When trying to find an AME, pilots want to know what other pilots think. They want an easy and no hassle process. Word of mouth and personal referrals are huge in finding an AME. This is just the kind of thing we try and leverage by linking Google Reviews and having our own PIREP system here on Pilot Doctors. However, wanting an easy and no hassle process and wanting someone who doesn’t even evaluate you are two separate things.
A good AME will have a smooth scheduling and check in process. They will have a well coordinated flow for the testing and vital signs (heart rate, blood pressure, etc.). The AME will review your MedXPress with you. They will discuss the answers to your questions on MedXPress and make any changes or comments necessary based on the discussion. The AME will complete a physical exam, guided by your medical history. It should definitely include some basics like listening to your heart and lungs and checking your eyes and ears. Then you should receive your certificate if you are among the 92-97% of pilots who are issued at their exam. If you happen to have a medical issue that is concerning for flight, they should be able to help you navigate the process to obtain your medical with minimal delay.
But have you heard of the Paper Mill AME? As a pilot, when trying to find an AME, you may hear about these kinds of aviation medical examiners, you might think that this is just the kind of doctor that you want. But trust me, it isn’t.
So what is a Paper Mill AME?
A Paper Mill AME doesn’t actually perform the process as they should. Some don’t even perform the required urine testing. They won’t ask you anything about your medical history. They may even change your answers on the MedXPress to prevent your case from having to be deferred. Then they don’t even bother to perform a physical exam. You are in and out in about 10-15 minutes with your certificate.
While this may sound great in theory, after all you are completely healthy, but is everyone that healthy? We have written about many diseases and conditions on our companion site. We know that, particularly as we age, medical issues become more common. And the average age of pilots in America is in the mid 40s . The Part 121 safety record is so good for many reasons. One of the reasons is the regularly required medical certification of pilots, with particularly close intervals for First Class pilots over the age of 40. And as we have stated many times, if you think you are safe to fly, then the FAA likely agrees; it just may take some convincing.
Not only is the Paper Mill AME breaking the law, but they are making our skies unsafe by turning a blind eye to those potential 3-8% of pilots who do need further evaluation. Most of those may still receive their medical, but some probably should not. The FAA medical process is designed to minimize the chances that a pilot is incapacitated and a passenger has to land the plane , as happened recently.
How does this affect you? In 2019 when Dr. Robert W. Kurrle in Miami was arrested and convicted of over two years worth of falsified FAA medicals  virtually all of those pilots that he certified received a letter giving them 60 days to get a new medical completed or their current one would be considered invalid .
If you fly regularly, particularly if you are employed as a pilot, this is now a major life priority for you that you were not expecting. It also may bring up questions at work about how you didn’t notice anything odd about not being examined; questions you may not want to have to answer. Not many employers would be happy to find out that one of their pilots was knowingly flying with an invalid FAA medical certification. For professional pilots that have had numerous FAA medicals, the excuse of not knowing it was bad won’t be easily accepted. Plus you paid good money for that FAA medical exam that turned out to be wasted. All of the sudden, because of that “really cool” AME, you aren’t as happy with just how easy the process was as you previously were.
You never know when your Paper Mill AME will cause you a problem. Is that worth the 15-30 minutes saved? When looking to find an AME, stick with a good AME, not the Paper Mill AME.
 “Average age of active pilots in the U.S. 2020,” Statista. https://www.statista.com/statistics/910024/average-age-pilots-in-the-united-states/ (accessed Jul. 31, 2021).
 “A passenger with no flying experience landed a plane at a Florida airport after the pilot became incapacitated | CNN Travel.” https://www.cnn.com/travel/article/florida-passenger-lands-plane/index.html (accessed May 25, 2022).
 “Investigations | Office of Inspector General | U.S. Department of Transportation.” https://www.oig.dot.gov/library-item/37483 (accessed May 25, 2022).
 “Doctor in Port Orange accused of clearing pilots to fly despite failing medical tests,” WFTV, May 31, 2019. https://www.wftv.com/news/local/doctor-in-port-orange-accused-of-clearing-pilots-to-fly-despite-failing-medical-tests/954112368/ (accessed May 25, 2022).
Also, see What do CACIs have to do with FAA Flight Physicals?