“I now have a clear view of our assigned runway ahead. I disconnect the autopilot and silence the whoop-whoop of the siren that warns me I’ve done so. We lower the landing gear and complete the extension of the flaps that expand and alter the wing. We read the landing checklist. The air is bumpier now.”
This is one of those articles that I’ll remember for quite some time. If you’ve ever wondered how pilots fly all over the world, start here. How do planes know their altitude? How are the skies organized? How are you still mesmerized by the Northern Lights after seeing them almost every day?
Nearly 45,000 flights a day in the US take off and land. And we’ll sometimes go years as a country without a major catastrophic crash. But why is it that more than 100,000 people a year die in America due to contact with the American Healthcare Industry?
Because doctors and pilots possess very different attitudes and behaviors. And if doctors could be more like pilots, far less people would die, life expectancy would increase, and our country’s health could be markedly improved.
Doctors are educated and trained in a dog-eat-dog hyper-competitive environment that rewards egos and stifles teamwork.
Graduating number one in your medical school class is something most medical students fight it out for. For those in the top of their class, it’s a positive feedback loop that feeds their egos and sets the stage for your name and career as a physician. For example, the brand of Johns Hopkins and Harvard is almost as powerful as you being called the best brain surgeon in the country. You don’t become the best without being the top of your class, then the Chief Resident, and then by having a reputation for being perfect. But no doctor can be perfect in a silo. They have a whole team of a rotating cast of nurses, aides, partners, etc. However, the team doesn’t get credit. And Harvard or Hopkins kind of gets credit. But the doctor’s name gets all the credit. It’s simply an ego thing that starts on the first day of medical school.
But what happens when doctors screw up? It’s on them. They are the target of the malpractice case. Their name gets tarnished and it’s on the permanent record forever. But…the vast majority of the time, they still get to practice. The patient suffers, or maybe even dies, but the physician moves on. It’s part of the game. Death and bad things happen to us all the time, you gotta shake it off. You have to desensitize yourself just to survive the psychological strain of dealing with so much death and disease. Essentially, we get mulligans all the time.
If we went down with the ship every time we made a mistake, and not only we died, but we took out 300 of our patients along with us, we’d probably start thinking and acting a lot more like pilots.
Commercial pilots understand that they are a cog in the wheel, supported by a team, and if they make a big mistake, they lose their life too. Because of this, they almost worship process, teamwork, and respect for the machine. A checklist and your team saves your life every time you fly. And when bad things happen, it’s in the news and the news is about the airline’s crash, not the pilot’s name. If 100,000 people a year die from medical mistakes, this would be the equivalent of an airliner a day crashing in America consuming a huge part of the news cycle.
Being a great doctor is not about you. It’s about your team. But the system that creates us rewards the wrong things. We should be rewarded for teamwork. We should be rewarded for worshipping a tried-and-true process. We should understand that we’re just a cog in the wheel of our nation’s health. We need to think of our operating rooms or our exam rooms more like planes that we need to respect because our patients’ lives depend on the machine. We should think of our careers as a social good designed to create the safest framework for our patients. And if we could do this, we’d save far more lives than anything doctors have ever invented.