Dr Claude Preitner: CAA role combines a love of medicine and aviation

Member news
16 April 2018

With a GP father and a psychiatrist great grandfather, it’s not surprising that Civil Aviation Authority (CAA) Senior Medical Officer, Dr Claude Preitner, became a medical practitioner.

However, Claude, a Fellow of the College, first earned a degree in mechanical engineering in his native Switzerland. A couple of years after starting work, a bit of soul searching saw him begin his medical training. He still finds it difficult to explain the change of direction, but he had been interested in medicine since his teenage years. “It’s a question my wife has asked me many times and she’s still not satisfied with my answer,” he laughs.

Dr Claude Preitner

Although it was difficult being six years behind his peers, particularly in earnings, he says it meant he was more mature when he began working as a doctor at the age of 32.

He had always been very interested in flying and earned his pilot’s licence, for which he only needed to be 17, before getting his driver’s licence, for which he needed to be 18. He obtained his commercial pilot licence and became a flight instructor which, apart from being “great fun” allowed him to earn some money while studying medicine.

Fortunately, for the medical profession, making a career out of flying wasn’t an option.

“I could never have afforded the ongoing training needed to work for a big airline, and other flying work was poorly paid and involved lots of time away from home. Medicine was slightly better in that regard and also a passion by then.”

After a few years working in hospitals in Switzerland, Claude was looking to travel. Fate intervened when he met Leigh, a Kiwi nurse, working in the same hospital. The couple travelled together to New Zealand, where Claude worked in hospitals and completed a post-graduate diploma in obstetrics and gynaecology.

After three years here, with one child and without the easy communication we have today, Claude felt the need to return to Switzerland, where their second child was born. The family – who still speak French at home – eventually returned to New Zealand for good in 1986.

Claude joined a GP practice in Rotorua, where his in-laws lived at the time. He established his own practice a year later and two children became three.

Despite being a busy GP and GP-obstetrician, working part-time at the hospital as a medical officer on special scale and gaining diplomas in aviation medicine and occupational medicine, he still found time to fly privately, including the occasional commercial tourist flight.

The family stayed in Rotorua for 15 years until Claude took up his CAA role in Wellington in 2001.

Apart from the opportunity to combine medicine and aviation, the academic nature of the position appealed to him. “It’s an interesting part of medicine because you need to have a very good understanding of a pilot’s working environment, so being a pilot is a great advantage for me.”

Obligations on medical practitioners to advise the CAA

He says New Zealand’s Civil Aviation Act, which obliges medical practitioners to advise the CAA if they have any concerns that their pilot or air traffic controller patient’s medical condition may interfere with aviation safety, is one of the strongest legislations in the world – and provides medical practitioners with complete protection for disclosure.

“The Act overrides the Privacy Act and the threshold for reporting is very low. A GP only has to suspect that a pilot or air traffic controller’s condition may interfere with aviation safety. Basically, if they have a question in their mind, that’s generally enough.

“Apart from the effect of medications, recreational drug and alcohol use are of concern to us. Even occasional use of recreational drugs is unacceptable. Similarly, if a GP feels their pilot patient is drinking excessively, we want to know. We consider drinking above the Health Promotion Agency’s safe limit to be a yellow flag.”

There are around 9,000 active pilots and air traffic controllers in New Zealand with a current medical certificate and 45 designated medical examiners who are able to issue the certificates on behalf of the Director of the CAA.

A big part of the work of Claude and his team is issuing accredited medical conclusions (AMCs). A favourable AMC allows flexibility to be applied where a pilot has a condition considered to be of aeromedical significance (for example, one which may compromise flight safety). The AMC will specify restrictions that may apply, such as the pilot being cleared to fly only if there are two pilots in the cockpit.

“It’s a robust system. Everything is peer reviewed and co-signed,” says Claude. “Sometimes, the process we undertake to reach the conclusion will include obtaining a copy of the GP notes. These can be useful in giving us a better feel for the issues under consideration. Occasionally they reveal an important condition that has not been disclosed.”

Pilots and air traffic controllers must also notify the CAA when there is a change in their medical condition. “Some pilots will ground themselves, as they are required to do, but they are still obliged to tell the CAA. We have the occasional one who doesn’t. Sometimes it’s a genuine oversight, sometimes it is not.

“Of course, they may have an optimistic view on their fitness to fly. That’s why we need GPs to report to us. Unless we are told, we may not know.

“I remember one case where the GP was extremely reluctant to report the pilot because they were concerned about breaching privacy. They must do so. As far as I know, there’s never been any negative consequences on a reporting GP.”

Claude says the benefits of our legislation are evident. “In 2015, when a German pilot committed murder-suicide by deliberately crashing the plane he was piloting, killing all 150 people on board, neither the aviation authority nor the airline knew he was mentally unwell, even though several doctors did, but didn’t report it.”

GPs are welcome to phone the CAA – anonymously, if they wish – to discuss any concerns they may have about a pilot or air traffic controller patient. “From there, the next step for the GP will be clearer. In some cases, we can say it’s not a concern and it doesn’t need to be taken any further.”

Dr Claude Preitner

Now aged 71, Claude part owns a “gorgeous-to-fly” 44-year-old four-seater aircraft, which he takes up when he has the time. But he’s not tempted to fly himself to and from his home in Nelson to Wellington, where he’s based from Tuesday to Thursday.

“The Cook Straight weather can be a bit capricious and the parking fees are considerable. I also don’t want to fly when I’m fatigued after a hard day’s work.”

Of course, when he flies for work or pleasure, he often recognises a pilot’s name. “I may know a lot about their health, even though I’ve never met them. I do feel safe flying with them.”

The CAA has a 20-minute slot in the plenary session at the Rotorua GP SME in June.

Resources

The right of confidentiality is bound by the Privacy Act but, as doctors, you can disclose patient information in certain circumstances. One such area is aviation safety. Dr Dougal Watson, Principal Medical Officer at the Central Medical Unit of the Civil Aviation Authority, explains your obligations (Medical Protection Society, 2012).

CAA Medical Information Sheet: Medical Practitioner obligations (MIS002).

CAA Medical Information Sheet: You must advise the CAA (MIS004).

To contact the CAA Medical Help Desk, phone +64 4 560 9466 or email med@caa.govt.nz.