Embracing the Principles of Preventative Medicine

By ALPA Staff

A key to ensuring you remain fit to fly is your proactive use of the basics of preventative medicine. This approach calls for the identification and subsequent reduction and elimination of any existing risk factors to prevent disease, disability, and, ultimately, premature loss of life.

The modern era of preventative medicine began in the mid-19th century when Louis Pasteur, an immunology pioneer, recognized that living microbes are the cause of infections. Great strides have been made since then, and, today, individuals are encouraged to eat well, get the required amount of sleep, exercise regularly, and routinely see a doctor for a physical evaluation.

As your ability to fly is dependent on the maintenance of your medical certification, the observance of these simple steps is even more important. However, a recent study of pilots in the United States revealed a significant prevalence of what’s been labeled “health-care avoidance behavior.”

While the study included 3,765 pilots, it’s important to keep in mind that those surveyed included military, corporate, and general aviation flyers as well as airline pilots, so the conclusions drawn don’t specifically reflect airline pilot behavior. Nonetheless, the study serves as an important reminder to get routine physicals and to see a doctor when you experience symptoms that may indicate a more serious condition or illness.

The study, conducted by Dr. William Hoffman, a neurology resident and aeromedical researcher, and six other physicians, found that 2,111 of the evaluated pilots (56.1 percent) identified a history of health-care avoidance. The primary explanation for this conduct was the fear of having their medical certification revoked. In addition, 994 participants (26.8 percent) who sought health care revealed that they occasionally misrepresented or withheld information for similar reasons.

The December 2022 issue of the Federal Air Surgeon’s Medical Bulletin highlighted typical health-care avoidance behaviors that might discourage pilots from seeing a doctor. These include seeking out information or suggested treatments from questionable sources, including generic health-care websites or even the advice of friends and family members.

Others might choose to conceal symptoms they’re experiencing, hoping that these indicators are insignificant and will abate over time. Full disclosure of your health history is vital because aviation medical examiners need to not only assess your current health status but also indications of any future health risks.

Another issue is the use of over-the-counter medications, particularly for allergies and colds, which may be unsafe while performing your pilot duties. The FAA provides lists of medications that are acceptable to take while on the flight deck. In addition, pilots are reminded to use the IMSAFE checklist when self-evaluating their readiness to fly—illness, medication, stress, alcohol, fatigue/food (i.e., sufficient sleep and proper hydration and nutrition), and emotional state.

“In the circumstance of having a medical condition, 100 percent, get the care that you need as soon as possible,” Dr. Hoffman stated in an interview. “While there might be short-term repercussions as it relates to your medical certificate, that’s how you can ensure that your health can be a tool for your long-term [wellness],” he added.

In addition, ALPA’s Air Safety Organization offers a variety of health and wellness resources through the Pilot Assistance Group. These include the Aeromedical Committee, which offers guidance regarding airline pilots’ occupational health; the Critical Incident Response Program, which addresses mitigating the damage from common stress reactions following an accident and serious incident; the Human Intervention and Motivation Study (HIMS), ALPA’s alcohol and substance abuse and addiction treatment program; and Pilot Peer Support, which offers assistance when dealing with emotional issues of either a personal or professional nature. Information about each of these programs is available at alpa.org/pilotassistance.

Keep in mind that promptly confronting health concerns can make a tremendous difference in your recovery and continued ability to fly. Be vigilant and use the many resources available to keep your flight crew, passengers, and cargo safe.

This article was originally published in the February 2023 issue of Air Line Pilot.