Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Time for surgeons to earn their wings

Jeffrey Woolford, MD
Physician
January 18, 2014
87 Shares
Share
Tweet
Share

Pilots never expect to hit a flock of birds on take off, or flame out an engine in mid-flight.  No one plans to get disoriented in the air or have an equipment malfunction miles from the nearest airfield.  And, it certainly isn’t routine to fly into hostile airspace with a heightened awareness of the known ground threats, the position of each member of your formation, and the safety of the ‘friendlies’ on the ground at stake.

As an Air Force pilot, I never planned for these emergency scenarios to occur.  But, when they did, I knew exactly what to do because I was trained to quickly assess a crisis situation and respond to it with a set series of steps.  Through training, the use of a checklist, and my “heads-up display” (HUD), I was able to analyze the situation, take the appropriate action, and bring my jet safely back to base, even when cards were stacked against me.

When I started medical school, fresh off a combat tour in Afghanistan, my aviation training was still foremost in my mind.  And, as I completed my first surgical rotation, I couldn’t help but think, “Surgeon’s could learn a lot from fighter pilots …”

Much has been written lately about whether or not surgeons could benefit from the successful aviation safety practices used by pilots.  As the developer of an aviation-based patient safety system and the CEO of a company dedicated to bringing aviation technology into the operating room, I admit that I am biased, but I am also uniquely qualified to address this discussion.

Lets start with this: The human body is not an airplane.

Even when compared to a combat situation, there are more possible points of failure in a human body than there are in an airplane.  That being said, I don’t believe anyone is comparing patients to planes!  As an advocate of aviation safety practices in medicine, I understand that there will be necessary modifications due to the complexity of medicine.  But that doesn’t mean the application of “Crew Resource Management (CRM)” can’t be successfully adapted for the surgical suite.  The ‘dashboards’ currently in production by multiple companies are a good start to enhancing communication in the Operating Room, but there is more work to be done.  In an aircraft, the HUD gives the pilot all the critical information they need for a successful flight – at eye level.  In the operating room, surgeons need that same technology.

Next:  Surgery isn’t like flying — there is an art to it.

I have heard the criticism that there isn’t an “art” to flying and that we simply do everything “by the book.”  This is a common misperception highlighting a misunderstanding of flight procedures.  Just like surgeons, pilots, and particularly fighter pilots, do not like to be told how to do things.  We each have our own techniques that we use to lead a formation of aircraft, accomplish a bombing strike, or engage in air-to-air combat. There are good techniques and there are bad techniques, a statement that is certainly true for both pilots and surgeons. Unlike surgeons, however, pilots are given a ‘check-ride’ each year to ensure they are meeting the minimum safety and execution standards of flight, and the grade they receive is part of their permanent record.  If their techniques are ineffective, or unsafe, they are corrected and shown another way to accomplish the objective.

How are surgeon’s techniques evaluated for safety and effectiveness?  How do we separate the skilled from the novice?  How do we ensure that each surgeon’s “art” is both safe and effective?  We need quality data to make these assessments and we need to establish a universal ‘Standard of Care’ which we measure surgeons against.

And finally:  “I don’t need a checklist telling me what to do.”

This one’s my favorite.  Like surgeons, fighter pilots study, train, and pursue excellence in their skill. As pilots, we don’t have a checklist that tells us every minute thing we need to do, and if we did, no one would use it!  We do, however, use our checklists to ensure essential safety steps are completed, and we use them in crisis situations to focus our thoughts, keep us on track, and ultimately get us back on the ground safely.  A checklist is a tool, and it is a powerful one.  Studies repeatedly show that checklist use decreases preventable errors, and yet, implementation has been slow as the medical community resists the idea.

I’ve spent a great deal of time thinking about both the similarities and the differences between fighter pilots and surgeons and I maintain that surgeons and surgical outcomes could benefit from implementation of proven measures already practiced in fighter aviation.

As any good fighter pilot would, I expect to get some “debrief” items from both surgeons and pilots alike.  I welcome your feedback and look forward to a lively discussion.

Jeffrey Woolford is CEO, Parallax Enterprises, LLC.

Prev

Finding the right EMR vendor can help navigate mandates

January 18, 2014 Kevin 10
…
Next

Drug shortages can jeopardize patient safety

January 18, 2014 Kevin 1
…

Tagged as: Surgery

Post navigation

< Previous Post
Finding the right EMR vendor can help navigate mandates
Next Post >
Drug shortages can jeopardize patient safety

More in Physician

  • From solidarity to co-liberation: Understanding the journey towards ending oppression

    Maiysha Clairborne, MD
  • Finding peace through surrender: a personal exploration

    Dympna Weil, MD
  • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

    Katrina Gipson, MD, MPH
  • Beyond the disease: the power of empathy in health care

    Nana Dadzie Ghansah, MD
  • How to overcome telemedicine’s biggest obstacles

    Harvey Castro, MD, MBA
  • The patient who became my soulmate

    Anonymous
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance
    • From solidarity to co-liberation: Understanding the journey towards ending oppression

      Maiysha Clairborne, MD | Physician
    • Changing the pediatric care landscape: Integrating behavioral and mental health care

      Hilary M. Bowers, MD | Conditions
    • Contract Diagnostics is the only firm 100 percent dedicated to physician contract reviews

      Contract Diagnostics | Sponsored
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Pregnant, Black? Here's Your Drug Test
  • Progestin-Only Birth Control Linked to Small Increase in Breast Cancer Risk
  • Fatty Acid Tube Feeding May Backfire for Preemie Breathing Disorder
  • Case Reports Detail Vision Loss Linked to Recalled Artificial Tears
  • Admin Trumps Med Students: Anti-Abortion Group Allowed on Campus

Meeting Coverage

  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Second-Line Sacituzumab Govitecan Promising in Platinum-Ineligible UC
  • Trial of Novel TYK2 Inhibitor Hits Its Endpoint in Plaque Psoriasis
  • Durable Vitiligo Responses With Topical Ruxolitinib
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance
    • From solidarity to co-liberation: Understanding the journey towards ending oppression

      Maiysha Clairborne, MD | Physician
    • Changing the pediatric care landscape: Integrating behavioral and mental health care

      Hilary M. Bowers, MD | Conditions
    • Contract Diagnostics is the only firm 100 percent dedicated to physician contract reviews

      Contract Diagnostics | Sponsored
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Time for surgeons to earn their wings
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...