Seminar or CBI?

Editorial, by Jon L. Jordan, MD, JD

Considering the demands of the private practice of medicine, I understand the reluctance of some Aviation Medical Examiners (AMEs) to attend the required periodic AME seminars. This is why, as announced in the Fall `95 issue of the Federal Air Surgeon's Bulletin, we now permit, at alternate three year periods, completion of the computer-based multimedia AME refresher course as a substitute for attendance at a seminar.

We have received favorable responses to this training mechanism from a substantial number of AMEs, and some have expressed the opinion that the value of the module is, in some ways, superior to attendance at a seminar.

This reaction is not unexpected, since the module concentrates specifically on medical certification criteria, as outlined in the Guide for Aviation Medical Examiners, whereas a broader range of subject matter relevant to the duties and responsibilities of an AME is covered in the seminars. While I fully endorse the computer-based program as acceptable for attendance at alternate seminars, the periodic coverage of a broader range of subjects, as provided by the seminars, is absolutely essential.

One example of this came to light recently as a result of a letter received by our Aeromedical Education Division from a malpractice insurance carrier regarding the insurer's coverage of an AME performing airman medical certification examinations. According to the letter, the AME informed the insurance carrier that, as an AME, he was considered an employee of the FAA, and that any liability that might arise out of his conduct of the examinations would be dealt with by the agency. Unfortunately, we had to respond to the insurer that this was not the case.

One of the frequently recurring questions asked by AMEs at seminars relates to potential liability of the examining physician in the performance of AME duties. For this reason, and because of other important legal issues associated with being an AME, we always have a representative from our Chief Counsel's Office lecture and meet with AMEs so that they may be fully informed of their responsibilities and duties. A major part of the lecture and discussions is consumed with matters of personal liability.

Among other subjects, AMEs are informed that the potential for personal liability in performing AME duties is extremely low (while litigation has been threatened and a few suits have been filed against AMEs, a recent review of our litigation experience failed to reveal any court decisions adverse to the physician).

AMEs are not considered agents or employees of the Federal Government and are not entitled to Federal legal representation or compensation should they be sued by a disgruntled applicant or by the survivors of an applicant who is killed or injured in an aircraft accident. For these reasons, AMEs are cautioned to take great care in the conduct of examinations and the application of the medical standards. If they do so, they may expect strong support from the FAA in respect to the propriety of their actions and any liability connected with the performance of AME duties will be minimized.

Because of the opportunity to raise issues and ask and answer pertinent questions, the milieu of the AME seminars is conducive to an exchange of relevant and important information that cannot be adequately covered by a computer-based instruction program. While I do not know the source of the AME's impression that the FAA was legally responsible for his acts as an examiner, it is this kind of misunderstanding the seminars are intended to resolve.