by Dr. Bill Blank, MD
Published in Midwest Flyer Magazine June/July 2023 Digital Issue
BasicMed became effective May 1, 2017. Part of the law authorizing it required the FAA in conjunction with the National Transportation Safety Board (NTSB) to monitor its effect on General Aviation and report the results to Congress. The first required report was submitted to Congress on March 10, 2023. It covers March 1, 2017 through December 31, 2019. Here are its conclusions:
• The implementation of BasicMed did not impact the estimated number of GA aircraft. There was a modest four-year growth trend from 2013-2016, followed by stable numbers.
• The implementation of BasicMed does not appear to significantly reduce the slow, long-term decline in the number of active GA pilots. Estimated aircraft flight hours demonstrate an equivalent rate of growth, both before and after the implementation of BasicMed.
• Almost 70 percent of BasicMed pilots have never held a pilot certificate above private pilot status. Less than 30 percent of BasicMed pilots held commercial or airline transport pilot (ATP) certificates as their highest certificates at one point in their aviation career.
• BasicMed pilots are older on average than airmen maintaining Third-Class Certification, and the pre-implementation Third-Class population.
• BasicMed allowed more than 18,000 airmen to conduct operations in aircraft that qualify for BasicMed. These airmen did not hold a medical certificate in the six months prior to qualifying for BasicMed and would not have been permitted to operate any aircraft other than balloons, gliders, or light sport aircraft without a medical certificate.
• Over half of BasicMed airmen had their last medical certificate examination between three and five years prior to registering for BasicMed, and 67 percent of BasicMed airmen had expired medical certificates at the time of registering for BasicMed.
• BasicMed airmen are much more likely to have required a Special Issuance. Referencing the meaning and purpose of a Special Issuance, this reflects a potentially elevated risk of incapacitation among the BasicMed population in the context of reduced FAA oversight. Mitigation is dependent upon airmen receiving regular care from primary and specialist physicians.
• No difference was found in the risk of airmen with BasicMed and airmen with Third-Class Medicals in regard to having an aviation accident from the start of BasicMed in 2017 through the end of 2019.
• No difference was found in accidents between airmen with BasicMed and airmen with Third-Class Medicals in the phase of flight in which their accident occurred.
• No difference was found among airmen with BasicMed and those with Third-Class Medicals in fatal versus non-fatal outcomes.
• No difference was found in autopsy findings among airmen injured who held BasicMed and Third-Class Medicals.
• When restricted to medically-related death, BasicMed airmen had an age- and Special-Issuance adjusted risk of mortality over the study period, which was 53 percent higher than airmen who maintained Third-Class Certification.
• BasicMed airmen had an age- and Special-Issuance-adjusted risk of death from stroke or myocardial infarction three times the risk for airmen who maintained Third-Class Certification. These conditions pose an increased risk of sudden incapacitation.
• BasicMed airmen had twice the age- and Special-Issuance-adjusted risk of death from cancer, than airmen who maintained Third-Class Certification.
FAA’s Conclusion: This report summarizes the findings of the first three years of operations under BasicMed. The FAA determined that while BasicMed did not impact small aircraft activity, it also did not significantly impact aviation safety.
While the data collected in this study provides a limited initial analytic impression of BasicMed, several more years of operational data with considerations of causation factors will be necessary to validate the conclusions of this report.
The Aircraft Owners & Pilots Association (AOPA) supports BasicMed. It notes that the past 3 or 4 years have been the safest in GA history, and that there has been a 30% increase in the number of holders of Third-Class Medical Certificates.
My personal opinion is that BasicMed has been successful and solved the problems in certification it was designed to solve without compromising safety. Here is a link to the whole 32-page report: https://www.faa.gov/sites/faa.gov/files/PL_114-190_Sec_2307_Effects_Regulatory_Changes_to_Medical_Certification_Certain_Small_Aircraft_Pilots.pdf
Happy Flying!
EDITOR’S NOTE: Columnist William A. Blank is a physician in La Crosse, Wisconsin, and has been an Aviation Medical Examiner (AME) since 1978, and a Senior AME since 1985. Dr. Blank is a retired Ophthalmologist, but still gives some of the ophthalmology lectures at AME renewal seminars. Flying-wise, Dr. Blank holds an Airline Transport Pilot Certificate and has 6000 hours. He is a Certified Flight Instructor – Instrument (CFII) and has given over 1200 hours of aerobatic instruction. In addition, Dr. Blank was an airshow performer through the 2014 season and has held a Statement of Aerobatic Competency (SAC) since 1987. He was inducted into the Wisconsin Aviation Hall of Fame in 2021.
DISCLAIMER: The information contained in this column is the expressed opinion of the author only, and readers are advised to seek the advice of others, including their own AME, and refer to the Federal Aviation Regulations and FAA Aeronautical Information Manual for additional information and clarification.
