As you all likely know I am a physician specializing in internal medicine and I’ve been an AME and an active pilot for decades.
This is BS on so many levels I’d have to take the day off to type it all out (I’m a slow typist) or put you all in a lecture hall and stand on a soapbox for an hour talking about it.
NO WAY an EKG could detect a cardiac event in any but the rarest of circumstances.
NO WAY a physical exam could do this either.
NO WAY lab tests or a lipid panel could do the same.
NO WAY to link a ‘cardiac event’ to this stall/spin event.
NO WAY to assume invasion of privacy increases aviation safety.
NO was to say if this should be done for flying it shouldn’t also be done for driving.
NO WAY to assume millions of drivers cause less risk to the public than thousands of pilots.
The workup for a false positive test can be more dangerous than the presumed condition.
Also, statistically a screening test in a low risk population will always yield more false positive results. This is why we don’t do STD screening on nuns for instance. Any positive test would most likely be a false positive. No value in the testing.
Many heart attacks occur in people with clean coronary arteries, and many people with ugly angiograms never have an event. You can estimate probabilities but not predict events.
I’m wondering how the Canadian cat 1 medical compares to the FAA first class medical. Does it cover more items or is it stricter like some of the Asian and European agencies have been reported? I do know ICAO does not recognize the time limits the US medicals have (calendar months vs 6 months from exam).
As a Canadian ATPL holder over 60, I have to have a medical exam by a MD who is Transport Canada approved Aviation Medical Examiner every 6 months and a EKG, paid for by me every year.
Since my resting heart rate is 48 bpm and my blood pressure is normal I was advised many years ago to have a double espresso before my EKG so it didn’t trigger a brachardia (sp?) alert and a second level review ?
What we have now is a WW 2 Air Force pilot medical protocol that has been incrementally tweaked. It would seem to me that it is time to reevaluate the entire pilot medical evaluation system. There is in my opinion, zero value in any medical certification for recreational flying. If you are fit to drive you are fit to fly.
The medical requirements for Professional pilots need an evidence based top down review starting with a blank piece of paper. The current system is just a self licking ice cream cone.
Age 72 and cholesterol about 190 at the time. Exercised each day. Mentioned this before, but my hanger neighbor, retired FedEx Capt, current class 2, frequently flew his Aztec, fell over dead, heart attack, while waiting for an oil change at the dealership. I had just given him a BFR a month before. Made me think about the shock I would have experienced if he had done it on short final. React??? Guess, but don’t know.
… and how many pilots will get a heart attack either worrying about passing such a draconian requirement OR die when they find out they can’t fly anymore?
And we have friends from up north that come to the US for care vs waiting in line…
Lets have Transport Canada Safety Board employees and officials (Same with the FAA Medical Board) subject to the same medical requirements as pilots to keep their positions. If they fail the exam they are out of a position. Then we will see how they react. Will they still want the same requirements knowing that one event can end their carrier? They talk safety when it comes to everyone else but will not implement the same playing field for themselves, typical bureaucrats.
Canadian TSB flight operations personnel are required to keep the same level of qualifications as regular Transport Canada Inspectors, that is a valid ATP license (airplane) or Commercial license with instrument rating (helicopter).
So why do so many Canadians flock to the US for necessary and timely health care rather than dying or suffering degraded quality of life while waiting in line for Canadian health care?
I’ve used health care as a resident of both Canada and the US (not at the same time, of course). I once calculated that if I added US health insurance to my US income taxes (paying in full, with no employer contribution), the total would be equal (or a bit more) than what I paid in Canadian taxes.
Otherwise, my experience is that if you’re in the US and on a good health insurance plan, and in a major metropolitan area, then health care is quick, easy and first-class. In Canada, I’m still waiting - as millions of others are - on a wait list for a family doctor, which is a prerequisite for getting specialist care. The option is to find a community clinic, pay membership fees out of pocket, and hope for the best. To put it another way, if you’ve been in the Canadian system all your life, with a family doctor readily available on speed dial, you’re set. If not, and you’re on the waiting list, good luck.
I’m an ER doc. My job consists of screening people to figure out who is having (or is at risk of having) a heart attack. My false positive rate (people w/ symptoms, but not the condition) is well over 98 %, and those are people who have chest pain. Screening asymptomatic populations is mathematically a fool’s errand and will produce vast numbers of false positives. What is Canada going to do with that information? Ground their entire pilot fleet?
But then again you countries with Nationalized medicine never mention the “warts”. Long lines, long waits, planning surgeries long in advance, Sheep in Sheep out, it is not all roses as some would have you believe. Also if you are paying $1000 per month ($12000 per year) yes we would all like a cost reduction to $10000 per year, but it never seems to work out that way. When politicians are involved (by the way they know nothing of how insurance or even business really works) they will screw it royally just to get votes, so it will end up in the latrine, like everything else they touch.
In the 1990’s the FAA tried to establish a cholesterol level test requirement for all pilots. After all the general aviation groups loudly complained the FAA proposal went nowhere and was dropped. Hopefully there are still some FAA medical people around who remembered that and the FAA won’t try that nonsense again. Just think about the stink that was raised about the last time the FAA tried to make certain testing required for sleep apnea.