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Doctors should stop being compared to the airline industry

Jordan Grumet, MD
Policy
April 3, 2013
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We have to stop comparing ourselves to the airline industry.

Sitting on the lounge chair at the pool, I can’t believe that just hours ago I was sludging the wintry streets of Chicago, rushing to the airport.  The kids clucked away happily in the back seat as the adults in front where more subdued.  As grownups do, we kept running through our mental checklists even though the ship had already sailed, we left the house.

The trip, in general, was quite smooth.  With the exception of seating.  For some reason, even though we had made the reservation months in advance, the four of us were sitting in completely different rows.  Now, although I miss my wife dearly even when the separation is just for four short hours, for the little ones sitting by themselves just wouldn’t suffice.

At the baggage check in, the clerk said there was nothing she could do and asked us to wait until we arrived at the gate.  At the gate, they blamed the airlines new computer system and unsuccessfully tried to convince other passengers to switch seats with us.  They refused.

While boarding the plain, I really started to wonder why we in the medical industry want to model ourselves so badly to the airlines.  There are so many things the flight industry gets wrong.

Let’s think about this.  How often do flights run on time?  How often are flights cancelled?  Why is it that baggage gets lost on a regular basis?  Why was it so hard to seat me with my young needy children?

The truth is, there are problems so complex that even the airline industry can’t solve them.  Sometimes, no one can predict how a cold front over the Atlantic will affect an intricate and interchanging landscape of schedules.  Things get lost, there is human variability and error.  And new computer systems sometimes aren’t programed how they should be, or the end user is not trained to use them correctly.

What becomes ultimately clear, is that human beings especially, do not follow a manual. The number of interconnecting parts are too great.  The whim of human frailty is largely a mystery.

So there are successes.  Airlines are great at making checklists for highly controlled situations where mechanical failures occur in flight.  These failures are knowable, predictable, and often amenable to corrective measures.  I would say that the medical field of anesthesia (also a highly technical field) has had similar success.  But for most other types of medical practice, as well as for the airline industry, we are plain lousy at dealing with the incredibly complex field of human (and climate) diversity.

When we finally got to our seats, a courageous young man looked at the four of us, and willingly moved so a mother could sit with her young children.  After all that wrangling, the answer became obviously clear when the involved parties were face to face with the reality of the situation.

Oh, and by the way, medicine is nothing like the Cheesecake Factory either.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.

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