Setting a Positive Example

Editorial, by Jon L. Jordan, MD, JD

Those of us who are parents appreciate the importance of setting a favorable example for our children. The parent who ignores this may find he or she has fostered a problem child with the potential for carrying self-destructive behavior into adult life. This not only negatively impacts the child and the parents, but society as a whole.

The same is true in our work life. The physician who counsels patients about the negative health aspects of smoking while holding a lighted cigarette is not likely to make much of an impression, nor is the overweight physician likely to get an obese patient to shed undesirable pounds.

All too frequently I receive anecdotal reports concerning aviation medical examiners who perform cursory examinations and who even counsel airmen to not reveal certain medical information on application forms because to do so will only "create problems." This sort of behavior, which frequently cannot be documented sufficiently to permit disciplinary action in respect to the AME, undermines aviation safety. If the AME is so blasé about the importance of the medical examination and the airman's medical history, you can be assured the airman will be as well.

In regard to setting an example, I was astounded by the findings in a recent airplane accident involving a physician that sends a terrible message to physicians and airmen alike. This physician, a seemingly highly proficient pilot and frequent educator of others in piloting safety, was involved in a fatal accident that took the lives of four people, including himself. The accident also caused significant damage to property and injuries to persons on the ground.

What was so startling about this case is that postmortem toxicology studies revealed butalbital in the doctor's urine and body tissues. A review of his FAA medical records revealed no entries regarding the use of medications or information on the presence of a medical condition for which the medication might have been used. However, a review of the doctor's personal medical records revealed a long history of migraine headaches and prescriptions for thousands of tablets containing butalbital. Fortunately, there was no evidence that any of his AMEs were aware of the medical history.

Although the doctor's use of butalbital was probably not a major contributor to the accident, the repeated falsification of his applications for medical certificates and his use of a medication that is contraindicated in aviation sends a sobering message. This is especially true in light of the doctor's experience and previous responsibilities in teaching others about aviation safety. If this knowledgeable doctor was willing to take this kind of risk, what about the typical pilot?

This accident serves as a reminder of our responsibilities to set a positive example for airmen. This can be accomplished easily through encouraging airmen to fully disclose their medical histories and by paying careful attention to the conduct of a good medical examination. It is an essential part of your job!