Taking the Reigns
Importance of Monitoring and Evaluating Aircrew Medicals
Two years ago, in the wake of the mass murder/suicide of 150 passengers and crew on board Germanwings 7525, I wrote about the importance of looking out for our fellow pilots’ mental well being. I pleaded that the rush to regulate in the wake of the disaster not be done in haste, lest pilots with mental illness are driven underground, stop seeking help, and further put the travelling public at risk.
Earlier this spring, the U.S. Congress enabled legislation enacting Basic Med for the general aviation community, which came into effect, in the U.S. only, for GA pilots operating aircraft with less than seven seats and under 6,000 pounds maximum gross weight. Arguments were made, successfully, that with less than one per cent of all GA accidents resulting from a medical event, that the burden and cost of a regular medical exam outweighed the benefits.
I am not intending to re-litigate this matter but the development led me into a recent conversation about what is done in the Canadian helicopter industry regarding aircrew medicals. A question was posed as to whether or not companies should take a more proactive role in facilitating the medical exams of their pilots.
Now, I am certain many of you will squawk about what I am about to write, about the intrusion into our personal lives, about the costs associated, etc., but hear me out. I previously wrote, and continue to be aware about, the practice that many pilots use of having a favourite doctor for their aircrew medical, separate from their personal or family physicians.
And the reasons are simple – going for a medical is the one day where we may lose our right to work, and lose our means of employment. However, if companies are truly interested in ensuring that their employees are fit for duty and fully compliant with the aviation medical standards, then they should take control of the process.
Transport Canada hosts on its web site a full listing of all doctors certified to sign off on aviation medicals. It reads: “The Civil Aviation Medicine Branch of Transport Canada appoints and employs doctors who check aviation personnel for medical conditions. These medical exams are done based on international medical standards for aviation. Physicians apply directly to Transport Canada and are interviewed by a Regional Aviation Medical Officer before appointment.”
There is a training program and a renewal process every four years. I do not know how often they are audited or how continuing standards of professional conduct are maintained. But I have been engaged in many anecdotal conversations about doctor shopping and standards for these medicals that run the gamut of, “Hello, how are you?” to pushups, burpees, step tests and the like! The point is, among the nearly 1,000 approved CAMEs, there is a divergence in the standard. This divergence is not good for aviation in general, and definitely not good for commercial operations.
The solution, however, is quite simple. All commercial operators should mandate that the regular aviation medicals required of their pilots be completed with CAMEs selected, vetted and approved by the employer. I am also advocating that since the employer is mandating which examiner is to be used, then the employer must also pay for these exams.
I am not suggesting that these exam results be shared with the employer. Privacy laws in Canada protect the doctor-patient relationship and Transport Canada’s rules are clear about when a doctor must report to the regulator. My position is simply that as a reasonable control against “doctor shopping” and as a sign of due diligence on the part of the operator, mandating which doctor or medical organization is to be used is actually a best practice.
Furthermore, regular medical exams should be mandated for aircraft maintenance engineers as well. Our AMEs are a critical piece of the puzzle, without whom we could not fly, and whose work is the epitome of “safety critical” activities. Maintenance errors can have catastrophic results and we all deserve to be assured that every step is taken to minimize risk to the travelling public. Therefore, having the employer step up to enact what I propose is not a big leap forward.
Doctors vow under Hippocrates to “Do no Harm.” Let’s join them.
Walter Heneghan is an experienced and well-travelled pilot who has served as the top safety professional at Canadian Helicopters and Summit Aviation. He is currently working with CHC Helicopter in Kazakhstan as an SMS development specialist. He is a regular contributor to Helicopters and Wings magazines.
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