The USA has a good number of AME services like this one (which I picked at random):
There seems to be a key difference with Europe in that this is legally possible at all, whereas in Europe an AME is an agent of his national CAA and – in the words of one European AME I spoke to years ago – there is no such thing as “off the record” chat. Of course that isn’t the reality in face to face interaction but he is supposed to report everything back to the CAA. Even in cases where I asked an AME about other people with specific conditions, not covered in Part MED clearly, he asked me to tell the person to contact him directly.
On top of that, the FAA has a clear list of “self grounding conditions” whereas practically speaking the whole of EASA Part MED is a list of self grounding conditions.
One can guess what effect the European system has on people getting medical stuff sorted out “off the books”…
OTOH some FAA medical stuff is incredibly strict, like a repeat angiogram for a Class 1 or 2 if you have ever had anything done there.
I don’t think it is true for German AMEs. All physicians in Germany are obligated by law to keep the patients data and medical history safe from third parties. This applies to all physicians regardless of where they work and what they do. AFAIK there is no exception for AMEs. You could seek one out and have an off the record chat. Of course the actual process of extending the medical does require contact with the CAA, but I don’t see why you shouldn’t be able to gather informal advice beforehand.
Patient doctor confidentiality goes so far in Germany that if I as a doctor treat someone who injured himself during breaking into someone elses house and he tells me so as a patient I’m not allowed to contact the police about this, with very few exceptions where I have to expect that he will harm someone else soon. The Germanwings Crash is an (unfortunate) case in point.
One can guess what effect the European system has on people getting medical stuff sorted out “off the books”…
If it does not leave a scar, keep it quiet. Vagal syncope? Never mention it on any form, and do not talk about it to anyone. Kidney stone?
If you are completely honest, after a certain age you will be in a heap of hurt. But don’t hide stuff that can be seen on a CT Scan 
That is also what I have heard from US pilots – private, military and commercial.
What the authorities achieve by being too strict is that one ends up hiding facts.
I understand this has become much stricter in recent years.
If you haven’t (yet) filled out a new medical application, and are not (yet) applying for a new Medical, why would the AME you are paying for guidance have any obligation to anybody but you? The only legal issue anyway would be if you were still flying with an expired medical (assuming it’s not operations under Sport Pilot or similar, i.e. no current Medical required) or when you should be self-grounded. Presumably since that’s irrelevant to getting a new Medical nobody would need to discuss it.
That aside, I expect even a small company that specializes in helping pilots as paying customers could easily ‘firewall’ personal details from those who may under certain circumstances have an obligation to report them – as an AME does when he fails you. How would an administrator, attorney or non-AME medical doctor be required to report anything you told him to the FAA or CAA?
Peter wrote:
whereas in Europe an AME is an agent of his national CAA and – in the words of one European AME I spoke to years ago – there is no such thing as “off the record” chat.I’m not so sure this is true. My AME (for whatever reason) got a new ID in the computer records system (which I believe is an EASA system and not a specific Swedish system) and I had to give express approval (in writing) for him to access my records which were saved under his old ID!
Give me an example of a situation where one might want confidential advice but is not trying to game the system?
There are many areas where you may want to ask an AME a question – e.g. this sort of thing
The problem is that if the answer is “you are OK” then you are OK, but if it is “you are required to report this” then he is required to report it and you are instantly grounded until he has reviewed the matter
Then there are cases where someone with an existing condition wants to find out whether he can embark on a PPL. If the answer is NO, or it is unclear, the AME is required to report that contact to the CAA, and it can be expected to appear on that person’s record for when he does apply for his initial medical, regardless of whether he still has that condition or not.
Another one I came across recently was whether you are required to report conditions to your AME if you are flying on the privileges of another country’s license (or in the UK the NPPL) whose medical doesn’t require the report. Apparently you are still required to report it because you are still a holder of a valid medical, even if you are not exercising the privileges. So a “silent downgrade to the NPPL” is apparently illegal; I am sure large numbers of UK pilots would be shocked to hear that. My question in that case was: what if on Monday you get a fresh medical, on Tuesday you get fed up with flying and abandon it for ever, and on Wednesday you get a cancer diagnosis? Are you still required to report the diagnosis to the CAA? Apparently you are because your medical was still current! So you committed a criminal offence. I find that totally bizzare because it means nobody could downgrade to the NPPL (and its medical declaration) until their EASA medical has expired!!
Many grey areas which can use confidential AME advice.
However from the AME’s point of view, probably everybody is trying to game the system
The AME’s access to your personal doctor’s records is a separate thing. This is rarely invoked anywhere, though I heard a rumour that the UK CAA (which always requires you to consent to the access, otherwise you will not get your medical) is now doing it automatically for initial Class 1. Obviously a lack of access (as in e.g. Germanwings) looks extremely prejudicial.
Are all AMEs in the UK full time AMEs Peter? My AME is mainly working as a family doctor (GP) and only occasionally does medicals. It’s more of a hobby for him, albeit paid. I don’t know any reason why he shouldn’tbe able to give me confidential advice if I ask for it. He certainly would need my permission in writing to forward anything to the LAB under German law.
Are all AMEs in the UK full time AMEs Peter?
No; some are normal GPs (general practitioners i.e. “family doctors”).
Sure a GP can give you confidential advice; he has a duty of confidentiality (within certain limits obviously). But if he is your AME then that duty is removed, in EASA-land. I am told by a well informed German pilot that this is true even in Germany (the Germanwings case involved the GP → AME information barrier, not an AME → CAA one).
This is why practically nobody who has one of these uses an AME who is also their GP 
It would be like doing personal banking with the same bank which your business banks with and which holds various loan guarantees signed by you
Most people won’t write about this stuff openly, for obvious reasons. One AME+GP said that when he works as a GP everybody tries to look as sick as they can and when he works as an AME everybody tries to look as healthy as they can. I am not bothered and I think it is informative
