Digital-health

The world of civil aviation and the strong focus on “safety” have inspired the clinical risk models that today are used in hospitals. However, leaving aside some very important aspects.

Checklists, incident reporting, teamwork methodologies are just some of the tools that health care has borrowed from aviation, where risk management policies have been adopted since the early 70s.

However, there are some aspects, strictly related to safety, that have not been taken into account and remain peculiar to the aviation world. Let’s see which, making a parallel between myself, a pilot for passion, and a surgeon.

To fly or to work as a surgeon you need specific training and exams that qualify you to practice a hobby (in my case, but even more so for commercial pilots) or a profession.

To be able to fly an airplane you have to be “current”, a concept not foreseen in the profession of surgeon, with the exception of the achievement of the ECM training credits provided by the regulations, about the limits of which we could talk at length.

As a non-professional pilot, after the age of 40, I have to pass a medical examination and some instrumental examinations every year (six months for professional pilots); surgeons are subject to periodic health surveillance which the competent doctor defines according to the levels and types of risk.

In order to fly and obtain the renewal of the flight license (revalidation) I must perform, every two years, a minimum number of hours as PIC and pass a check with an instructor. If I do not meet both requirements I will stop flying unless I perform and pass a new training activity. None of this exists for surgeons; when you become one it is forever.

We could then talk about aircraft type ratings, for certain types of flights and more but I will stop here not to bore you.

Some may think that the parallel is inappropriate or exaggerated to compare a pilot with a surgeon. But if health care has felt the need to study and adopt aviation safety methodologies, it means that in terms of complexity and risk the two worlds are not so far apart.

In the United States alone, for example, it is estimated that between 48 and 96,000 patients die each year due to medical errors; it is as if, every day, a Jumbo Jet (747) falls in the USA.

My mistake, while piloting, could put at risk the safety of my eventual passengers (2-3) or of people or things on the ground. Even a surgeon can put at risk the safety of his patients, but there is no minimum activity or checks to certify his expertise and competence.

Wouldn’t it be appropriate, for health care, to adopt these aviation safety policies as well?