MilesBuzz! - Compensation for assistance with medical emergency

I travelled recently in paid F on Hawaiian (HNL-SAN) with a medical doctor friend. An hour into the flight an FA requested help from any medical person for a sick passenger(in Y). Both my friend and an RN responded to a passenger that it turned out was very ill. They spent over 2 hours kneeling beside this person to treat her and monitor her condition. Then the FA insisted that he fill out the incident report with the medical details which took another half hour. While this was going on, he missed the F meal service (and any sense of a relaxing First Class flight). The pilot told him that had it not been for their help, they would have had to return to HNL, dumping fuel prior to landing (costing HA a lot of money). My friend eventually was served a hurried, warmed-over meal and melted ice cream. About 30 minutes prior to landing, I was asked to move back to the sick passenger's coach seat to allow my friend to help her out of the plane so the waiting paramedics could tend to her immediately upon arrival. On arrival, there were no paramedics, no airline personnel, no help from the wheelchair guys (who said they had to wait for all the passengers to disembark), and my friend ended up pushing this woman all the way to baggage claim to meet her waiting husband.

My doctor friend is a really nice guy who is always ready to help others and expected nothing from the sick passenger who, by the way, could not have been more appreciative for my friend's and the RN's help. On the other hand, the airline, having received the incident report, sent my friend a 2 line form letter thank you. I felt he deserved more form HA. I suggested my friend write a very nice letter to HA explaining exactly how less than enjoyable his paid first class flight turned out to be on behalf of the airline (he added my downgrade incident) hoping the airline might stick some bonus miles in each of our accounts, (and believe me, he deserved them a lot more than I). He received a less than friendly "no" letter in response. I have seen FT members receive bonus miles for a lot less than this. Has this happened to any of you medical people out there? Have you ever received any type of compensation?Please share so we know if this request for miles is out of line or if HA is just being stingy.

It seems extraordinary to me that an airline can take for granted a doctor caring for an ill patient on board. Unfortunately, your experience seems rather common. There was a recent thread (http://www.flyertalk.com/forum/Forum50/HTML/021463.html) in the United forum with some very active conversation on this topic.

I am a physician who has helped out a number of times during midair medical emergencies on Delta and have never gotten anything other than a thank you from the FA. A number of years ago a coach passenger had a full cardiacc arrest and he was successfully resuscitated. Another time two passengers suffered heart attacks on the same flight.I never received anything other than a thank you from the FA. Although people go into medicine due to the desire to help people, with the current medical malpractice crisis, airlines should be grateful that we are helping them out. The good samaritan law does not always prevent lawsuits from being filed.I have never had this happen but know physicians where it did.

It is utterly indecent of the airline not to give compensation to the doctor who saved them both money and a lot of nuissance.

Whereas it is a moral duty to help fellow humans at peril, and even prescribed as obligation in many legal systems, and moreover one is to expect a doctor to act so first and foremost -- it is still absolutely appalling that the airline is not compensating the doctor with -- at the very least -- one hundredth of the price of: 1. hiring medical personnel; 2. dropping fuel and flying back; 3. paying penalty to passengers for rerouting and hotels for those who cannot make connections in the day.

As a matter of principle, I think the doctor should bill them at his or her hourly rate, prorated by a quotient of -- say 6 -- for extenuating circumstances, and demand payment of interest for not paying right away at the highest bank loan rate in the state where the incident occurred.

[This message has been edited by Master (edited Nov 29, 2003).]

This just further proves my point from numerous threads. The major Airlines CREATED the atmoshere that they currently operate in. When you view the customer as the enemy you shouldn't be surprised when they take a hostile attitude and demand compensation. They don't even refer to us as customers thay call us PAX. NUFF Said!

I'd also suggest your friend send them a bill based on his standard rates X the numbber of hours this patient required attention. Since it was at the Airlines discretion and request he treat the patient, they effectively hired him on the spot to do so.

Send it certified along with a photocopy of the incident report.

Regards,
-Bouncer-

Something to note: If he does bill someone, any possibility of using the Good Samaritan defense if there was an adverse outcome evaporates in virtually all jurisdictions. (In some jurisdictions, physicians are not allowed to use the Good Samaritan defense as I understand, but in others, they can so long as they don't bill for the services, and they meet the general standard of care for someone of their training (as opposed to the standard of care for a specialist in that problem)
I'm not a lawyer, so before billing anyone, I would strongly checking with one!

Threaten to bill!
And call, don't write.

In this situation, if I were the doctor, I would send them a bill. My bill would consist of the following:

- 2.5 hours of work x the standard hourly rate for a HOUSE CALL (not an office visit) (it was only 2.5 hours, right? If not, bill for whatever the actual time was)

- This total would be multiplied by a factor of 10 for emergency treatment under adverse conditions and extinuating circumstances.

- The total cost of the F ticket paid out of pocket, as the flight experience paid for in F was not enjoyed/used

- A partial cost of your F ticket, as you were required to sit in Y for at least part of the flight

- A statement telling them that they are subject to a 1.5% interest charge on the outstanding balance of the bill for each month that their bill goes unpaid

Such an amount would seem reasonable to me, considering the cost to the airline if they had to turn around. If I saw any less than this from the airline, I would refuse to treat patients in the future while flying, no matter how serious the problem. This man deserves full compensation for services rendered, and is getting the short end of the stick if he receives any less.

Playing devil's advocate here, wouldn't it be more appropriate to bill the patient, if anyone is going to get billed? Do you think the airline is relying on that rather than offering some compensation of their own(miles, travel voucher)?

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by clrankin:
If I saw any less than this from the airline, I would refuse to treat patients in the future while flying, no matter how serious the problem. </font>

Somehow I suspect medical ethics would preclude that, wouldn't you think?

Over the past 10 years, I have helped several times. I can remember it happening on US, NW, and DL.

None of the airlines want to pay even if you help them save thousands. A vindictive person would refuse to help and let the airline burn up fuel and money.

I do not bill the patient because I can only offer good samaritan type services. I don't have the proper equipment. Billing the patient may result in him/her expecting care that can be given in a hospital or office and sue as a result. Furthermore, I would guess that the patient would run away without paying based on such behavior by patients who are visiting from out of town. (sad commentary about people).

The MD passenger on HA might write again to the airline asking for compensation not for medical services, but for assistance in preventing a diversion, which also resulted in his losing his first class perks. To avoid having the airline reply with legalese claiming that they are ungrateful and that the passenger voluntarily gave up his meal and helped, the complaint letter should be short and even ask them not to be hardnosed.

Golly! It seems to me that the starting point for the airline would be to offer at least something worth $1,000 or at least three times that in flight upgrades or certificates.

The link above to the United forum is really scary. I can't believe so many posters are so hostile to the doctor.

I have rendered assistance about a half-dozen times, but most of the time it was minor and did not take a lot of my time. The one time the assistance was for a relatively serious condition and took up about 1.5 of a 2 hour flight (on CO), I was upgraded to first class for the continuation of the flight. I was fine with that.

On the whole, I would not hesitate to render assistance not give a thought to any compensation, even if I was not able to enjoy my biz or first class seat. However, the point above is well made -- airlines will compensate passengers who complain about inconvenience much less serious than a medical emergency. You would think for the airline it would be a no-brainer.




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Da DOK

Along with many others, I don't think the doc was out of line. Essentially, he gave up a lot of time and comfort, used his very valuable expertise and saved the airline quite a bit of money. In return, the airline and its employees couldn't even do the simple task of arranging for the plane to be met by paramedics. And when he asks for a little something for his time, they get huffy.

Think about how much time and effort many of us spend trying to get an upgrade. Add to that the whining posted here when someone doesn't get upgraded (and there is usually much support and commiseration when this does occur). If something on same order as the above happened over a denied upgrade, the wailing here would sound like banshees.

I have only had one real experience with a significantly ill passenger. I was in FC on Cathay flying SFO-HKG and the man across the aisle started suffering chest pains. This occurred about 40 minutes after takeoff and the FA put out a call for assistance. An internist and an ER doc responded. In this case, the docs don't have much to work with; just a stethoscope, a blood pressure cuff and some oxygen. Eventually, they did get some nitroglycerin from another passenger. The man appeared to be feeling better, but it was decided to divert the flight to Anchorage anyway. The docs couldn't be sure that the man would remain stable for the ~12 hours left in the flight.

What was Cathay’s response? Along with the profuse thanks of seemingly every Cathay employee on the plane, they moved both docs and their spouses to FC for the remainder of their flight and gave them bottles of champagne to take with them. They also told the docs that they and their spouses would be upgraded on their return flights. Now, that was a nice gesture from an airline!

I can’t believe how stupid Hawaiian was. Remember that the guy was in PAID FC! He’s a very profitable fellow. What do you think the chances are of him flying them again? A truly dumb decision on the airline’s part.

Side note:
It took quite a while to set up the diversion to Anchorage on our SFO-HKG. The pilot came out later and explained that he had had to wait for the fuel tankers down below to line up so he didn’t drop any fuel on them. He also related that one the ships’ staff had remarked that it looked like it was raining jet fuel.

If a doctor rendered medical services to me on a plane, in his office, in the street or wherever, I would fully expect to pay for that service.

If I owned a business (perhaps an airline) and requested help for a customer, I would expect to compensate those that helped. Just as they do when you give up your seat when overbooked.

Paying the doctor is a little tricky with insurance issues, etc, but if real life saving service was given, then shame on the patient that did not pay without a bill!!!

The airlines should change what appears to be a poorly thought out policy. Compensation is always tricky, but at least 1) hold harmless letter, 2) full refund of carriage (miles, dollars, upgrades or whatever) and a domestic free ticket in comparable class of service.

IMHO

I've helped out on quite a few occasions,and never got (nor expected) any compensation other than a bottle of bubbly once and an upgrade for the rest of the flight (to premier exec), until recently when on UA, in C. Spent about 1 hour with someone not very well on an ORD - LHR flight. Crew were great, patient was ok, and purser filled in a customer service card for me. I received a thank you letter and $200 travel voucher from UA. Last week, when sat in Y onLHR - IAD another call for a doctor, again patient was ok, and crew very helpful but no customer service paperwork, only the incident report, so not expecting anything. I couldn't sit and not respond if they really needed help.

Louise

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by Weez:
I couldn't sit and not respond if they really needed help.
</font>

From a passengers point of view, I really appreciate that. If and when the time comes that I ever need assistance, I'm glad to know there's medical professionals that are ready to help out, particularly if we're thousands of miles from land.



[This message has been edited by tom911 (edited Nov 30, 2003).]

I am not sure about whether there should or should not be any compensation for doctors in this situation. I don't think that I have heard about too many incidents of paramedics, nurses and doctors stopping at an accident and being delayed from important incidents. Even regular people stopping at accidents or when someone is stuck getting compensation.

I think that the comment thread that really bothers me is the comment that people here on the board have complained and been given compensation for other things that have been really minor. Maybe I should look for a way to get some thing next time it snows here in Omaha and I decide to stop and help someone get unstuck. Then again, I guess that is why it seems that people don't help others as often and cry about anything that makes their life anything less than perfect.

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Robert

I am a physician, and I have helped out on several occasions, however the only thanks I have ever recieved is from the FA's.

However a friend of mine flying on Virgin was upgraded mid-flight for his assistance. So there are some airlines that do appreciate your help.

Just a word of caution to all other physicians, after discussing this with my insurance company, it is always wortj firstly checking this in your policy, and secondly making sure that the ailine will also cover you, as several now have written policy on these issues.

Just as a parting note, despite all the intricacies that this issue entails I will always continue to help out in the air, and provide any assistance that I can http://www.flyertalk.com/forum/biggrin.gif.

I think that policies may have changed. My dad is an MD and has helped several times. He used to get ( maybe 15 years ago) a thank you letter and a voucher for 1 domestic ticket. The last time he helped was someone severely ill ( had to be resusicitated, he went with her to ambulance etc) and all he got was a " thanks". I think that was 5 years ago. Like the other medical posters, he would never hesitate to help. The compensation is never the motivation but it would be nice to get an upgrade or a few 1000 miles in the FF account. Sometimes the arrogance of airlines amazes me. If I asked a customer of mine for that level of help you can be sure that I would at least buy him dinner!
Every time I have seen a medical problem on a plane there has been a nurse or a doc willing to help . I am sure that they were not "looking for a freebie" when they gave up their time, risked lawsuits and worked with very limited equipment. It would be nice if something was done for them. Maybe the next time we see it happen we should write the airline and encourage them to do something nice for the doctor ( or nurse or paramedic) who helped. Maybe a few letters from frequent flyers would shame them !

I would contact the news media in whatever city this airline is most based out of. I'm sure you could get someone to copy their letter to you in the newspaper which would serve them right. You could also stress in the article how they had no provisions upon the landing of the aircraft. You might even be able to file a compalint with the US Department Of Transportation for their failure to meet the plane etc.

Regarding the discussion about the applicability of Good Samaritan laws, persons rendering aid for a medical emergency on an airplane might want to familiarize themselves with the Aviation Medical Assistance Act of 1998 (P.L.105-170).
http://thomas.loc.gov/cgi-bin/bdquery/z?d105:HR02843:|TOM:/bss/d105query.html|

This article may also provide some insight.
http://www.drakegroup.com/products/journal.htm

As well as this article:
http://www.aafp.org/afp/990901ap/801.html
These airline emergency kits are required on all US planes and I would assume that is what the physician on the HA was finally able to obtain.

[This message has been edited by jerry a. laska (edited Dec 01, 2003).]

The ironic thing here is that the two industries we are talking about - air travel and health care - are the first two that come to mind when I think of industries that set up the customer as the enemy. (Anyone who has ever dealt with an insurance company and all of their paper-intensive, inefficient processes knows what I mean.)

The sad thing is that the vast majority of people on the front line - the docs, nurses, and (in the case of the airlines) FAs and pilots - are good people that want to do right by their customer.

The right, human thing to do in this case would be for HA to send the doctor a voucher or two for future flights. The doctor isn't going to send HA a bill - probably more because he's a good person who wanted to do the right thing than because it could violate some insurance law.

It's just another case of how out of touch the airlines are with common human decency.

I think this would make for a great Dateline, Primetime Live, or 60 Minutes piece. You should contact the airlines and tell them there are a lot more people out there who have made the same sacrifice for nothing in return.

If anyone is to be billed, it is the PATIENT. The patient received treatment, not the airline.

If I have a heart attack at a grocery store and store employees call the paramedics for me, can I skip out on the bill and tell the EMT to either shove it or bill the grocery store? That's absurd, yet that's what everyone demands on an airplane.

If you don't want to deal with billing an out of town patient who was treated on an airplane rather than a hospital or office, that's your decision.

But don't try to stick the airline with the bill. They should not be the dumping ground for their passenger's financial problems.

Not having to turn around and waste a lot of fuel is completely irrelevant. Thousands of flights every day are completed without dumping fuel. "Not waste" and "save" are two different things.

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"It's as easy as 1, 2, C" -- Kelly, Married With Children

I'm not a doc, just an ordinary road warrior and the it's kind of mind boggling that, based on comments from the docs on the thread, that it appears that airlines generally do their best to ignore the aid medical professionals are called on to offer during flights. Letters of thanks, extra miles, upgrade certificates, a bump up in elite status, are the "no out of pocket cost" things they could, and should do, to thank people who have saved them money and possibly saved lives. I don't get the concept that providing some recognition results in additional legal liability to the airline. It would seem that the incident report, the original poster referred to, created whatever paper trail would (if it came to it) lead to legal liability.

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by tom911:
Somehow I suspect medical ethics would preclude that, wouldn't you think?</font>

At the risk of sounding like a jerk, just why should doctors, nurses, or anyone perform medical acts aboard a plane and risk a lawsuit if there is nothing to be gained?

If I am flying somewhere and my company expects me to work on the plane (software development), then I am compensated for it.

If a lawyer reviews a client's case while flying cross-country, you can bet that's considered billable time.

Why should a doctor or nurse performing his/her job aboard a plane receive any less consideration? And why should anyone expect them to be so willing to work the next time around if they've gotten shafted the first time by not being compensated?

I think the issue is not compensation for the medical professional who helps out on a flight, but recognition by the airline for that professional doing something he or she does not have to. Being thanked by the flight crew is, as what I perceive is the general opinion in this thread, not enough of an official and documented recognition or is insubstantial recognition by the airline.

Compensation is another issue. I don't know if a doctor driving by an accident scene who voluntarily stops to help out would bill the victims or not. If that is customary, but somehow I doubt it, then so would billing for helping out on a flight.

Thank you all for taking the time to share your opinions. There are some great suggestions which I have been passing on to Dr. Nice Guy. I am glad I am not the only one that feels that medical professionals deserve more than a brief "thank you". I don't believe there are very many doctors who feel they need to bill someone for voluntarily helping in an emergency, and I don't think any doctors help a passenger only to get an airline perk. It is more of an airline public relations issue. After all, if the airline (through the flight attendants) asked for help from medical professionals who in turn assist one of the airline's passengers, why wouldn't the airline want to show some meaningful appreciation to that person? If a passenger is bumped from a flight or an elite status member runs into a nightmare situation, the airlines often (or at least sometimes)apologize to that passenger by offering them bonus miles or upgrade certs, etc. I just can't imagine why an airline wouldn't do more to thank a doctor who saved someone's life.

By the way, the doctor I wrote about helped a very ill passenger on an SQ flight mid-pacific and the FAs gave him a very expensive silk tie from the Duty Free cart and fussed all over him (he was in J anyway) for the rest of the flight. He was perfectly fine with that. Strangely, no letter or acknowledgment arrived from the airline itself.

I think this is a no-brainer. The airline should refund the purchase price of this doctor's ticket AND provide a voucher good for a future free roundtrip in the same class of service. Anything less is plain disgusting.

I just talked to a friend who is a F/A on British Airways.

He says that there are medical emergencies on most every flight he's on. (He flies London-Tokyo). They no longer ask for Doctors on board, because they subscribe to a service that puts them in voice contact with Medical personnel on the ground. For this they pay plenty of bucks, I bet.

It seems that the airline above, Hawaiian, and many others, are avoiding this cost by relying on the "Doctors on Board" volunteer program.

Hardly seems right. The airlines should be grateful and generous when professionals come to the service of passengers. In turn, perhaps the airline should bill the sick passenger. Unless, of course, that passenger was made sick by the antics of said airline http://www.flyertalk.com/forum/wink.gif

Hawaiian is an airline in total chaos, it seems...and it might require a reminder or two to prod them into action. One possible approach is to write a snail-mail letter to Keoni Wagner, Hawaiian's PR director, and cc it to Josh Gotbaum, the current bankruptcy trustee...

For me, and I think for most docs, compensation is not an issue because we live in a very litigious society. On a plane, there is rarely sufficient or correct medications, equipment, etc to properly care for a person as I would in my office or in an ER. (I cannot imagine how to manage a person with a heart attack with what is available on board.) If an untoward result should occur, and I were paid for my services, I would be liable for malpractice. However, if I volunteer my services with the equipment available, I believe that would fall under the Good Samaritan laws.

Therefore, monetary compensation is out of the question. "Like-kind" compensation (free ticket, etc) of significant value may be troublesome too. A token thank you (free drinks, etc) are probably OK. HOWEVER, in the original case cited above, the doc paid for a FC seat that he effectively did not get to use. At the very least, the airline should have refunded the cost of FC or given him a FC voucher for a future trip. That would not be compensation, but reimbursement for a service (FC) that he did not get.

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Da DOK

A good friend of mine went on vacation for a couple of weeks just after finishing her last rotation in medical school but before officially graduating. As luck would have it, on the return trip (ZRH-IAD on Swiss, I think) there was a minor emergency on board and she was the only passenger with medical training. The flight attendants were nice enough to offer her a bottle of wine from the first class cabin, which became her first compensation of any sort for providing medical services!

Take the word air out of airship, and I assure you that you pay for medical services rendered

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by ranles:
Take the word air out of airship, and I assure you that you pay for medical services rendered</font>

But then the plane would crash and everyone would die --- moot point! http://www.flyertalk.com/forum/smile.gif

As an EMT I've helped passengers on more than one occasion and have never even gotten as much as a thank you from the airlines. Problem is that since I am a certified EMT I have a duty to act and can be held liable to some extent if I fail to render assistance. Then again, I didn't get into the business to get rich. http://www.flyertalk.com/forum/smile.gif

I too am a medical doctor (internist), and I would not feel right accepting any compensation for this. I happened to be on a transatlantic flight in an upgraded Business Class seat when a medical emergency developed in First Class. The person became very short of breath and had to use the portable oxygen for the rest of the flight. The time spent with him was a challenge trying to figure out what was wrong with him and using the equipment available to assess and treat him. I also spent the entire flight worried about whether he would get progressively worse. So of course, I was not able to enjoy the flight at all.

The FA were very nice and offered me a bottle of champagne which I declined.

Turns out the man was an ex Secretary of State! (I found out after I got off the plane.)

Although I expected no compensation (and would not have accepted), I did find it bothersome that the airline did not send me a letter thanking me for my services.

I work every day in a hospital which only treats their patients, but I am told that no matter who you are or what your coverage is, if you have an emergency they will treat you. My understanding is they would bill the patient or the person's HMO in that case for emergency services, but medical ethics precludes such considerations before treating the patient.

I think a letter to the airline stating that you provided these services and hence were unable to enjoy the flight would hopefully have them offer you a free first class R/T certificate so you can enjoy the experience you initially paid for.

Good luck and thanks for helping the patient in distress.

I was on a flight from NRT-DFW a few month ago and apparently there was a medical issue on board. They moved a doctor and his son to empty seat in first class for the rest of the flight. I am not sure whether the patient was originally in first also but the patient and a travelling companion were also in first when I woke up. The only way I noticed was the seats in front of me were empty when I went to sleep and full when I woke. I made a comment and my seat mate told me about the medical incident.

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dallasflyer, Let's put the fun back in FlyerTalk!

I have had two experiences in recent years with family member physician being involved in providing medical assistance on international flts. In both cases the airlines (American and BA) did thank us. American gave all affected passengers 10,000- 15,000 miles (flt delay on a transcon). They upgraded the rest of our trip from J to F. They also gave the physician member another 15,000 extra miles.

IN one case there was another physician in coach. He was very eager to help. We were already in Business or First (I can't recall). After he completed his help, the FAs upgraded him from coach to Business - and he seemed to be very pleased by it.

I guess the problem here was that the physician was already in First. Sometimes it is not arrogance but ignorance that makes service desks forget these favors. I think it is OK to politely let them know that you did give up your travel comforts to take care of the patient - and as it was not a compensated service airline appreciation in the form of miles, upgrades, etc would be in order.

If an untoward result should occur, and I were paid for my services, I would be liable for malpractice. However, if I volunteer my services with the equipment available, I believe that would fall under the Good Samaritan laws.


OK, before billing wait to see if the pax lives.

Good samaritian laws are really weird, I wouldn't be so sure that you would fall under any such thing.

A few thoughts:

1) On an international flight, the rules of the high seas and the Geneva convention apply. They make liable for NOT helping someone in danger to the best of your ability in general, but I'm not sure of the specifics. I have no idea who the responsible party would be - patient, airline, or both. Keep in mind that many US based insurances will not cover a physician internationally, but probably would on a U.S. Flagged carrier.

2) On domestic flights, the federal laws would apply. I have no idea what the federal good sammaritian law is -- or if one even exists. State laws can vary widely!! In some states, the good samaritian laws are basically useless, in other's unless you cause additional intentional harm your immune.

One final note, my mother (Family Practice / General Practice in the UK) was flying back from BKK on NWA 1st class, and wound up spending 3 hours taking care of a patient who went into shock and had to be intubated until they could land.

She was actually insulted by the fact that rather than a thank you letter or card, they gave her 500 FF miles and called it even. If they are not going to pay her, so be it, but don't insult someone by giving them $5.00 worth of FF miles when they have performed $2,000 worth of services (or more).

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by squid:
(Quoting DaDOKin DC) If an untoward result should occur, and I were paid for my services, I would be liable for malpractice. However, if I volunteer my services with the equipment available, I believe that would fall under the Good Samaritan laws.

squid: OK, before billing wait to see if the pax lives.</font>

I am not sure if your post was supposed to be light-hearted or snide.

But my point was NOT to bill the pax, irrespective of outcome. Under those circumstances, it is ethically questionable (at least) to bill for emergency care in that setting. Additionally, though, once a doc bills for services (as some had previously suggested) he/she is liable for the pax's outcome. The chances are that a bad outcome would be due to lack of adequate equipment on the plane, not malpractice on the part of the doc -- not that it would matter in a lawsuit. My point was that billing the pax was not only of questionable ethics, but also places the doc at a legal risk through no fault of his/her own.

I advocated not billing for ethical reasons, but one cannot overlook the legal ramifications these days, either.

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by clublounger:
I just talked to a friend who is a F/A on British Airways.

He says that there are medical emergencies on most every flight he's on. (He flies London-Tokyo). They no longer ask for Doctors on board, because they subscribe to a service that puts them in voice contact with Medical personnel on the ground. For this they pay plenty of bucks, I bet.

It seems that the airline above, Hawaiian, and many others, are avoiding this cost by relying on the "Doctors on Board" volunteer program.

Hardly seems right. The airlines should be grateful and generous when professionals come to the service of passengers. In turn, perhaps the airline should bill the sick passenger. Unless, of course, that passenger was made sick by the antics of said airline http://www.flyertalk.com/forum/wink.gif</font>

True, there are multiple such services available worldwide, some have their own in-house medical depts that support this instead of a 3rd party contractor. However, there are instances when an uplink just isn't enough, you need hands on. IE: Pt with pneumothorax on a BA flight from SE Asia to LHR a few years ago.

Unexpected events happen from time to time, but people with underlying medical problems really should consult with a physician trained in travel & tropical medicine, and who is up to date on the current scene. Pre-travel medical advice is much more than just getting "shots".

Some recommended links for travel health information, insurance, and provider clinics:

www.iamat.org (http://www.iamat.org)
www.internationalsos.com (http://www.internationalsos.com)
www.istm.org (http://www.istm.org)

Feel free to email me if anyone has further specific questions or needs recommendations.

Other than being an ISTM member, the above references are based the quality of services they provide.

seems to me that if some airlines made it a priority to reward doctors who help out. and if they advertised themselves as "doctor friendly" then this might increase revenue. i know that i would feel safer flying on an airplane where i knew that there's a good chance that there will be a doctor available to help me if needed.

<font face="Verdana, Arial, Helvetica, sans-serif" size="2"> Unexpected events happen from time to time, but people with underlying medical problems really should consult with a physician trained in travel & tropical medicine, and who is up to date on the current scene. Pre-travel medical advice is much more than just getting "shots".
</font>

While it is true one should check with a travel-savvy physician for travel to other countries, esp non-industrialized or tropical countries, that is a separate issue from what has been discussed.

I would wager that most in-air emergencies are a result of flare-ups of chronic medical problems [heart disease and heart attack. emphysema and pneumothorax (=collapsed lung)] or acute non-tropical disease (food poisoning). Sure, I guess you could see someone with symptoms or SARS or malaria on a plane, but the management of any of these conditions -- while on a plane -- is very basic medicine. A doc is pretty limited in what he/she can do for any problem that arises in-flight.

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Da DOK

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by asquare:
...(In some jurisdictions, physicians are not allowed to use the Good Samaritan defense as I understand, but in others, they can so long as they don't bill for the services, and they meet the general standard of care for someone of their training (as opposed to the standard of care for a specialist in that problem)</font>

In Washington State the Good Samaritan defense kicks in after you've helped beyond your trained ability. For example, If I'm trained in CPR and I kill somebody improperly applying my training I'm liable. The training has to be current for this to hold true.

I don't know if Hawai'i has a similar interpretation. My guess is Hawai'i would be the jurisdiction here since they hadn't hit the midpoint over water.

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by RunawayNFly:
I am a physician who has helped out a number of times during midair medical emergencies on Delta and have never gotten anything other than a thank you from the FA. A number of years ago a coach passenger had a full cardiacc arrest and he was successfully resuscitated. Another time two passengers suffered heart attacks on the same flight.I never received anything other than a thank you from the FA. Although people go into medicine due to the desire to help people, with the current medical malpractice crisis, airlines should be grateful that we are helping them out. The good samaritan law does not always prevent lawsuits from being filed.I have never had this happen but know physicians where it did.</font>

I think asking for any compensation other than what they freely offer as an atta-boy demonstrates poor class, if not unprofessionalism. After all, what's the alternative; not use your training and allow someone else to die? But if the doctor ends up getting sued, I'd (as the doctor and/or his insurer) expect the airline to indemnify; especially if a FA or flight crew solicited the help.

500 miles. Yeeks.

That was what I got last year for helping out someone who was injured by the FA's cart.

Northwest SIN - NRT.

I believe that Cathay did the right thing as reported by BillMorrow above. Makes me happy 2 have a J ticket on their plane BKK-HKG & HKG-LAX http://www.flyertalk.com/forum/smile.gif.

Re: roadwarriorintraining's suggestion: I am a member of Investigative Reporters & Editors ire.org (http://ire.org) , so I have e-mailed this thread to an IRE officer.

JS has a good point on the cash bill if any, however I do believe that HA owes the MD a fare refund &or a free F ticket for the future.

Re Rives21: Oh-so-right-on http://www.flyertalk.com/forum/smile.gif!

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Play the travel game 3 vacations into the future!

[This message has been edited by Brendan (edited Dec 14, 2003).]

i had a very different experience than most of you.

i am a chairman's preferred frequent flier with us airways, and i was aboard a fra-phl flight two months ago during which several people (both passengers and flight attendants) in one particular part of the aircraft became ill. i was sitting in row 1 aboard the airline's flagship a330 (upgraded from a coach fare), and we were about 2 hours into the flight when the captain announced calmly that we were turning around and would be landing in london because "a passenger needed some medical assistance". i looked at my finacee and rolled my eyes -- oktoberfest had been exhausting (but very fun!), and we had both been looking forward to getting back to the states.

anyway, about a minute later there was a bunch of commotion behind us and then a much more panicked sounding female voice on the overhead, requesting "all portable oxygen tanks and any medically trained personnel" to come back to coach.

i'm an emergency medicine doctor, so i got up and went back there. i found out later there were at least eight physicians on the plane, but the only two people who responded were me and this guy who described himself as a "terminally differentiated beaurocrat", which he went on to explain meant that although he had trained in medical oncology long ago, he had spent the last 20 years doing bench research for pharmaceutical companies. so i was pretty much on my own.

basically, it turned out that there was one person (a flight attendant) who was genuinely ill, and then several people around her who were panic-stricken and hysterical, believing that the genuinely ill person's symptoms were being caused by some loss of cabin pressure or insufficient ozygen content in the air in that section of the plane.

i helped out the sick person, sacrificing my seat in first class (which was then taken by one of the other "sick" people, so they could get her out of the "bad area" on the plane). that put her right next to my fiancee, who doesn't deal well with medical things/sick people, so she was less than thrilled.

there were several non-medical people who were helping me assist the sick person, and once she was stabilized, i had a chance to meet one of them. it turned out he was chief of security for the transatlantic portion of usairways route structure (or something like that). he was a really nice guy, and during our conversation i mentioned to him that when my fiancee and i had first boarded the plane, we realized that we had left our portable dvd player in our rental car. he insisted that i give him my name and let him copy down some information from the car rental receipt.

we wound up landing in shannon, ireland actually, and had to spend the night because of labor hours rule for the crew. they put us all up and bought us a very nice buffet meal that night.

i saw the security guy at the airport on the way out the next day, and he said that he was going to look into my missing dvd player for me. i thought it was pleasant lip service at the time (and i figured that it already belonged to some german avis employee anyway), but i'll be dammed if i didn't get a call a couple days after getting home from germany -- some woman whose accent was so thick i could barely understand her identified herself as a us airways employee and told me that my dvd player had been located and that they were going to send it on the next flight to the us with one of their flight attendants. sure enough, a few more days pass and then the dammed thing shows up on my doorstep. inside the package was an effusive letter from crystal city, thanking me for my medical services aboard their flight and for my lonsgstanding loyalty to us airways. also included was a voucher for a free roundtrip coach ticket to anywhere us airways serves in north america.

i certainly didn't expect to be compensated for anything i did to help the flight attendant; i imagine i wouldn't have received the treatment i did if it hadn't been for the security chief, but it was definitely above-and-beyond.

sorry this was so long, but everyone on this thread seemed to have such negative opinions/experiences about how airlines handle things like this. i know there were some extenuating circumstances in my situation, but sometimes the airlines do things right.

-- he who slacks

[This message has been edited by OverpaidSlacker (edited Dec 16, 2003).]

Just a short comment: Airlines are definitely insured against someone getting sick onboard and them having to turn around, be it shannon or anchorage: just like they would if there was a technical fault, bad weather or other acts of god that prevent them from flying on.

Compensating the guys who are there at the right place and the right time is customer service. If the crew or anybody from the airline present has common sense, they do it.

I have helped strangers in bad situations and sometimes received a deep expression of gratitude, sometimes nothing. I expected nothing. Such is life!

Regards Oliver

Thought I would add a little something to the original post that I forgot to mention. My doctor friend is recently retired. Although he maintains his medical license in 2 states (Hawaii & Calif.), he no longer has malpractice insurance. If he were to get sued, he would have to spend a lot of money hiring an attorney to defend himself under any Good Samaritan law that might exist. So even if it were determined that he did nothing wrong, it would cost him a small fortune to do that. Perhaps letting his licenses go would put him in a better position legally, i.e., he would become Joe Citizen rather than Joe Doctor and be treated differently in Court. I can only wonder if the airline would really jump in and provide him a free defense. Although he would never refuse to help someone in need, he really takes a chance jumping in to help. He has a friend who never identifies himself on a plane as a doctor and basically "doesn't get involved", and he HAS malpractice insurance.

Not being a doctor, but realizing how "thank you" rewards are given out, if I were to give medical, engineering, or any other service to a commercial flight when I had purchased a ticket, after it's all over, I'd ask the most appreciative FA how I could get a voucher or refund for my flight.

I'll bet that a FA when pointed in the right direction could get the ball rolling on a proper reward.

My general advice to any physician who is retired but maintains their license is to continue to carry malpractice, and maintain courtesy privlidges at one hospital. Although the situations don't come up often, if you wind up treating someone (friend, acquaintance, etc) without the above you run a definate risk.

Considering your friend has already made the decision to invest 1-2 weeks a year in continuing education to keep his license current, the 2-3K / year for a part time, general practice, minor surgery malpractice policy is probably worth it.

Also, in my experience physicians rarely retire for long, they may slow down, but almost never actually retire -- be it supervising nurse practitioners part time, doing case reviews, etc.

rubindj