Expert Medical Advice as Near as the Phone
Although many Association members are familiar with ALPAís Aeromedical Office, many others are not aware of this serviceóprovided free of charge to ALPA members in good standing.
Air Line Pilot,
November/December 2002, page 30
By ALPA Aeromedical Office Staff
ALPAís Aeromedical Office was established in 1969 in response to a 1968 Board of Directors action. At that time, the Association retained Dr. Richard Masters to advise ALPAís President and to provide professional medical assistance to ALPA members on request.
Under Dr. Mastersís direction, the ALPA Aeromedical Office provided assistance to more than 15,000 ALPA pilots and developed a medical specialist referral system to help evaluate and treat disorders that threaten a pilotís FAA medical certification. Over the years, ALPAís Aeromedical Office has also been instrumental in getting the FAA to change many restrictive policies and allow pilots to regain or maintain their medical certification, often with conditions that the FAA previously considered permanently disqualifying, such as coronary bypass surgery and angioplasty, isolated seizure, and a number of others.
The Aeromedical Office is also responsible for administering the ALPA HIMS contract for identifying, treating, and getting returned to duty pilots suffering from alcoholism or substance dependence. Since 1974, with the cooperation of the FAA and almost all the airlines in North America, more than 3,500 airline pilots have been successfully treated for alcoholism, able to return to their flying careers.
Dr. Masters retired in 1993, and Dr. Donald Hudson was appointed ALPA Aeromedical Advisor and remains in that position. Dr. Hudson, director of Aviation Medicine Advisory Service (AMAS), is an internationally recognized expert in aerospace medicine. He supervises a staff of five physicians who are all Board-certified in aerospace medicine and have extensive experience in helping pilots with medical conditions that might affect their FAA medical certificate.
The work of the Aeromedical Office broadly encompasses two main functions: policy consultation with ALPA international and individual pilot medical assistance. In addition to advising ALPAís Officers on medical issues, the consultation function includes such things as administering the HIMS program, helping with medical research, petitioning the FAA regarding medical policy changes, and consulting with ALPA master executive council volunteer Aeromedical, Pilot Assistance, Professional Standards, Critical Incident Response Program, and Training Committees.
Help for individual pilots
Although many ALPA members are familiar with ALPAís Aeromedical Office, many others are not aware of this serviceóprovided free of charge to members in good standing. The Aeromedical Office, as pilots often call AMAS, consists of six physicians, five administrative assistants, an FAA case manager, and an office administrator.
The medical office is like no other. Located on the second floor of a four-story office building in a suburb of Denver, Colo., the expansive windows provide a panoramic view of the mountains of the Colorado Front Range. However, few pilots see this scene because 95 percent of pilot contact with the facility is via telephone or mail. Each of the six doctors, instead of wearing a white coat and carrying a stethoscope, is "armed" with a telephone headset and networked computer that stores patient information at the office. Each administrative staff member also has a headset and a computer taking calls from pilots and entering patient data into the computer retrieval system.
Business hours are 0830 to 1600 MST Monday through Friday. The phone number, 303-341-4435, serves five incoming lines.
When an ALPA member so requests, the Aeromedical Advisors will review detailed information about the individualís medical problems as they might relate to health, continued employment, FAA medical certification, or at times, disability. This special medical service is not a representation service but a medical advisory service provided at no cost to ALPA members in good standing. The AMAS office protocol for handling pilot inquiries is straightforward. The secretaries answer the phone, take what is called "basic information," and assign the call to the next available physician for a call back and discussion of the medical problem or question. The office does not accept anonymous or collect calls. Generally, a doctor is not able to take the call when it comes in but returns the call (usually within the hour) to discuss the situation and answer questions.
A pilot who calls AMAS should have certain information available. In addition to identification and contact information, the office staff will ask for the date of the pilotís last FAA physical and, in general terms, a description of the problem. AMAS keeps specific notes that become a part of the permanent computer file kept in the office. As in any doctorís office, medical information is kept strictly confidential and is not divulged to anyone without the pilotís specific consent. Herein lies the primary benefit of this unique serviceóthe pilot may discuss health matters, in complete confidence, with a physician who knows and understands the professional aviatorís work environment and FAA regulations and policies.
In the return call to the pilot, the AMAS doctor will discuss the pilotís situation and how it might affect his or her FAA medical certificate. The doctor may refer the pilot to medical consultants who are known for their expertise in a specific medical specialty and are also usually acquainted with aviation medical principles. Each specific referral is tailored to the needs of the individual pilot and depends on the medical problem, past history, FAA regulations, and the availability of specialists. Often, medical reports are then reviewed in the office, and with the pilotís permission, AMAS doctors sometimes will speak with a pilotís personal physician. Most private physicians are not familiar with FAA medical policies and what evaluations may be necessary to satisfy the FAA and help a professional pilot keep his/her medical certificate.
Many of the difficulties pilots face when their medical certificate is threatened can be prevented or alleviated if the pilot contacts AMAS promptly instead of waiting until a certificate has been denied or revoked. Frequently, the FAA delays a certification decision because the pilot, acting on his or her own, has furnished inadequate or inaccurate medical information that the agency cannot use to make a reasonable judgment.
The AMAS staff can also advise a pilot about how best to prepare a case for presentation to the FAA and the most expeditious way to have the case successfully resolved. With the pilotís permission, AMAS staff can communicate directly with the FAA and serve as an advocate for the pilot with a medical problem. However, in each case, the medical advice that AMAS gives to the pilot will be consistent with good medical practice and give appropriate weight to the individualís health and ability to perform in the aviation environment. Of course, the advice provided to the pilot is only that. Ultimately, the pilot decides whether to follow the course of action that AMAS has suggested.
As with the other "service provider" functions that ALPA provides, the Aeromedical Office has seen a large growth in demand for its professional expertise. Last year, the AMAS doctors helped more than 7,000 ALPA pilots with their medical questions and prepared more than 2,500 medical record packages for FAA review. The ultimate goal is to preserve both the pilotís health and FAA medical certificate. That focus is consistent with the unofficial slogan of the Aeromedical Officeó"Keep íem Flying."
Meet the Doctors
Don Hudson, M.D.,the director of Aviation Medicine Advisory Service in Aurora, Colo., came to AMAS as an Associate Aeromedical Advisor in July 1987. He is a 1978 graduate of the Mayo Medical School and certified by the American Board of Preventive Medicine in Aerospace Medicine. After graduating from Mayo Clinic, Dr. Hudson completed residency training in psychiatry at the University of California in San Francisco, receiving extensive training in the treatment of alcohol and drug dependencies. He then served a year as a teaching instructor in psychiatry at Boston University Hospital before going on active duty with the U.S. Air Force as a flight surgeon in 1982. He served on active duty for 5 years, completing residency training in aerospace medicine in 1985 before joining AMASís aeromedical staff in 1987. Dr. Hudson is the former State Air Surgeon of the Colorado Air National Guard and is an active pilot with more than 1,400 flight hours. In 1996, he received the Aerospace Medicine Associationís Boothby-Edwards Award as the foremost practitioner of aviation medicine for professional pilots. He lives with his wife and three children in Golden, Colo.
W. Keith Martin, M.D., M.P.H., has been an AMAS Associate Aeromedical Advisor since August 1991. Before this, he served in the U.S. Army for 10 years. He received his medical degree from the Medical College of Virginia, and a masterís degree in public health from the University of California at Berkeley. Dr. Martin con-ducted his residency at the U.S. Air Force School of Aerospace Medicine. He lives with his wife, Ann, and daughter in Boulder, Colo.
Quay Snyder, M.D., an Associate Aeromedical Advisor, joined the staff of AMAS in September 1994, after serving 17 years as a flight surgeon in the Air Force. A graduate of the Air Force Academy and Duke University Medical School, Dr. Snyder is Board-certified in family practice, occupational medicine, and aerospace medicine. He has more than 2,300 flying hours in 52 different aircraft and holds CFI and DPE ratings. He also is chief flight surgeon at the Air Reserve Personnel Center Headquarters and teaches aerobatics in gliders as an instructor pilot at the U.S. Air Force Academy. Dr. Snyder lives with his wife, Beth, and their two children in Monument, Colo.
Robert J. Stepp, M.D., M.P.H., who joined AMAS in January 1996, served 21 years as an active duty Air Force flight surgeon, holding several senior executive positions including command surgeon for Air Force Space Command, commander and dean of the USAF School of Aerospace Medicine, and chief flight surgeon at Strategic Air Command headquarters. Dr. Stepp is also past president of the Society of Air Force Flight Surgeons and served on the Aerospace Medicine Specialty Board Examination Committee. He is a graduate of Creighton University School of Medicine. He and his wife live in Monument, Colo.
Tom Yasuhara, M.D., M.P.H., a graduate of the U.S. Air Force Academy and the Uniformed Services University of the Health Sciences, is Board-certified in family practice and aerospace medicine. He served in the Air Force for 25 years before joining AMAS in 1999. Dr. Yasuhara is a past director of the USAF Aerospace Medicine Residency program, and is a fellow of the Aerospace Medical Association and of the American Academy of Family Physicians. He and his wife live in Parker, Colo.
Robert W. Weien, M.D., M.P.H., hired in August 2002, is the newest Associate Aeromedical Advisor at AMAS. He is a graduate of Louisiana State University School of Medicine and Harvard University School of Public Health. A career military flight surgeon, Dr. Weien recently retired from the U.S. Army. He is Board-certified in aerospace medicine and occupational medicine. He lives with his wife and two children in Colorado Springs, Colo.