As a local family physician for nearly 40 years and a private pilot since he was old enough to drive a car, Dr. Bob Habig of Westfield Premier Physicians appreciates first-hand the dangers of flying and how a pilot’s health problems or certain medications can jeopardize the safety of the skies.

“It certainly imprinted on me, from day one, how healthy pilots need to be to perform at their best,” Habig says. “As pilots we must make sure we're as healthy and fit as possible, because things happen fast in the air and aviation is unforgiving with mistakes.”

Habig started flying planes at age 16, inspired by his father’s service as a World War II pilot. His dad offered him flying lessons and even bought him an antique airplane, a 1941 Piper Cub he still owns to this day.

In 1984, Habig became an Aviation Medical Examiner (AME), a Federal Aviation Administration certification that gives physicians the authority to perform pilot physicals and issue aviation medical certificates required to fly any aircraft — at least up until a recent change in federal law called BasicMed.

BasicMed, effective in May 2017, eases the medical certification standards for private pilots, which includes all recreational and general aviation pilots like Dr. Habig. Up until last year, private pilots were required to visit a trained AME to receive a third-class medical certificate every five years up until age 40 and then every two years after that.

Habig explains BasicMed was mandated by Congress, not the FAA, after decades of lobbying by prominent aircraft owner associations. The FAA oversees and enforces all rules related to aviation.

“The FAA testified they were not for this and felt it was a bad idea, because there certainly could be individuals in questionable health who will now be able to fly on basically a driver’s license,” Habig says. “I think there’s a lot of merit in the argument against it. They’ve unfortunately made the skies more unsafe by loosening the requirements to be a private pilot.”

Under BasicMed rules, private pilots who’ve obtained a medical certification in the past 10 years can now skip going to an AME and opt to visit any state-licensed physician for a medical exam every four years instead. During those exams, the primary care physician completes and signs a medical exam checklist for the pilot’s own records. They’re not required to fly with or submit the medical paperwork. Private pilots must now also complete an online medical education course every two years.

“That physician is reading through this questionnaire, doing what exam they feel is necessary and then signing off that they feel the pilot is safe enough to continue their aviation duties, and therein lies the problem,” Habig says. “A lot of doctors aren’t familiar with aviation medicine and they put their own career liability on the line.”

As an experienced AME and aviator himself, Habig knows there’s much to consider when deciding if a pilot is fit for flight, such as forbidden prescription medications or health conditions restricted by the FAA. For example, people with active kidney stones or migraine headaches cannot fly an aircraft because they’re so debilitating, and anti-anxiety medicines like Valium and prescription ADHD medications are strictly prohibited for licensed pilots.

It’s ultimately the pilot’s responsibility to immediately report any health status or medication changes to the FAA, and never fly when feeling less than 100-percent healthy. Habig says the FAA must now rely on this self-reporting process to flag medical issues that could compromise a pilot’s license, like a doctor unknowingly prescribing a prohibited medicine.

If there are any issues concerning a pilot’s new medication or medical condition, the FAA often works with the pilot’s primary care doctor, sometimes consulting an AME like Habig, to see if there’s a permissible solution to keep them in the cockpit.

While BasicMed relaxed the rules for private pilots, the medical requirements for other types of pilots remain the same as before. Commercial pilots who fly for airlines like Southwest and United must get a first-class medical certificate from an AME every year when under the age of 40 and every six months after they turn 40. Second-class medical certification covers pilots who fly for business, such as a crop duster or banner towing, and they must get medically certified by an AME every year no matter their age.

Habig, who often addresses physician groups and talks at local airports about this issue, invites fellow pilots or Indiana-licensed doctors with questions about FAA medical standards to give his office a call at 317-763-2131.

“I get daily calls and make myself available to any pilot, whether they’ve seen me before or not. I’m happy to give advice,” Habig says.

As for Indiana physicians willing to perform these new pilot physicals, Habig also welcomes their questions, but not without some words of warning. “I feel there would be some risk in [signing off on a pilot’s medical exam],” Habig advises. “If I wasn’t an aviator and not an AME, I would not sign off on these. There’s an area of liability that’s not necessary to take on.”

He says all primary care doctors should be prepared to field these kind of questions as patients who are pilots ask them to sign off on these exams. “It’s going to be a touchy area,” Habig predicts. “Physicians need to feel confident that they can make that call.”

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