There are two people in particular, who can, and probably should rip these thoughts to pieces for me. At which time I can reassemble them in a massive EDIT. Regina, Michael, this means you.
I had some thoughts on similarities and differences that exist between aviation maintenance, and the business of medicine.
I don't have a problem thinking of medicine as a business. As long as it is an ethically run, evolving, customer oriented business model. That could be a very good thing.
I have it easy in aviation in contrast to being a doctor. My 'patients' don't have families, or feelings themselves for that matter. I don't have to worry about pain management, or other human considerations.
I do have something akin to health plans though. The customer who owns the aircraft.
When I look at something, whether it's in the big Repair Station at my main job, or on the side, with a small plane and a regular guy owner; the customer always has the final say as to what gets fixed.
Now, if certain things don't get fixed, then I can't certify the aircraft or part as being airworthy. So there is a certain amount of things that can get fixed without much consultation.
But some things, especially things which are considered cosmetic in nature, it is really up the customer whether or not they get repaired. And truth be told, although quite honestly nothing that I've ever signed the final airworthiness release on, the customer can elect not to have pretty significant things fixed. I don't agree with it, nor would the FAA; but there it is.
I can fix it if I choose. But nobody will pay me to do it. Sometimes I have though. If it didn't involve a lot of time, and I could scrounge up the necessary airworthy parts for free.
How does that compare to the business of medicine? It's not my speciality, but I can see some parallels.
In the analogy, you would be the airplane, the insurance company is the customer who is paying out, and I'm the doctor.
Of course, it breaks down a little bit when you consider that the human patient can pay out of pocket to have something done. The poor airplane has no thumbs, and no wallet, thus not that option.
There are some areas where medicine and aviation can, and should, and probably already have, shared practices. That would be in error reporting.
In aviation, errors result in incidents, and accidents. We have unnapproved parts problems, sometimes not causing a big deal, but they could. Those can range from using a bolt from the hardware store instead of an aviation company, to parts made counterfeit, on the cheap, with fatal flaws that aren't caught due to the cost cutting in the counterfeit process of production.
For such parts, we have the FAA Suspected Unnapproved Parts program. It's a way we can report such things to the FAA. An investigation can be launched, and notices sent out to all effected parties if needed.
We have incident, and accident reporting. Incidents being things that happen, that don't involve damage, injury, or loss of life. Accidents are when something gets smashed up, or someone is hurt or killed.
The wonderful thing about all these reports, are that they are public record. And we can learn from them. All one has to do is look in the right place at the NTSB, or the FAA, and the reports and investigations are there.
Another thing I think, and hope, that doctor's and nurses share with each other: Tribal knowledge.
These are the tips, tricks, and lessons all learned from doing the things we do for a living. Told with candor, and humility, and often humor.
You think a story about someone being horribly injured, or killed, can't be funny? You haven't talked to many aircraft people. It's usually a mix of the funny and tears, depending on the amount of alcohol involved. But I've been there for those stories. I've learned from them.
And more importantly, knowing all that stuff, has made a difference in how I go about my job. When I approach a particular thing, I often think of the stories, and I tell myself: Ok, I know not to do THIS, or THAT. Because something bad happened.
Another thing that should be universal, whether it's fixing aircraft, or humans: Honesty, as in transparency.
There are policies, at the best aircraft repair places, where there is an immunity clause.
If you accidentally damage the aircraft while working on it, you will not lose your job because of coming clean and telling your boss about it. Usually, there are no consequences, sometimes there are small ones. Depending on the situation.
By the same token, if you damage the aircraft, and you try to hide it by not telling anyone. Your job is most often instantly terminated.
I think that this is a very very good thing. If you accidentally put a hole in the fuselage of an aircraft, maybe even damage the support structure under the skin; it would be a very bad thing for that plane to fly away without that being fixed. People could die.
So having an escape like that to bolster people's integrity, is very important.
I've damaged the airplane before accidentally. It happens. Plan it into the budget, and deal with it.
I might be crazy, but I think doctors and hospitals need to do that same thing. Hopefully they do.
Here's where it gets a little sticky though. In an ideal world, a doctor makes a mistake that causes major harm, crippling or killing someone. I want him or her to be able to tell about it, and own up to it. To share what happened, with all the humor and tears, and not lose their job, or be ruined over it.
Lousy doctors shouldn't be allowed to practice on people, but we have that in aviation too. Licensed mechanics, that can't seem to tighten a bolt without breaking something. We put them in places where they can't hurt things anymore. The stockroom, inspection (!). You get the idea. Knowledge and skill can be utilized without throwing the person away. We all have limitations.
On that same deal, should patients be allowed to sue the pants off doctor's who make mistakes such as that? Part of me says yes, part of me says no.
If they can, then it inspires doctors and hospitals to put up the 'blue wall of silence' and cover things up, make things a mystery so patients don't know what is going on. All for the sake of reducing exposure to liability.
But if patients can't sue, then they may be left with the loss of the ability to work for the rest of their lives, permanent pain or physical limitations, the loss of their very life. Hurting those left behind horribly, emotionally and financially, by their absence.
Medical lawsuits drive up the cost of medicine, and medical care. You'd have to be a fool not to see that. Not just measured in money, but in transparency, and honesty to the patient.
Insurance costs and liability can be a huge issue in my industry too. But we still press forward with trying to be open about things. There are flaws, there are coverups. Perpetrated by individuals, companies, and federal agencies. But I'd like to think we are trying hard not to. I'd like to think we are trying to make people understand more what we do. How it makes things safer, it's just science and technology, people.
I'd like to think Medicine does the same thing. That at least everyone wants to be open, and inclusive.
I tend to wonder though. About both industries.
Cheers, to making a more open and less scary world.
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