DISCLAIMER: This sponsored article was created by Insight magazine, the sponsored content division of MHM Publishing, on behalf of Wingman Med.
It’s a frightening prospect that, sadly, prevents many pilots from getting the help they need: The possibility of losing their livelihoods due to a failed medical certificate examination.
But what many pilots don’t realize is, the right guidance from a qualified healthcare professional with extensive knowledge of the aviation industry can make all the difference in the world.
“One of our mantras is, get treated and get better,” said Dr. Daniel Monlux, a flight surgeon and former F/A-18 pilot who is also an aviation medical examiner (AME) certified in human intervention motivation study (HIMS) and co-founder of the aerospace medical consultancy Wingman Med.
“If you think you have a problem, go see a doctor. Get the appropriate treatment for it, and more than likely, there’s a pathway back to the cockpit.”
Unlike a pilot’s license, a Federal Aviation Administration (FAA) medical certificate has an expiration date, and a host of factors can lead to it not being approved. In many cases, it boils down to paperwork errors that get flagged in a fickle bureaucratic process.
In other cases, the FAA might raise concern about a past medical condition, or a prescription for painkillers the pilot may have stopped taking years ago.
Those kinds of issues don’t necessarily disqualify a pilot from flying, and an experienced medical consultant from Wingman Med can catch them upstream and prevent them from slowing down the approvals process.
“The doctors at the FAA reviewing division — the aerospace medical certification division in Oklahoma City — they never see you physically … they are literally just looking at the paperwork that gets sent in,” said Dr. Keith Roxo, a trained aerospace medicine physician, Top-Gun-trained adversary pilot and co-founder of Wingman Med.
“You can be as fit as a fiddle, but if your paperwork is garbage, you’re not getting your medical. That’s a crucial thing for people to understand … paperwork errors or just incomplete paperwork are some of the primary reasons why people get stuck in the certification process.”
Still, even in the face of a serious medical condition like high blood pressure, heart attack or diabetes, there’s often a clear path back to the pilot’s seat.
“People who have had heart attacks can still get medical certificates,” Dr. Monlux said. “I think the flying public will be happy to know there’s a pretty rigorous process that pilots need to go through before they’re allowed to fly after that. But there is a process for it.”
Medical and aviation expertise
Wingman Med is a rare medical consultancy that backs up its healthcare expertise with extraordinary first-hand knowledge of the factors pilots face.
Dr. Monlux and Dr. Roxo founded the company after retiring from pilot careers in the U.S. military that saw them rack up thousands of flight hours. They both also spent time as military flight surgeons, overseeing the care of some of the world’s elite military aviators.
“That gives you that instant credibility,” said Dr. Monlux, who started his career in the U.S. Navy and has more than 2,000 flight hours, including combat service in the F/A-18. He was also a commercial pilot for more than 20 years and is a certified flight instructor for single-engine and multi-engine aircraft, as well as for instrument flight.
“When you walk into a squadron, they don’t see you as a doctor first. They’re seeing you as a pilot first,” Dr. Monlux said.
Dr. Roxo has over 2,000 flight hours in high-performance aircraft, including the F/A-18, F-16 and F-5, along with multiple military flight instructor qualifications, an airline transport pilot certificate, and an FAA civilian flight instructor certificate.
Together, they started Wingman Med with the goal of keeping pilots in the air while practicing rigorous medicine, using a model Dr. Roxo compares to one used in the U.S. Navy.
“[In] the Navy model, you are the doctor for the pilot,” he said. “So it’s your job to take care of them — and when there’s a problem, get them back to qualification as expeditiously as possible. I believe [this is] something that has helped us with the FAA side, because we know how to take care of pilots.”
This approach also encourages pilots to get the help they need, rather than avoid getting medical treatment due to a fear of being disqualified to fly.
“It’s one thing that I try and express — not just to pilots, but I’ll do this to younger doctors that I meet,” Dr. Roxo said. “You can’t take care of someone else if you can’t take care of yourself. If you go up in the air when you’re sick and now you have an issue in the cockpit, how are you going to finish your mission? How are you helpful to somebody else at that point?”
Qualified medical advice
Wingman Med leverages more than six decades of combined expertise from its board-certified aerospace medicine physicians, who remain active pilots.
They have a keen understanding of the passion and joy that comes with flying, as well as the dedication required to stay qualified. Thousands of pilots have trusted Wingman Med to help them navigate the FAA bureaucracy with sound medical and administrative advice.
“Having a disqualifying condition is very rarely the thing that holds people back from getting a medical certificate,” Dr. Monlux said.
“You’ve got to treat that FAA medical exam like a check ride,” added Dr. Roxo, using the colloquial term for an FAA Practical Exam. “It’s not an annual checkup with the doctor. It’s a check ride … You have medicine, which is its own complex science, and then you have federal bureaucracy overlaid on top of it. So it’s difficult for the average person, even the average highly-intelligent person, to be able to decipher that in a way that they can truly understand.”
The process often begins with a visit to the Wingman Med website, which includes a searchable database of medications flagged by the FAA, and the MedXPress Simulator, which provides access to the types of questions an AME may encounter from the FAA during their evaluation.
Wingman Med also operates a sister website, PilotDoctors.com, another searchable database that helps pilots find a qualified AME in their local area. In contrast to the FAA’s own published list, PilotDoctors.com has a user-friendly interface that makes it easy to filter AMEs based on their individual qualifications, with enhanced datasets that incorporate Google reviews and other sources meant to evaluate an AME’s track record with patients.
“It’s really hard to find somebody who you have any confidence is actually going to know how to do a good exam,” Dr. Monlux said. “And if you really have an issue, having an AME who knows what the FAA’s current regulations are and how to apply the standards, is critically important.”
After browsing the Wingman Med website, pilots can book a free 15-minute consultation with a qualified AME who can provide advice about how to approach their medical exam. Simple queries are often cleared up at this stage, and don’t require a follow-up appointment.
“I would say about two-thirds of the people that we talked to never pay us a dime,” Dr. Monlux said. “We’re able to provide some reassurance and send them in the right direction without any kind of financial obligation to us whatsoever. And that’s really rewarding, to be able to give back to the pilot community in that way.”
If a follow-up is required, Wingman Med staff develop a customized plan based on a detailed questionnaire. Dr. Monlux stressed the plan is not aimed at influencing the opinion of the pilot’s physician; it’s aimed at highlighting which labs they might need to order, which tests to run, and what details need to be documented to meet the FAA’s guidelines.
“The pilot still has to pass all of those evaluations,” he added. “If you cannot show that your heart is fit to fly, there’s not much we can do about that. But what we can do is shorten that process with expertise and efficiency by giving you very detailed instructions.”
After doctors provide an assessment, Wingman Med also reviews all the results and its accompanying paperwork to prevent any unnecessary delays in the approvals process.
“One of the most common reasons why somebody gets in a protracted delay with the FAA is documentation errors,” Dr. Roxo said. “They’ll send one thing in, and I like to joke about it — the FAA asked for capital X, lowercase y, and italic z. And the pilot sends in lowercase x, uppercase Y, and bold z. The pilot thinks: ‘Yeah, I sent them what they asked for.’ It’s close but not quite. You’re either missing a key piece of information, or some other piece of information slides its way in there that is troubling to the FAA and they didn’t know about.”
Outdated medical records can also cause unnecessary red flags, like a prescription for painkillers that lapsed one year after a surgery, or a poorly-explained treatment plan for diabetes that is keeping the illness in check.
“We’ll get that fixed pretty quick,” Dr. Roxo said.
It’s crucial to stress there is no substitute for rigorous medical treatment for any health concern that might lead to a medical disqualification. Safety trumps every other factor. But it’s equally important for pilots to understand there is often a path back to flying, even in the face of a serious condition.
Heart attacks, diabetes, alcoholism and other serious conditions don’t necessarily disqualify a pilot forever. Honesty is always the best approach, followed by medical treatment.
“Own up to the fact you have a potentially disqualifying medical condition,” Dr. Monlux said. “Get it treated, make sure that the condition is under control and the medications you take to treat it are free of any safety-related side effects, and then get back to flying.”
For more information, visit wingmanmed.com.