Originally Posted by
DocDorfman
Interesting post, but perhaps the product of your imagination? Seriously, do you really think that they announce "is there a Doctor on-board?" routinely enough to give you this many experiences? It has never occurred in my 30 years of practice. Maybe you are just lucky?
And frankly, Doctor, these matters are more often outside of our practical treatment experience and we always lack the tools for evaluation that we normally use - plus with such an announcement the aisle is going to be full of Paramedics, EMT's, RN's and other well meaning allied health care providers - all equally qualified to address the circumstances you present.
Not to mention liability for abandonment and the complete lack of Good Samaritan protections. I'm not sure what your insurance costs, but mine is enough to let the other health care professionals step up first. Pre-hospital care is not what most Doctors are good at - and other trained professionals exist with better protections, and far more experience.
You can't swing a cat on an airplane and not hit a qualified health care provider - so being a Doctor does not make me the most qualified to assess the circumstances, as given by your own examples.
I agree with the poster upthread - it's not the years of travel or practice, but rather the frequency and duration of flights; emergencies do seem to be more common on longer flights.
I am a frequent flyer (like many on this website), and spent 12 years in jobs involving almost daily air travel (150,000+ miles BIS annually), though I have changed jobs and cut back to 50 - 100K annually, which has been a pretty stable baseline over my career - family trips, vacations, annual Third World humanitarian aid trips, CME, Star Alliance MegaDO, etc. So no, this is not a "product of my imagination."
I suspect that many health professionals have your attitude about CYA, but personally, I'd rather help the sick person as best I can than know someone might have been seriously injured or dead because I didn't offer emergency assistance. In general, Good Samaritan Acts cover the liability aspect of such assistance. Of course I don't bill the patient or airline, nor have I ever received any "compensation" other than one bottle of wine from the FA once, and a couple of letters of appreciation from the airline.
Usually I am the only health professional to come forward; if there are others available, we look at the nature of the patient's problem, the skills of the people on hand, and let the most qualified take the lead. If there had been a cardiologist or an EMT on board when those two suspected heart attacks occurred, I'd have gladly deferred, and one time a State Highway Patrol Officer and I planned how we would do CPR together if it had become necessary. It did not, but I was just glad to have someone else around trained in BCLS, whether she was a licensed health care professional or not. Once an ophthalmologist was relieved to defer to me when the sick traveler had asthma.
I'm a family practitioner, though I have spent many years in an urgent care setting, which is reasonably good preparation for the in-flight emergency situation. In-flight is never as good as an ambulance or ER, but it is not as though there is a choice. At least today, there is almost always oxygen available, and usually contact with an on-the-ground emergency medical services consultant; sometimes there is the capability to transmit an EKG in-flight to said consultant (yeah LH!).
I have never "abandoned" a traveler I assist in-flight, so long as they need it and consent to continued monitoring (not all consent, and not all need it). That is why I do not fall back asleep on red-eyes when someone is ill though - it's bit nerve-wracking for me worrying if the other shoe will drop. If the traveler is quite ill and consents, I remain with them until the ambulance meets the plane at the gate after landing. And for all but the most minor events, the captain calls for the paramedics to be at the gate. It doesn't matter what the initials are after my name - the captain is always in charge and makes all the decisions, sometimes with my medical input.