Blondes, pilots and doctors. Who should learn from whom?

Blondes, pilots and doctors – who should learn from whom?

The Malaysian Airlines plane disappearance remains a very sad mystery. Our hearts go out to the missing persons and their families/friends, it must be unbearable agony.

Now we hear in the papers that young blonde girls were entertained in the cockpit in 2011 by one of the pilots of missing plane. http://www.dailymail.co.uk/news/article-2578146/Young-blonde-says-missing-Malaysia-Airlines-pilot-invited-friend-ride-cockpit-entire-flight-2011.html

I am not taking any moral stand here, pilots or anyone are welcome to entertain blonde girls or any other type of women or men anywhere. My problem arises when these pilots put passenger safety at risk by such acts.

I heard this news on the morning of 12 March 2014 on my way to the CHFG conference in Birmingham. I would have normally laughed out loud, then stay angered for a while and then move on. But there was something else bothering in my mind. Then at the conference, as in any healthcare conference these days, I heard a number of people repeating what has now become a cliché that healthcare should learn from pilots and airlines. What was bothering me then surfaced to provoke me into writing this blog.

If you thought for a minute that this cockpit privilege is dished out only in Malaysia or in some other distant country, you are probably mistaken and it may be time to change your mind.

A few weeks ago a colleague who is a senior doctor with additional responsibilities in the UK told me about travelling in the cockpit of a major airline on a scheduled short haul international flight in Europe. It was obviously very thrilling for the colleague but as a safety enthusiast it was disturbing me. As a senior doctor it might have been appropriate to decline the offer on the grounds of ensuring safety; that is another debate. If that colleague lied to show off etc that is a personal probity issue.

Then the colleague said that this privilege was also offered to another family member a couple of months earlier, who took a flight in the same sector for stag or a hen night. This is even more unsettling since it seems such behaviour by pilots are not one off or localised but probably frequent and international. Update: Since this blog was originally published about 48 hours ago, I have had a very senior doctor now retired telling me that he sat in the cockpit while flying over the Alps on the way to Italy. Goes to show that it is not only localised and frequent, it is also chronic poor behaviour by pilots.

I think the constant bu*****t about healthcare learning from pilots has to stop. This blog has argued for healthcare to learn from all sorts of good sources. I have previously written about animal air transport. I have written on the pilot error rates not falling since 1950s and the very large variation seen in the 'ultra-safe' airline industry. I still believe that healthcare needs to learn from everyone including airlines. But it should not be one-way traffic. Perhaps pilots can learn from doctors who will not pick out anyone from a waiting room on the basis of hair colour or allow 'friends' to join them in operating theatres as a thrill of the day.

We should not also make the error of mistakenly attributing the improvements allowed by technology as advances in human behaviours and interactions.

©M HEMADRI 

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Scheduled airlines are safe – just like out patient clinics

http://successinhealthcare.blogspot.co.uk/2012/09/scheduled-airlines-are-safe-just-like.html

Healthcare is not similar to aviation but lessons can be learned http://successinhealthcare.blogspot.co.uk/2012/04/healthcare-not-similar-to-aviation-but.html

Healthcare not similar to aviation but lessons can still be learnt

Healthcare learning from other industries needs a much higher degree of sophistication

When are you in control and when are your patients in control?

When a plane is flying the passengers are not in control. It is the pilot who is in full control. The pilot also has controls on him/her but that control is not exercised by the passengers. Well, when there are 50 to 500 passengers in the cabin it will obviously be a problem to let individual passengers be in control of the flight itself. The passengers do get some control over their pre-made choices such as seats and meals; the passengers also get some control over when they use the toilets and when they can walk about as long as they are prepared to sit down and belt up as soon as they are instructed to do so. It is actually against the law to disregard pilot or cabin crews instructions; you do not have to harm yourself or others as a result, just not following the pilots orders is an offence.

Healthcare has made big noises about learning from aviation. We can argue that there are some similarities and some differences in the way passengers are treated and patients are treated. Just within the context of this short write up, can a chief exec of a small healthcare organisation or a chief clinician of a large unit say ‘we have a large number of patients to treat and hence we cannot accommodate individual patient choices’? Can clinicians tell patients ‘you have a choice over meals but for the rest of your healthcare you will do as you are told when you are in the hospital’? Will it ever become law that if patients’ disregarded their doctor’s instruction in a hospital they will be prosecuted (for potentially adversely affecting other patients care as a result)? Clinicians 'orders' are not orders at all. Of course it is an entirely different debate on whether the patients will get good results even if they followed their doctor's instructions completely.

The similarities between healthcare and aviation or any other industry for that matter are quite limited. This is for the simple basic reason that healthcare is direct and personal to the recipient – as direct and personal as a professional poking fingers and instruments into various orifices with consent in an attempt to make the lay patient better. That directness and ‘personalness’ does not happen in the often quoted ‘ultra-safe’ industries such as nuclear power plants, scheduled airlines, European railways and so on. It is a totally different empathetic human to human interaction where the 'relationship' is the main driver/lever. The synthetic 'have a nice day' with an artificial smile will not work in healthcare. Its a kind of relationship that a pilot or crew might have when the plane has crash landed and they are trying to rescue frightened and traumatised passengers; not something that they would wish to do everyday and that is something that many in healthcare do every day.


That does not mean healthcare cannot be safer than what it is now. It also does not mean that the ultra-safe industries have nothing to share with clinicians; of course we need to learn more from crew resource management methods, etc. It only means that the lessons and methods can only indirectly be applied; the principles have to be adapted and only then adopted. We are really poor in translating the lessons from other industries into healthcare.

I am very passionate about patient safety and quality enhancement. I have learned a lot from other industries including aviation. Healthcare is a risky business. If we attempt a direct application of the principles from other industries, healthcare will continue to remain a risky business. The translation and transfer has to be much more sophisticated than what it is right now. It is possible.


HEMADRI