Quite right Robin. Why the hell are we doing it. The medical profession are completely incapable of predicting our demise. Bunch of Quacks. Self perpetuating, self interested, incapable idiots.
Crickey, I thought I was cynical.
I would have thought the purpose of the aviation medical is (or should be)
- To predict sudden demise
- To detect acute and chronic disease
- To promote health
Apart from "barn door" cases, and there will be some anecdotal evidence, I wouldn't have thought that it's much good at 1 or 2, and actually, there are other routes for this anyway. The prediction of 1 and 2, mostly relies on measures designed to assess risk of a population.
Cardiac disease is an interesting one. The high tech stuff (the ecg) is not a reliable predictor. We can, however, make some idea of "risk" for an individual with some degree of accuracy.
If, for example, a 50 yr old bloke, who smokes 20 a day, has an elevated blood pressure, slightly raised cholesterol and who's dad died of a heart attack aged 45, then I could predict with some degree of accuracy, that he has a 30% risk of having a cardiac event in the next year.
If I had a hundred blokes with the same factors, then I know that 30 of them would topple in the next ten years - what I don't know is which 30 will, and which 70 won't.
So if I was the AME, do I ground all 100? And at what level of risk do I ground them?
More sophisticated measures (scanning the arteries) are no more better at predicting risk, and don't fulfil the requirements of screening that I've listed above.
The principles of managing risk can also be extended to other areas of health. The biggest cause of death in a 25 yr old ? - suicide.
Whilst your average 25 yr old may be livin g the dream on the day of his medical, there is nothing stopping him from dumping his airbus into the sea the day after, when his girlfriend has dumped him. No medical in the world would predict this, but if, say, he had a history of depresiion and attempted suicide, then he would be considered higher risk.
As for 3, health promotion, the stuff I've heard has,at the least, been questionable.
So, can the medical reliably predict risk at an individual level? Probably not. What it can do is help us juggle the odds.
Does medicine improve health? Not as much as Town Planners can.
Happy flying.
