Why Can’t You Get an A+ Like Your Brother?

By  |  May 18, 2011 | 

For years, comparisons between the airline industry (checklists = perfection), and health care (chaos = inefficiency) have rolled off the presses.  Kind of makes you feel like the kid brother (or sister) being told by mom, “can’t you try harder,  your brother/sister is always number one in class!”

Then comes this:

[…] As the flight begins its descent, a call comes over the intercom: “Is there a physician on board?” Three internists traveling together to a meeting respond. A woman has lost consciousness. She is incontinent and unresponsive, with a strong pulse and intermittent breathing. The physicians ultimately determine the patient has hypoglycemia and a seizure. It takes multiple requests before the flight attendants provide the physicians with the emergency medical kit. […]

[…] in-flight medical emergencies occur frequently. Yet the kinds of approaches that have improved flight safety have not been extended to providing optimal care for passengers who become acutely ill while on board airplanes. […]

Odd.  Airlines have their act together on the flying thing.  Turns out, they are just as dysfunctional with health care delivery at 30K feet, as we are at sea level.

Hey, I know, not good for the passenger in need, but there is something oddly ironic (and satisfying) about this.  Kind of like that older sibling, for once, getting blamed by mom for leaving stains on the carpet.

UPDATE: New York Times feature on the same subject

About the Author:

Brad Flansbaum
Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education. Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates. Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University. He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.


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  1. Claudia Kim Nichols May 20, 2011 at 1:45 pm - Reply

    Point well taken! As the daughter of a Navy fighter pilot, and co-pilot with him in small planes, I will vouch for the checklist though…. My hat is off to the medical profession for its willingness to scrutinize its practices and be actively involved in continuous improvement.

  2. Rachel Lovins May 22, 2011 at 10:35 pm - Reply

    Someone recently mentioned to me the major differences between doctors and airline pilots illustrating that the same fixes may not work for both. I hated working 36 hours in a row, but it’s true that what a pilot needs to maintain their focus while flying monotonously for many hours is different than what a doc needs to maintain their focus while getting called to emergencies in the msidst of doing an admission. Having residents restrict their hours and not stay overnight with their patients may not be the best thing for the resident or the patients. But I’m all for check lists.

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