I will disagree. I've had a "little peek" too. Notice, I limited my comment to medical issues they don't understand.
That is the thing, the FAA Aeromedical Branch does understand A LOT about aviation medicine. It is not like they have taken a politically connected general surgeon and said, 'Congrats! You are now the FAA Flight Surgeon (or regional Flight Surgeon)'. They have experts in pretty much all medical disciplines that can be turned to for information about a condition.
Sure, if the problem is common and has a clear solution, they're pretty good. I've seen a disqualifying condition requiring an SI where it was handled pretty well, even given the $1,000-$5,000 annual testing expense the treating physicians thought was completely unnecessary. But I am also familiar with the opposite. The "Do these tests. Oh you passed? Now do these tests. Oh, you passed those? Sorry, too bad, so sad" when there is a lack of absolutely clear guidance on a condition as described in the King article happens. The acceptance of the most negative voice on the panel. Aviation articles abound warning pilots not to have certain tests done because of the risk of a false positive that can trigger certificate denial unless (and even if) thousands are spent by the pilot to exclude the problem. I've seen OK City documents stating, no matter what information is presented, "we will never grant him a medical certificate." I've seen pilots granted a third class medical with no special issuance who, next time around, were denied a medical after multiple passed special issuance tests, although there was no change in the pilot's condition.
A few things here.
First, overall, the FAA Medical Certification Branch has actually made it easier to get a medical recently. Take a look at the changes to sleep apnea, those with depression and their ability to take SSRIs, and changing the period of a First Class Medical for those under 40. The FAA has also cleansed some of the AME ranks and you have less, but more experienced AMEs who know what they need to do to get their patients back in the air if an issue arises.
Secondly, I have come to the realization long ago that just because it is published in Flying Magazine it is not in the best interest of aviation safety. Look at this article a few months after the Colgan Accident about long time Flying Magazine advertiser Gulfstream Aviation Academy
http://www.flyingmag.com/safety/training/gulfstream-training-academy-provides-alternative
Gulfstream was getting a lot of bad press at the time as the last three fatal airline accidents by a United States airline were graduates from the program. So Gulfstream had Flying Magazine do a fluff article about them. Did that happen with the Kings, long time Flying Magazine advertisers? Who knows what is really going on with John Kings Medical. Point is, just because I read it in Flying Magazine doesn't make it gospel.
Thirdly, it is the extremely rare exception, not the norm, that additional tests are required by the treating physician to be acceptable for the issuance. 99.99999% of the time the treatment plan as long as it is in reason and result is what the FAA is looking for. With that, it is also extremely rare that the FAA comes back and asks for more information on medical conditions as long as the paperwork is in order. It is more common with substance abuse cases, sure, but for other medical issues it is rare.
Fourthly, the articles that tell folks to not get certain tests because it may show something that the FAA wouldn't like isn't good advice.
I'm not saying I blame them. Denial of medical certification is low-hanging fruit - there is so much "agency expertise" and "discretionary function" tied into medical certification (read the Court of Appeals decidion upholding Hoover's denial) that FAA medical decisions are rarely overturned. And they have PR repercussions. Deny a John King or even a Bob Hoover a medical certificate without a solid reason and no one, except in the tiny aviation community gives a crap (in Hoover's case, the aviation community gave an especially huge crap and the FAA ultimately revisited the issue). OTOH, watch the public outcry if there's an 'FAA OKAYS FLIGHT AFTER PILOT SEIZURE" headline after a serious crash.
I have had the last two FAA Flight Surgeons, tell me to my face and then to a big group that they completely understand that they will never be able to catch every medical condition for every pilot that could cause an issue. They completely get that. The FAA Aeromedical Branch is also NOT one to get emotional with PR and make rash decisions. Look how the aftermath of the Eurowings Murder Suicide was handled and the resulting ARC and the recommendations from that ARC. They have some very level heads.
Once again, I can't emphasize this enough. The FAA Aeromedical Branch wants us all to have a medical to allow us to fly. Their goal isn't to ground people.
