No Substitute for Training and Experience Both in the Skies and in Healthcare

On Saturday morning, passengers on United Flight 328 heard a loud boom.  Right away, they knew something was gravely wrong. The plane’s engine had exploded mid-air with flames visible through the windows and debris dangerously falling over parts of Colorado. The pilots immediately made a mayday call requesting an emergency landing and returned to the airport. Fortunately, there were no injuries reported among any of the more than 240 passengers and crew or people on the ground.

After the incident, the Pilot Union of United Airlines issued the following statement:

“We commend the crew of United Flight 328 for safely returning to Denver after experiencing significant uncontained engine failure. We are thankful for the tremendous teamwork shown by the entire flight and cabin crew, and that there were no injuries on the ground or in the air.

Extremely rare engine failures like this prove there is no substitute for experience and that the most important aircraft safety system is two well-trained, highly-skilled professional pilots at the control of the flight deck.

What does this have to do with midlevel care and training in the US?

As with pilots, there is also NO SUBSTITUTE for the experience and training of highly skilled physicians who have completed a rigorous and standardized curriculum of training to care for patients. Every Code Blue is an “uncontained failure” of a patient’s health. And in times of crisis for any hope of survival, you need calm and competent leaders at the helm.

One passenger of United Flight 328 commented to reporters, “I think the pilots had a huge hand in making everybody feel safe and comfortable.”

This is also what physicians do for their patients and is something that is learned over time and through training, not online, and not through shortcuts. It comes from countless hours spent in the classroom, clinics, and hospitals honing their knowledge and skills. It does not come from marching up the Capitol steps, through lobbyists or poorly written legislation.

Every Team Needs a Leader

During the United Flight 328 emergency, no one complained that the pilots were only concerned about their “ego,” refusing to let anyone else into the cockpit. There were no accusations of pilots being in a “turf war” with flight attendants or that the pilots were anti-teamwork.  While the pilots were focusing on the job they were trained for, other members of the flight team were playing their role. For example, flight attendants were preparing the cabin and calming passengers.  After all, having a team leader does not minimize the contribution of others on the team.

Taking Advantage of the Pandemic: Contrasting Airlines with Healthcare

During the COVID19 pandemic, we saw emergency legislation enacted to increase the scope of practice of nonphysician practitioners to “fill gaps in care” while physicians experienced reduced hours and layoffs. Compare this to the Pilot’s Union, which refused to compromise safety, stating, “Throughout this pandemic, we have never reduced safety margins. At United, no pilots were furloughed, and we ensured that we kept our pilots qualified and proficient on our flight decks.”

It’s unfortunate that we can’t say the same for our healthcare system. #StopScopeCreep and ask for a trained, skilled physician to lead your care for any “engine failure” you may encounter to best achieve a safe outcome.