A man could go for a routine physical one fine day, feeling like a million dollars, and be grounded for fallen arches. It happened!—just like that! (And try raising them.) Or for breaking his wrist and losing only part of its mobility. Or for a minor deterioration of eyesight, or for any of hundreds of reasons that would make no difference to a man in an ordinary occupation. As a result all fighter jocks began looking upon doctors as their natural enemies. Going to see a flight surgeon was a no-gain proposition.If the provider doesn't know you're a pilot -- or even your real name -- they can't report you.
In general, this principle works for lots of things. Drug use at your office job? No problem so long as I can’t tell you’re on drugs. And so on and so forth.
The alternative isn’t some clean job. It’s where people who are incredibly stupid and scatterbrained have a “reasonable accommodation” and then you’re on a plane run by a fucking moron so that when the other competent pilot falls ill the moron will have to fly it by himself and then you all die.
You thought you had 2x redundancy? Well one of the machines was always failing. No thanks. Let’s keep doing what we’re doing.