One of the main reasons doctors might be uncomfortable with BasicMed is that they might not have training or experience in aviation medicine. BasicMed doesn’t provide a medical “standard,” like part 67 does for medical certificates. BasicMed relies on the physician’s general medical training (and their own experience and discretion) to make the decision about whether the pilot has a health condition (or combination of conditions) that precludes them from operating under the limited recreational flying allowed under BasicMed.
In drafting the bill that created BasicMed, Congress gave this broad discretion to physicians to exercise their own medical discretion when conducting the physical exam. This means that much of the decision-making on what is, and is not acceptable, is left to the judgment of your own doctor, rather than a FAA-prescribed medical standard. This gives you and your doctor latitude in how they resolve any issues, and it also reinforces the same responsibility you have when flying using a medical certificate.
You must make a risk determination on your fitness for flight every single time you get in the cockpit, no matter when your most recent BasicMed physical or FAA medical certificate exam occurred. You need to remember to be realistic about any potential challenges in your medical fitness. By being realistic and honest about medical conditions, you can work toward finding a sensible solution with your doctor, including the possibility that you will need to do more work to address any troubling medical conditions before flying under BasicMed. It’s a good idea to have some suggestions ready as to how you might be able to mitigate those concerns when you go to your doctor for your BasicMed physical exam.
While we’ve always advocated a strong partnership to help with medical certification, BasicMed exists to provide another alternative to pilots. Whether you opt to operate under BasicMed, or continue to maintain a medical certificate, your objective should be the same — ensuring that you are healthy, and fit to fly.