I flew my last trip as an airline captain On twa from televieve to jfk The age 60 rule Was a result of the introduction of the dead aircraft into the airline fleet in the mid fifties When the chairman of the board cr smith of american airlines went to his buddy general kasada of the fAA And he said i don't want to train these old people. They're going to take too long make a regulation That's how the age 60 rule was put in force There was absolutely no studies For or against it Over the years because the fAA was forced to Defend the rule It took on a life of its own now all of a sudden it was part of your physical aptitude Half of us never did make it to 60 because we couldn't pass the physical but those of us could could easily fly well past it Now i keo in their wisdom allowed pilots to fly to 65 But had a caveat that co-pilot had to be less than 60 Now just recently the congress dragged the fAA screaming and kicking into the 21st century And said i could fly until i was 65 now i missed by a few years And i found other things to do include training at flight safety for four years before i retired To sarasota, but that's what happened with the age 60 and i think any attempt to equate that with physical ability Is just false There was no question i happened to be walking by and i heard this Bologna about the age 60 rule And i just want to get that on the record i don't know what's bologna, but but certainly medical facts are medical facts And You know i think we are all living longer Healthier lives and to move the age from 60 To 65 is Absolutely an idea Whose time has come that being the set you can't deny the fact that as you age You are more susceptible to sudden or subtle incapacitating medical Diseases that could certainly adversely affect The piloting of an aircraft Uh just where where where are you going to draw the line? Certainly there are people that are 80 There are people that are 90 that are still perfectly physically And mentally capable of piloting an aircraft on the other hand all of you know people that are less than the age of 60 that for some medical or psychological psychiatric reason Probably shouldn't be piloting an aircraft. It's really a very individualistic science But i for one am glad that the The rule has changed or else i would be spending much of my life Doing testimony as to why we should or shouldn't change that rule. I think there's another hand Ready oh Last year i got a survey from oklahoma on my experience with my medical exam And uh nobody else seemed to know about it or heard about it. My doctor didn't know about it He said well, that's good that they're checking on us is what it amounted to But i was informed about some medical tests that i needed that i wasn't aware of all at once And i wrote on my little survey. There needs to be a pre type letter sent out for people like me and maybe it's the new medical express thing you're explaining that's That i wasn't aware of to let the doctor know ahead of time what i'm about to tell him not in his office And because some people that would have been actively flying would have had to go out and do some medical testing So Is that the form that you you're you're Well with FAA med express is just basically an own an online form that you can fill out That basically Allows you to have all the time you need To complete that form and provide all the medical information that you might not have at your fingertips When you went formerly went to your AME's office and you sat out front and and just filled it in at the at the time Uh now your AME Is not aware of that until you show up with your confirmation number But certainly the beauty of med express is that you do it at your leisure It saves you time you're able to fill out the form with all of the accurate information And uh, it's really it's really been a great success story with both airman and with our aviation medical examiners Are there any prohibitions with people who have special issuance from using med express? Oh, absolutely not Absolutely not That being said Once you have your authorization You're going to have a piece of paper That that tells you you're going to need to show up with you know You're going to have to have a current status report from your oncologist or your cardiologist And you're going to have to have a cholesterol and and And a fasting blood sugar, you know that kind of stuff you'll have a piece of paper to do But the other the other part of the history No no reason in the world in fact for a special issuance Person there's more reason for you to use med express because you probably have More medical history than someone that might be 21 years old and just learning how to fly Okay. Well, I want to I want to tell you that if you have a specific medical question we are very fortunate to Have a booth just outside as we do every year And we have dr. Carter from from cami. We have dr. Northrup and dr. barston both from the southern regional office and if the computers are up We have access to all of all of the medical records that we maintain in oklahoma city And we could actually look up your specific medical case if you have specific medical questions likewise if you have Specific medical questions Uh, you could certainly corner me after this lecture and I'd be happy to talk with you about those Richard. Did you have something to say Regarding the airman's inquiry, there are times when the airman may get a letter from us that seems to come out of the blue That was unexpected for example, wrapped Eva. We sent out letters to all the airmen on wrapped Eva Informing them that we would need an update from their doctor That's right. That's right When we get word of something like Varena clean that I talked about earlier or wrapped Eva would be a newer instance when the FDA learns that there's good reasons to pull those drugs off the market We have the means to be able to look at the electronic medical records and those airmen that reported using that medication We're able to get the word out to you and thereby keep not only the national airspace safe, but keep you Uh healthy and and and make sure you're working with your doctor to get off of any drug that's been found to be hazardous to your health Are there any other questions? Up we have one more With regard to just what you said, uh Their insurance companies are pushing real hard for people to take generics Uh some and I'm thinking a Lipitor now has a generic Our AMEs Up to date on that or when do you need to report if you are taking some kind of a generic that may or may not affect you Well, I'm you know unlike the military where you check with your flight surgeon every time you start a new medicine Or you change medicine and in our big huge civil aviation system You are only required to list your medications at the time of your next physical exam And and certainly use of generics is very widespread and and has been something that's been in process For a long time There's there's certainly no issue at all in terms of your aviation medical examiners Asking you about or noting that you're on a generic Versus a brand name kind of medication Okay, well, thank you very much for your intention. I enjoyed talking with you Dr. Fraser my AME came out with an excellent suggestion the last time I saw him and he said we should go to doctors that are schizophrinics At least we could get a second opinion for free Any other questions come on up Next show is in half an hour Here we got one You bet. Do I turn this off here?