A CASA Christmas Present Again?
 

I have been trying to follow whats happening to the CASA Avmed Consultation on medical self certification and I am prompted by Ben Morgans (AOPA) excellent summation of the situation including the evident foot dragging by CASA. My opinion, FWIW and, since the Public Service is renowned for dropping bad news on public holidays, is that we are in for a very nasty Christmas Present from CASA Avmed.

This review and consultation of Australia's archaic aviation medical standards was foisted on CASA/Avmed by the obvious and now undeniable success of private pilot medical self certification in the UK and America.

Until 2021 (?) CASA / Avmed had successfully frustrated the push for reform of private pilot medical standards by pretended reform - the introduction of the "Basic Class 2 medical Certificate - available from any GP" this reform, as intended, was stillborn because it carried at least three poison pills; it required the application of a commercial drivers licence standard that was modified by CASA / Avmed with the addition of exclusions, it required the GP to report to CASA any "conditions" the GP might think the applicant might have and most importantly it required the GP to attest that the applicant "unconditionally" met the modified standard, Once the GPs and their insurers worked out who was going to be liable, since everyone has "conditions", this alleged reform was stillborn. From a CASA / Avmed viewpoint this program was successful since it staved off meaningful change for a further three or four years.

Once the industry had digested this bitter failure, they raised a new argument that CASA, now under obvious pressure for reform on multiple fronts, could not ignore - equity. The RAA, gliding federation and parachuting body have successfully operated under self certification schemes for decades; why should such a scheme by denied to Australian private pilots considering the success of self certification overseas? CASA had no answer.

The result is another consultation deliberately set up in my opinion to frustrate reform by the simplest and crudest method possible - restore equity by the destruction of RAA, GFA and parachuting self certification schemes. Misery loves company; 'there now, you are all equal again"!

What rattled my was an anecdotal comment that CASA is pressuring RAA to toughen its criteria. This was in addition to an earlier instruction by CASA that any pilot refused a Class 2 medical certificate by CASA was to be ineligible for an RAA operators certificate (in other words, "No escape).

Further evidence of CASA recidivism is the resurrecting of the entire color blindness restriction disaster.

I would imagine that unfettered access to pilot medical records is still on Avmeds agenda.

In addition the tone of the submissions by obvious Avmed insiders as well as multiple AAT transcripts indicates that Avmeds is a deliberately adversarial approach. The messages are always the same;"All pilots lie", "it is our job to discover what they are trying to hide", "drone operators should require medical certificates too", "only sick pilots want the system changed".

Be prepared for a very unpleasant discussion paper to be released during the Christmas holidays. CASA / Avmed is not going to give up without a fight and destroy the industry in the process. Whatever happened to "First do no harm"? This is going to be a repeat of the 2016 debacle, as I wrote then; "there is not a snowballs chance in hell that CASA wishes to voluntarily reduce surveillance and control of medical certificates, they have too many staff whose careers depend on maintaining control and institutions NEVER voluntarily surrender power ever..

All you will get in the end is: " I know the FAA has agreed to XYZ, but the Aviation Act does not permit that because of ABC, risk to the public blah, blah".. The desired end result is that CASA can say they responded to change, consulted widely and came up with a revised class 3 medical certificate that looks like its overseas equivalents, but still ties us into the medical straitjacket we now have to wear. Pointless exercise until the Act is changed."

I wonder how comfortable AvMed is with the fact that each time a pilot slings a leg out of bed for a days aviation s/he self certifies. Must put a stop to that surely. And heavens to betsy a PIC is the sole person responsible for an aircrafts operation, how are these untrustworthy people given such responsibility?

That was a good summary Sunfish.
I believe it is indeed true, if you are "denied" a CASA medical, (that is, CASA says NO.) you can't jump over to RAAus.
But, a lot know they will be denied a medical next time, (or they just don't want to go through all the hassle) so the solution is to jump before putting yourself through all the hassle and possible/probable denial. (If you don't apply for a medical, you can't be denied.)
The the aviators self-certify each and every day they fly, (am I feeling good? Yes!) and go on to fly safely for many more years. But in the VH world, flying the same aircraft in many cases, you are a dnager to humanity.
RAAus and the others have all proven without a shadow of a doubt over 30-40 years that self-certifying is safe - for private flying.

Whilst I agree with most of your well articulated summation, it’s worth calling out a couple things. Ben Morgan has been so inaffective to date that his most recent attacks have only ensured he won’t get what he wants and that he’ll probably ending up in court for defamation. Hope he has deep pockets….. Also, he and his cronies have been calling for the RAA to have tougher medical requirements. Just look at his so called AGAA response to the recent medical consultation. His sole mission in life is to try and kill RAA because he hates them with such passion. But then he says he represents GA and recreational pilots…. Wtf….

Could you quote the statements by Ben Morgan that you say are defamatory? Could you quote the statements by Ben Morgan, or any of his cronies, calling for RAA to have tougher medical requirements?

And you may be surprised to learn that Avmed and the medical industry are perfectly capable of aspiring to get its tentacles into sports aviation, unilaterally. The questions in the Part 67 'survey' were not the idea of Ben Morgan nor any of his 'cronies'.

LB, t nasty detail is in the consultation summary.

As I read it, CASA is proposing Class 5 CERTIFICATE which would in theory involve self certification. So now the 10,000 odd RAA pilots, instead of making an annual declaration when they renew their membership, which is also their permission to fly, they now require a class 5 medical certificate.

So now RAA loses self certification as an adjunct to membership, because it now requires a pilot to have a MEDICAL CERTIFICATE, so RAA pilots are now covered by exactly the same administrative strait jacket as other certificate holders - they have been forced into the system where before they were outside it.

‘’And of course over time, the requirements of class 5 can be easily. tightened.

So Sir Humphrey wins again; in a professed desire to simplify and relax requirements, we do the reverse - 10,000 more medical certificates to play with.

Sunfish, it might be just you they're trying to force out? Once you're gone they might open it up a bit.

Toss bag, I was thinking the same about you.

’The idea of CASA / avmed as a necessary and effective gatekeeper is intellectually appealing but logically flawed. That is what British and American evidence demonstrates.

One could perhaps say that if you think you need a medical certificate for normal GA flight, then you don’t have sufficient mental abilities to fly.

Sunfish

For a while CASA published the number of medicals issued under this scheme and it was pitiful. Another mechanism they used to frustrate it was the selection of some medicals for CASA review. The Force foight back on these medicals and won.

If you ever needed a demonstration that CASA AVMED was not acting in the best interests of safety and was pursuing its own agenda, it is contained in ATSB reports. The ATSB has created 2 reports into pilot incapacitation in flight. If AVMED had real interest in improving safety, it would work on the identified issues from the top down. The things that CASA get hung up on and harass pilots with daisy chaining requests for medical tests do not appear on the ATSB list at all.

When AVMED came under the control of Rob walker he vowed to inprove AVMED. He moved on without visible signs of improvement, however I suspect some of the recent hopeful signs of improvement can be traced back to him. There are signs that cause optimism. There is a new permanent secretary for the DIIRD who has a reputation for bring changes to departments. Pip Spence is clear;y having a go and Dr Kate Manderson is the first non academic PMO for a liong time - maybe since Rob Liddell???

Also, we may have COVID to thank for some changes. With the current staff shortages in medice generally and general practice specifically, its hard to imagine that CASA will be able to attract any doctors to its review team. And as tight as things are now it will become desperately critical as the baby boomer doctors - who are continuing to practice in their late 60's and 70's - finally retire. It might force CASA back to trusting their DAME's and maybe - just maybe they might start to accept specialists opinions rather then their own behind-the-times low-rent generalists.

These days AVMED will argue that pilot incapacitation due to medical conditions is not on the ATSB’s list because of AVMED’s intervention to save us all from dangerously unfit pilots and their dangerously incompetent GPs and specialists. That is a confusion of correlation and causation, but it makes intuitive sense to the public. That, and cognitive bias, keeps Avmed in a job. The contemplation of dying in an aircraft crash results in a natural over-estimation of the probabilities of the crash and cries for preventative intervention which Avmed is happy to provide.

The single most likely cause of pilot sudden incapacitation identified in ATSB’s reports is gastro (I’m paraphrasing) and, in many of those cases, the pilot cannot continue to perform duties. Can anyone cite the regulation which deals, in detail, with the preparation, testing and consumption of food by RPT flight crew immediately before and during duty? Surely there’d be one somewhere in the thousands of pages of regulations, given the safety implications.

Ask passengers on an RPT jet whether they would be scared if the flight crew are about to be given orange juice and a ham sandwich for lunch.

Ask the same passengers whether they would be scared if the flight crew have a colour vision deficiency.

That’s why Avmed generally gets away with what it does.

Sadly. if Ben Morgans (AOPA) general comments about CASA thinking (16/5) are correct, CASA has cleverly moved the Goalposts by shiftiing the objective of extending self certification universally - iin other words, doing away with the need for a medical certificate entirely,, as accorded to the RAA and Gliding fraternities, in favor of a so called"'streamlined" certificate class 5 that EVERY pilot will require.

Thus the notional new "freedom" for PPL holders is purchased at the expense of the RAA and gliding community as predicted.

As for a "streamlined" class 5, I think we can count on the CASA legal crew to surround this dubious privilege with barbed wire such that anyone with a "condition" is subject to AVMED's tender mercies. Given the alleged size of the RAA pilot community - 10,000 (?) this should result in a vastly increased workload for AVMED staff.

I expect the associated regulations will be a shock to the RAA community.

I recall saying something about this, starting about 3 minutes and 20 seconds into this:

Clinton, it appears you were right. RAA can't make a peep because they want the 760kg limit etc.

We will soon see whether Dr Manderson has the same messianic delusions as her immediate predecessors like Navathe. Is Dr Manderson on a crusade in the belief that Avmed is the last bastion between aviation safety and aviation carnage, or will she be able to comprehend what the objective evidence and objective risk data show?

Sadly, the dumping, without warning, of the NZ Operational Colour Vision Assessment and its replacement with a newly invented Australian wheel, designed to trap and cull as much of the unclean CVD population as possible from the cockpits of commercial aircraft, does not auger well for an evidence-based and risk-based approach. (I have submitted an FOI request for documents relevant to the dumping of the NZ OCVA and its replacement with the newly-invented wheel called the ACVA.) We’ve returned to the dark ages where CASA Avmed seems to be congenitally incapable of understanding that, in modern civil aviation, CVD is an operational competence issue to be assessed by operational experts, not a medical issue to be micro-managed by the CVD industry.

Dr Manderson would hopefully be aware of published studies like the one with this Abstract:For the education of Ms Spence, this is a classic example of what’s called a “perverse incentive”. A process that is theoretically aimed at ensuring pilots meet or exceed a particular standard of medical fitness has the opposite effect. And it’s why my view is that Avmed has now become a force inimical to aviation safety.

Next time you board a commercial aircraft, ask yourself whether you’re sure that the folks in the cockpit are not among the 50% or so of the pilot population who are engaging in “healthcare avoidance behaviour due fear for losing their aeromedical certificate”. You can safely assume that the incentive in Australia is as perverse if not more perverse than in the US. And part of the incentive arises not just from loss of certification, but also from the prospect of costly and time-consuming tests that Avmed imposes to obtain certificate renewal, despite qualified opinion that the tests are not justified. (And one can only speculate as to the opportunity cost of all those medical resources being diverted to unnecessary tests and reports rather than something beneficial.)

My fear is that the natural response of medical bureaucrats with messianic delusions, to studies like the one whose Abstract I quoted, is to redouble their efforts to entrap all the criminals who aren’t throwing themselves under the Avmed bus. Of course, that would make things even worse and would be contrary to the objective evidence. The objective evidence is that all that aviation activity is happening safely out there even though there is so much withheld from Avmed and even though there is so much healthcare avoidance behaviour going on. And that’s setting aside all of the pilots who are exempted from Avmed interference.

If Dr Manderson wants to actually improve the health of the pilot population, the single most effective thing she and her team could do is trust pilots - and trust the medical professionals whom pilots trust - to be perfectly capable of maintaining and monitoring fitness, so that pilots are not living in constant fear of Avmed’s damaging and unqualified overreactions.

I've seen far more evidence of pilots being able to manage their own medical status than AvMed. In most cases an actual event will happen where the pilot self grounds themselves until their own medical professionals say it's ok to continue. That's when AvMed puts up a wall of stupidity that basically calls the pilot and their medical professionals liars/idiots until AvMed can prove it it correct itself.

A lot of pilots I know that have had grounding events such as heart attacks were Class 1 holders for decades prior to the event, the yearly rigmarole and hoops did nothing to prevent the occurrence at all. But AvMed and CASA definitely put hurdles up for their return to flying. Mental health is even worse, there have been numerous pilot suicides (not involving planes), these pilots obviously did not get grounded prior by the system. However AvMed will put up a huge wall of requirements for those pilots who have sought help and treat them like they are suicidal for just having a run of bad days, even when the associated doctor says that the pilot is stable/cured or of no harm they will be required to have an expensive yearly report submitted.

Fair enough have extreme policy for those that have tried to dodge the system and are not getting help or are a genuine risk, however the current system definitely punishes the honest pilots for getting help they need. And if CASA does not trust all doctors/specialists, why not publish a list of specialists fro the more common things like cardiology, psychiatry and ENTs that are approved so pilots can seek them out.

CASA Avmed reckons that the collective brains trust at one of its ‘Complex Case Management Meetings’, informed by their review of studies they’ve googled, makes them better placed than some mere specialist to decide the aeromedical consequences of some condition and what to do about it.

It’s like a bunch of private pilots getting together and, having flown a bunch of heavy metal time on Microsoft Flight Simulator, deciding that they are better placed than someone with a few thousand hours on type to decide the safety implications of something that happened in the cockpit of an aircraft of that type in the real world.

I’ve said it publicly, numerous times: Any idiot with access to the internet can do what Avmed currently does. Google up whatever is available about a ‘condition’, cherry pick the bits about the worst possible consequences of the condition, extrapolate that to an aviation disaster, demand whatever are the ‘biggest and best’ tests in relation to the condition as often as suits Avmed, or simply ‘ground’ the person, and steadfastly disregard any treating specialist opinion to the contrary.

I recently became aware of an applicant who disclosed he’d had a sports injury a while ago and was prescribed pain killers to take while he recovered from the injury. Avmed went ‘full retard’ and required the applicant to provide evidence that he was not addicted to pain killers. As if that response encourages the disclosing of information to Avmed.

There was once a story that a pilot had answered the question posed of have you ever seen a psychiatrist?
And he answered truthfully YES he had, and then all hell broke loose and he was grounded.
He HAD seen one, because his poor wife had schizophrenia, and he wanted to learn some strategies from the doctor as to how he could handle her condition more effectively.

If I consulted an Oncologist about my wife's cancer, I wouldn't put down that I had consulted an oncologist on my medical. Its irrelevant to my medical profile. Im just consulting an expert for advice about someone else's issues.

To be honest, your friend was a bit naive. I hope they got it sorted quickly.

Something that Australians and AvMed need to get over is that there is thousands of things a psychologist can help you deal with from eating disorders, irrational fears of things like shadows or clowns, fears of going outside or meeting people, to yes suicidal thoughts. The later being the extreme of depression and such. So to have a stupid tick box that wants to know if you've seen a mental health professional which is followed by having to prove you are not suicidal enough to fly a plane into something when you had a fear of cats you are trying to deal with is stupid. Its the same as saying "have you had any flu like symptoms" and then asking the pilot to prove they don't have cancer.

At some point AvMed will admit that at least half of active pilots have some form of mental illness and then what?

Why naive to expect that something that has nothing to do with air safety would ground you? It's more an indication of how stupid the system is that jumps to conclusions that pilots don't know when they are safe to fly or not, when they do that every other day up to a year between AvMed assessments. If they really want a safer industry mandate at least a weeks mental health leave a year and make all sick leave as leave that accrues and needs to be paid out when leaving the company. You will see companies ordering you to take sick leave each year to clear 'liabilities'. No one will need sick certificates or stat decs.

It would be interesting to know of anyone AvMed has grounded that went onto being incapacitated by their conditions vs those that self grounded after finding out themselves. I'm talking about pilots in long term careers that is, not somebody that found out on their first medical attempt. I know a number of pilots who had heart issues only months after aviation class 1 medicals including ECGs which found nothing wrong. Should they possibly sue AvMed for not picking up things that they should have, and could have been fixed prior to the occurrence? Or is AvMed going to admit their medical process is a joke, with no real safety benefit and let pilots take onus of their own health?

"Why naive to expect that something that has nothing to do with air safety would ground you?"

Then why tell them? It's irrelevant. And it's not in the "spirit" of the question. In this case they are asking if you have consulted a psychologist for YOUR medical issues.

But I agree, seeing a psychologist is not a bad thing. Getting help for any mental health issues early is a great and positive idea. CASA need to grow up. Its ok for them to ask more questions, they do that to "fat" me all the time. I just answer them and get my medical. But they should not go overboard and i would hope they have a more mature understanding of the issues.

It was a ‘psychiatrist’ in the anecdote, not a ‘psychologist’. Two similar but very different things. I think the psychiatrist is the one that shows you dirty pictures. (that is not a cue to tell us everything you know about mental health 43”, that is me being light-hearted about a serious subject.)

Never tell CASA AVMED ANYTHING! If it can't be discovered in the actual Medical with the DAME it never happened.

In short the Psychologist might be the start of your journey, or the Psychiatrist is more specialized in you're issue, so you get triaged to them even though it's a more minor problem. Mental health professionals have been in high demand especially since covid, so there is a chance you might be handled by a whoever is available at a clinic. Again CASA assumptions that just because you see a psychiatrist means that its an extreme disorder equaling suicidal behavior is the issue.

Very bad advice as in the modern climate your so called mates will dob you in at some point when symptoms manifest and then you'll be 'coming out' on CASA's terms not yours. Or worse it manifests on a flight and somebody is injured and you will end up being sued, which will go down the lines that you were aware of your issue, and were not legally fit to operate, so all insurance and legal coverage is null and void and you end up the rest of your days paying off somebody else.

Not telling CASA Avmed is not the same as not obtaining proper and successful medical care. As the Abstract of the study notes above, plenty of pilots seek what the study calls "informal medical care".

The laws of physics mean that there is no causal connection between Avmed's levels of knowledge or ignorance of a person's medical history and that person's level of medical fitness. A person's level of medical fitness is what it is.

There are plenty of pilots out there who are not obliged to tell Avmed anything and about whom Avmed knows nothing, and those pilots meet the aviation medical standards. They just don't have a piece of squashed tree from Avmed saying so.

(Note: I am not advocating that people should withhold information from Avmed.)

The problem you have there is that it is a legal requirement to disclose your medical issues to CASA, and then for CASA to decide whether you are legal to fly. So in any case where you have a condition that AvMed deems you require surveillance and you are not under that surveillance program and signed off you are not legally able to exercise your privileges of your CASA licence. So being medically (un)fit is determined by CASA and the pilot can only determine their fitness for duty in absence of any medical condition that is deemed disqualifying. Then they bring in in Aviation that negligence is not a defense, as you should have reported all medical conditions as soon as apparent and you are educated on air law by examination, so are qualified to read and understand your requirements as a license holder.

Aviation IS all fun and games, until somebody gets hurt, then its lawyers and economics....

BTW, your road license has similar conditions that you must report all long term medical conditions that may affect your driving ability to the issuing authority, and have a supporting doctors report on it. If you have an accident where an undisclosed long term medical issue was part responsible, good luck in court.

PS I'm all for fighting the aviation medical system, however my feeling is 'non-disclosure' is what AvMed secretly wants, then they don't have to make decisions or be liable for what happens if there is an accident. Make things hard for everybody, nobody wants to disclose, not our problem, it'll be their problem if it causes a crash. A version of the US DADT (don't ask don't tell) policy.

So you're saying that there is no pilot out there - not one - flying e.g. under the auspices of RAAus who meets the Class 1 or Class 2 medical standard but just doesn't have a piece of squashed tree from CASA saying so? You're saying that - by some magical process - a person's physical and mental state can be changed by what's in the head of someone sitting at a desk in Canberra?

I understand the legal arguments you're making. I'm making arguments about the immutable laws of physics.

I agree with you, that the conditions may have nothing to do with air safety, but as it's written CASA decides what is legal for CASA issued licences. So unless its a medical condition as outlined in regs where you don't have to disclose, such as cold and flu lasting less than 7 days or whatever, the rest has to be reported. If something were to go to civil court regarding costs the prosecutor can get all sorts of quacks to prove a non related condition as related, so it is in a persons interest to disclose and be 'certified' fit.

I also know that a number of pilots defer certain care as they know it will be problematic for their medical to proceed. So they 'postpone' seeking treatment, which as we know can be life threatening. This is a direct result of the regulations being unforgiving and cumbersome. I know if I report a mental illness I will be grounded indefinitely, then have to jump through CASA hoops to re-certify, because it's all via secret AvMed discussions I have no idea if and when I can get back to work. Where in reality the decision should be the sole domain of the pilot and their medical professionals to decide, provide a written report to CASA that everything's fine and move on. Therefore the pilot knows they can seek treatment, be cured and get back to work when they know they are ready, which can all be planned.

I agree entirely with most of that.

My only point of disagreement relates to your statement that the perverse incentive is "a direct result of the regulations being unforgiving and cumbersome". It's actually a direct result of the way in which individuals in Avmed have chosen to interpret and administer those regulations. People with messianic delusions on a crusade in the belief that Avmed is the last bastion between aviation safety and aviation carnage interpret and administer the regulations differently than people who are able to comprehend what the objective evidence and objective risk data show.

And the mechanism which continues to have the single most profound practical consequences in the regulatory regime is always available to get around "unforgiving and cumbersome" regulations: Exemptions. That's why there are plenty of pilots flying 'legally' and 'safely' out there who are not obliged to tell Avmed anything and about whom Avmed knows nothing.

My idea on AvMed is that it should be more like the ATSB. They investigate and publish causes of Aviation incapacitation, publish aviation related medical issues and papers and that is accessible by medical professionals who treat pilots as a guide. As well as providing guidance on what constitutes fitness to fly, rather than being the traffic lights on the subject. This then can be legally used by the medical practitioners to make reliable decision on a patients fitness to fly. The pilot then can work with their GP and specialists to maintain their own fitness, with some form of basic certification each year to ensure each pilot is maintaining their fitness.

Because of the liability implications you will not be getting GPs to just sign dodgy certificates so it would be a robust system.

Even without a doctors signature, you will still have to pass AFR/BFR/IPC or whatever regularly, so it would be obvious to those testers who is obviously unfit and who isn't. After all you were issued an non expiring license that says you are eternally competent as a pilot, and other approved pilot can deem you suitable to exercise your privileges.

I think safely may be a fine term, but legally is what I'm disputing. Just because AvMed does not know, does not mean it's legal. It would be up to a court/coroner report to find if you were legally able to fly on such an occasion, and depending on who's out to get you will alter how hard it will be to get out of that corner.

Sometimes my brain's not big enough to understand some of your arguments, 43. I didn't say that just because Avmed does not know, means it's legal. I gave your post a 'like' before you added that.

There are plenty of pilots who are not legally obliged to hold a medical certificate issued by CASA and are not legally obliged to tell CASA anything about their medical 'conditions'. Agreed?

Those are consequences of a regulatory regime created by exemptions granted by an organisation called "CASA", for whom the safety of air navigation is the highest priority. Agreed?

You seem to be trying to make the point that mere compliance with the civil aviation legislation - or exemption from it - does not automatically result in someone discharging their duty of care when taking to the skies. If that's the point you're trying to make, I agree. (BTW: It's also true that non-compliance with a statutory obligation does not automatically result in the circumstances of non-compliance constituting a breach of a duty of care.)

But that's the same outcome whether the person is obliged to have a CASA-issued medical certificate or is exempted from the obligation, and the same outcome whether the person is obliged to keep CASA informed of specified matters or exempted from the obligation. Agreed?

I suppose the question is 'if' you are exempted from the requirement to hold a medical 'certificate' are you still exempt from notifying the governing agency of any medical conditions. As with the conditions of disclosure attached to a drivers licence. Then if you are truly self certifying and something should go wrong, how well are you protected legally without an agency having approved your condition. I would suggest it would be an answer very similar to the car driving legalities. The later answers can really only be tested in court if somebody is injured and your 'condition' or 'fitness' were to be questioned.

I made the very naive mistake on my initial Class 2 issue of disclosing a mental illness which I suffered from in a finite period of time as a teenager, and the fact that I'd had LASIK - despite getting a near perfect core in the vision test. The total cost to confirm that these were not in fact current aero-medical issues ended up being over $1000 out of pocket. The aviation opthalmologist and psychiatrist that I had to see to certify that I was not visually impaired or insane both thought it was a ridiculous waste of time.

This initial issue was under the long-gone Dr Navathe's regime. Repeatedly calling them for updates only to have to jump through more hoops almost drove me to tears. I will make the point since then that my renewals have been straightforward and I saw a DAME2 for my last who issued it on the spot - it seems not all DAMEs have this 'accreditation'.

All of this to say I am convinced that the research cited in this thread earlier is correct and that there are many, many Class 1 or 2 holders that a) withhold information from their DAME and b) would never see their DAME as their GP.

Briefly scanning through the 420 FOI stuff that Clinton uploaded also makes me wonder how many of the people who work in CASA can actually go home and consider that they've done a solid day at work improving aviation safety...what a waste of our taxpayer dollars.

This is typical of the bizarre, stressful and costly world in which Avmed guinea pigs so often find themselves.

Medical professionals with specialist qualifications and long experience in their specialisation apparently don’t know what they’re talking about, but Avmed people without the specialist qualifications and experience apparently not only do know what they’re talking about but know better than the professionals with specialist qualifications and long experience in their specialisation. It’s one of the many mysteries that contribute to the mystique of aviation.

Wonder no more. Those in Avmed with messianic delusions of being the last bastion between aviation safety and aviation carnage go home each day knowing they’ve prevented carnage by, for example, imposing their botched form and unqualified opinions and demands on guinea pigs who’ve declared a diagnosis of ADHD or ASD.

Meanwhile, in the real world, their work is increasingly detracting from aviation safety.

I have had more than one DAME say to me that `The less CASA AvMed are told, the better.`

Something which I find quite shocking!

I found it mildly shocking 30 years ago, but now it's said regularly, because the doctors don't trust CASA to have an appropriate response. It really applies to a lot of industries in Australia where the laws are inconveniences to business, but no one wants to do anything about it, and rather sweep things under the carpet. OH&S, fatigue management, and worker health are all areas that people tip toe around rules. One word saying report all you want, the system will look after you, and then turn the other cheek when you do and get you to jump through so many hoops and talked down to with frowning faces it deters anyone doing it unless they really really have to. As I said earlier, some of these systems make it hard to get things done, because they really don't want that to happen, but make it look like it's possible, because the have to. Arrrghh, another heart attack victim wants to be a piloot, I don't want to be responsible for another one, lets make them jump through so many hoops that they either give up, die or prove some super human feat that they are truly worthy of a medical cert and then it will be the others that proved its fault not mine...

If you flood the system with real issues, it collapses, which is what has probably happened at AvMed now. Once it's proven that most of us suffer all sorts of issues and pilots are no different then they can't operate the way they do without shutting down the whole industry and real change will happen. But that would take everyone being ultra truthful and disclosing everything.

Imagine if every pilot disclosed they had a single suicidal thought last year, what would they do? ground every single pilot until each one could be vetted for whether they intend to act on it?

Well obviously the ADHD form "Cannabis culture" should have been field tested amongst the CASA staff, who likely would have found themselves diagnosed as potentially having ADHD. (see "May be the centre of attention" for explanation.)

Pinkbits, for every DAME that says that, there are 3 zealots (that you wouldn't let treat a wart on your finger) that will follow the AVMED line that you're a filthy diseased pilot who must be run out of aviation.

1. I've spoken with one Optometrist who successfully completed the training to qualify as an Aviation Optometrist.

However after reading the accreditation paperwork presented to her by CASA, she declined to sign it and has foregone the opportunity.

The reason, according to what she told me, was that the CASA contract required her to make a mandatory report to Avmed if there was any sign of deteriorating eyesight, regardless of whether the pilot met the required standard or not , AND WITHOUT SEEKING THE PILOTS PERMISSION.

She saw this as an attempt by CASA to insert itself into what she held to be the sacred doctor/patient relationship and she refused to accept it.

On reflection, in my opinion, the more CASA Avmed attempts to insert itself into the doctor/patient relationship the worse the safety outcomes are going to be. This is a predictable outcome. Britain and the U.S. at least have wised up.

2. The bureaucratic medical establishment, like AVmed, is a useless concept because their preferred outcome if you have ANY condition is that you stop flying and go away - its safer for the bureaucrats that way. They have absolutely no incentive to keep you flying and a big personal incentive for you to get lost.

By way of example, In a slightly different profession - law enforcement - I have an acquaintance who had a major health meltdown over a divorce that saw her hospitalised and treated for alcoholism with the full knowledge of the Police and the support of the Union. Thankfully she made a complete recovery, but that was never going to be good enough for the police HR/Medical establishment which exhibits AVmed traits. Naturally during treatment and recovery she was deemed "non operational" (ie grounded). It took three full years of her jumping through every medical and psychiatric hoop that the medical establishment could dream up - and changing the goalposts multiple times, and a union ultimatum to police command, before she was grudgingly made operational again, and that only with quarterly liver function tests in perpetuity. CASA avmed has exactly the same drivers.

P.S. The police force is crying out for more officers and trying to recruit new ones. Their own HR/AVmed/feminazis are forcing officers out at the rate of over 20 a month on spurious health and now ethics claims (eg domestic violence allegations during divorce proceedings) - which is way more than the recruitment rate..

As one fortunate enough that a Class 2 is as much as/more than I'll ever need (and even that's getting harder to hold as the grey hair increases), for this and other reasons (increasing $$$) I'm seriously considering ditching the DAME and switching to a Class 2 Basic next year.. and it's only downhill (RAAus?) from there.

I imagine I'm not the only one either. The Avmed horse has bolted already and all they're willing to do is stand around and watch. :(

Anyone who entered commercial aviation in the last 30 years MUST be mad and therefore should be denied a medical certificate.