Guest blog post by David Antoon, member of Safe Patient Project activist network and retired pilot

In conversations last year with fellow patient safety advocates, we were discussing the story on Vox that makes the point that some hospitals treat medical errors like car crashes and others treat them like plane crashes. It is a catchy piece that makes some good points.

However, as a retired pilot, I have to offer a rebuttal to the notion that health care safety can be made analogous to airplane safety. The cultures are different and the incentives are different.

Pilots sit at the “pointy end” of the aircraft and suffer the same consequences of their errors as do the passengers. They are safety oriented because their lives depend upon safe operations. There are no conflicts of interest for a pilot.

Doctors in the fee for service environment, often including payments by big Pharma and Medical Device companies, have terribly different incentives which prevent safety. Tort reform, confidentiality rules, and bonuses for procedure volume drive their “airplane.” For doctors, there is no consequence for “negative outcomes.”

The proverbial saying that “Pilots die with their mistakes and doctors bury their mistakes” rings very true in our current environment.

In our medical system, there are no consequences for negative outcomes. There are no consequences, as well, for fraud and other criminal acts. The status quo will be difficult to change.

From a legislative perspective, tort reform and confidentiality laws prevent patient safety improvements. Can you imagine if there were tort reform and confidentiality laws legislated to prevent the causes of aircraft accidents from being known or exposed? It is quite ironic that my 40 years of flying came to an end because of medical error involving fraud, confidentiality of findings, tort reform to prevent discovery, lack of credentialing, false credentials, conflict of interest with a medical device corporation, etc.

Can you imagine approval to operate a new aircraft based upon a FDA “510K” process that assumes if you have flown an aircraft before, you can fly any aircraft? In medicine, profit trumps safety.

If aviation operated as our medical system, we would be crashing commercial aircraft each day with no incentive to improve, except, of course being in the pointy end of the plane.

Guest blog post by David Antoon, member of Safe Patient Project activist network and retired pilot