AFRs etc
Agreed your airline pilot will get attention for obvious symptoms that might have bearing on fitness to fly. In the other hand a big percentage of private flying is with passengers who may judge their pilot’s fitness also.
The real question has to be is it such a problem of magnitude that’s a great worry in the first place?
In regard to AFRs that requirement is a latter day invention and though opinion seems to be all for the idea I disagree on this blanket requirement, and like so many opinions around aviation matters there’s no empirical supporting evidence of the overall efficacy of such regulation. The three takeoffs and landings no pax rule is one additional measure regarding recency.
In my view at least aircraft owners, CPL holders and instructors should be exempt from the AFR, and this would boost GA in those areas leading to more flying and overall safety.
In regard to instructors and medicals, sensibly no medical is required in the USA where the student has soloed.
And again when was this ever some problem that will be solved by an AVMAD medical?