Yes, it is not simply black and white “gaming the system”, but not getting entangled in some expensive, kafkaesque bureaucracy that is neither proportionate nor risk based in its way of thinking. There is sometimes a wide gap between the rules (and especially their interpretation in some countries) and what commonly would preclude you from the safe operation of an aircraft. Confirmed by a chief AME who said: “It is not about being safe to fly, it is about the rules”. So remember, while usually you would think a doctor is a person of trust, don’t put that kind of blind trust into an AME.
Instead of the sensible reaction – had pneumonia, clearly healed now, there’s your medical – it went to formal doctor’s records and reports going to both authorities and with some process delays I was with no medical when all my ratings expired.
That’s quite a story Cobalt. However AFAICS you could keep any licenses and ratings current even with no medicals, because it can all be done with either a safety pilot or an instructor or examiner.
But more importantly, you need to be in the hands of an AME that know the system, knows the FAA/CAA and can see things through but also has the trust of the issuing body. There are not that many of those around.
There is virtually no expertise in Europe. Your average FAA AME here cannot help. If you are in Europe and you need the FAA Special Issuance, you can forget it for ages – probably many months. The FAA is really picky about the format of the docs and the medical professionals (“consultant” surgeons etc) here mostly live in their bubble and it is hard to get them to generate the reports – even if they are getting paid a couple of hundred an hour for typing it up. It is just not an exciting job… One guy I know is looking at invoking a route for when the consultant has died right after doing the procedure, but nobody seems to know what that is either (but there must be one otherwise many airline pilots would never get their job back). The EASA route is generally easier for documentation required, and there is more experience of it in the medical business, but for most cases much more expensive – most things cost 4 figures.
The FAA medical grounding conditions are widely published
That is another Big Plus of the FAA system: clarity for many conditions. The pilot can get himself fixed properly without losing his medical in the meantime.
and bringing up the example of depression
The problem with using depression as an example is that it is extremely emotive – Germanwings etc. If you turn up at a UK hospital A&E and they see you standing up so they want to send you back home, just tell them you work for Germanwings 
Suddenly the waters will part…
There are many grey areas where confidential advice is applicable, and in any case there is no problem if the pilot is not flying as PIC at the time. Well, unless one accepts that non-notification is a criminal offence even if no flying (as PIC) is taking place, which is possibly true even though the CAA has not ever prosecuted it. And obviously insurance will not be a problem unless you crash, etc.
An AME is not bound by any “doctor patient confidentiality” when acting as AME. An AME is simply a person from the authority that is an expert in aviation medicine. Any doctor can be an expert in aviation medicine and aviation bureaucracy without being an AME. If they exist, and they offer their service, what can be be wrong with using them? I would think the bureaucratic part is the most important anyway, do things in the right order, get the right documents in the correct order and so on.
Peter wrote:
However AFAICS you could keep any licenses and ratings current even with no medicals, because it can all be done with either a safety pilot or an instructor or examiner.
All in all, “losing” it is not that big a deal, since for the ones in question (SEP, MEP, MEIR) a renewal is not that different from the revalidation. Currency after a longer bureaucratic grounding is more of a problem….
LeSving wrote:
An AME is not bound by any “doctor patient confidentiality” when acting as AME.
Is he acting as an AME if you have not filled out an application for a Medical Certificate, and if he is being paid cash by you? What pre-existing contract is he under that prevents him working at your direction? AMEs do not work as direct government employees in most countries with a substantial GA activity.
This thread is an excellent example of how the ‘simple’ medical required for Private Pilots is a remarkable fear inducing value subtraction for people and pilots minding their own business and flying in their own planes. The issues are just silly, over-the-top nonsense given that injuries prevented by Private Pilot medicals are statistically insignificant. In time one can only hope that the current goal and trend to eliminate them will be realized.
Sving wrote:
I would think the bureaucratic part is the most important anyway, do things in the right order, get the right documents in the correct order and so on.
Of course, that’s a major portion of the value being subtracted from the pilot by the Medical system.
Silvaire wrote:
Is he acting as an AME if you have not filled out an application for a Medical Certificate, and if he is being paid cash by you? What pre-existing contract is he under that prevents him working at your direction? AMEs do not work as direct government employees in most countries with a substantial GA activity.
According to the FAQ on LT’s net site, it’s not a contract, but a license. Anyway, all AMEs I know of, do this on hobby basis more or less, some of them are GA pilots (PPL). The FAQ also say that when you visit an AME for the purpose of renewing your medical, then the AME is not bound by any confidentiality. So if it’s not about renewing the medical, then you can expect confidentiality. But, what other reasons than to renew your medical exists for visiting an AME?
LeSving wrote:
But, what other reasons than to renew your medical exists for visiting an AME?
One piece of advice frequently given when visiting an FAA AME is not to give him the MedXpress application confirmation number until he has agreed to pass you, after the exam. Until he has that number, he is not formally connected with any application and you can walk away unharmed, if needed. I expect confidentiality from an AME until I make a written application and provide it to him in its entirety (including the number) because that specifically defines the reason for my visit, which in turn formally defines his FAA role. I do not pay him to make casual assumptions based on verbal communication, and would not employ an AME to review and process my medical application if that were to him unacceptable – particularly if any judgement were required by him in relation to pass/fail or ‘refer to FAA’ criteria.
I imagine you can pay services such as the one referenced in the original post to tell you the same thing.
LeSving wrote:
Anyway, all AMEs I know of, do this on hobby basis more or less
Most of the AMEs I’ve used do it for one reason, to make money, usually with very little work involved. Often its apparent from the home office situation that the intent is to supplement other retirement income.
Silvaire wrote:
One piece of advice frequently given when visiting an FAA AME is not to give him the MedXpress application confirmation number until he has agreed to pass you, after the exam. Until he has that number, he is not formally connected with any application and you can walk away unharmed, if needed. I expect confidentiality from an AME until I make a written application and provide it to him in its entirety (including the number) because that specifically defines the reason for my visit, which in turn formally defines his FAA role.
hmmm, I don’t think I have ever met a bureaucrat being so “by the every little comma in the book” as that 
That’s the typical American way I think. in Norway the legal system is more based in intent and the meaning/purpose/spirit of the law as well as common sense, not just the letter. Something like that would never work legally (if it came up in court), as your intention clearly is to renew your medical. Besides, the medical license is not based on confidentiality between you and the AME, but between you and the aviation authority. The AME is purely a middle man here, a necessary one, but really nothing more than a inspector.
I don’t know, maybe it’s because I have been in the military for a couple of years. I’m “brainwashed” enough so I’m not particularly picky about my privacy regarding the my state authority. A valid medical license to fly a light aircraft is no human right afterall. But at least I know that the AME and the aviation authority has no other agenda than to help me get it back, if I lose it somehow. If the case is hopeless, then so be it, then my flying days are over.
Nevertheless, renewing the license is one thing. How to keep it (not fail the medical in the first place), and how to get it back in the fastest and most efficient way possible, is another thing altogether. Even an AME could in principle do that, and they do. As to the confidentiality? who knows? I don’t see exactly what should be so confidential in the first place about this.
The ability to anonymously walk away from a failed medical is absolutely not allowed in Europe.
This was a key feature of the Hungarian “JAA” medicals in the good old days. Probably thousands of airline pilots got their initial Class 1 medicals in Hungary. Because you are allowed to fail each of the four available colour vision methods only once in your entire biological lifetime, being able to have multiple goes at it is very valuable
My AME has probably figured out that I’m going to ask him to follow the ‘letter of the law’ when it benefits me, assuming he wants to earn my $100 in 20 minutes without leaving home.
That aside, the primary benefit of the new Basic Med parallel system being rolled out in the US is that you don’t have to protect yourself from the doctor’s authority to the same degree. If he has a bad day and decides he’s not going to pass you under Basic Med, there is never an application number or FAA record in relation to that incident and you can just go to another doctor without concern. Also, while the questions defined on the application are the same as for a 3rd Class Medical, the pass/fail criteria in relation to those particularly ‘important’ issues are left to the “medical discretion” of the Doctor – there are no absolute requirements. It’s as far as they could go while still satisfying certain political interests. I have no medical issues that I discuss with the AME so I believe I’ll keep going with the 3rd class, but there is some small additional risk in doing so.
Meanwhile eliminating the whole system continues to work fine under FAA Sport Pilot (I need only a valid driver’s license as medical certification to fly the more challenging of my planes), so perhaps in time the medical certification system can still be completely eliminated for most FAA private pilots.
