Doctors can learn something from United’s woes


By now, we have all seen the cell phone footage of a doctor being dragged off a United Airlines flight. I’ve seen it on Twitter, on Facebook, on cable news and read about it in the printed press. I’ve been texted links to the various videos each from different angles but all showing the same images — a man being dragged away with a bloody face. This has prompted quite a bit of discussion. Why do airlines overbook? Could they have handled it better? Why didn’t he just de-board the plane? Why was airport security so aggressive?

These are all great questions, and we can from this situation. For starters, I am not telling anyone on a United Airlines flight I am a doctor. Secondly, there are some very talented meme creators out there. More importantly, I think in health care we can and should learn from this tragedy.

Here we have an overbooked flight — something that routinely happens every day — that devolved into a social media firestorm that has cost United Airlines hundreds of millions of dollar in stock value alone. Social media justice is swift and exponentially powerful with each passing moment. We would like to think that something like this has nothing to do with our day to day practice of medicine, but I would point out that every day we have countless routine interactions with patients.

I would hope and pray that none of them end up with us having a patient dragged from an exam room forcibly with blood trailing the path out, but some of our interactions are likely to go less ideally than we would have hoped. Some of our patients are going to be upset with how things turned out. We know this since we all get those dreaded Press Ganey comment scores every month.

We don’t like looking at them. We come up with reasons why they aren’t valid. Maybe they aren’t the best judge of how things went, but we live in a day and age where that patient experience can and will end up on Facebook, Yelp, Twitter or countless other forms of social media and explode into something we could never image and forever damage our ability to care for patients.

Many people are looking back at the United Airlines incident and wondering why they did just offer more money to have a passenger voluntarily leave the flight. Some reports even indicated that airline staff scoffed at the idea of offering more compensation to passengers. In retrospect, that small sum of money seems insignificant to the fallout — financial and otherwise — that erupted. In that same thought process, when we see a patient encounter moving in a negative direction that we didn’t anticipate, we have two options.

The first option is to quickly assume we have done all that can be reasonably expected of us and demand change of the patient to scoff at the idea of doing more. The other option is to stop for a moment, step back from the situation and think, “Is there a way to make this a positive experience for the patient even if you feel you have done more than any reasonable doctor would do? This could prevent that negative online review that snowballs into a social media nightmare and help build a relationship with a patient that allows better care going forward.

After the initial reports came out about United Airlines, the airline’s first response seemed to lay blame with the passenger just as our first reaction when we see an online review is to want to post a long explanation indicating how the patient showed up late, didn’t listen to us, wanted narcotics or thought that sea salt could cure cancer. In the case of United Airlines, the first responses didn’t sit well with anyone. In the case of our patient reviews, I would think those responses will have a similar reaction.

Every day, we have routine interactions just as an airline boards passengers countless times a day. Every day one of these interactions can become negative. If we truly want to take care of patients, which is why we all got into this, we have to work harder when things don’t go as expected — just as United Airlines should have worked harder to make it right. In this day of social media, it’s not only how to provide good care and what patients expect of us, but it is also the standard social media justice will hold us accountable to.

The United Airlines incident was a terrible situation that hopefully will never happen again. I learned from it as an airline passenger, doctor and patient. I hope you did too.

Nari Heshmati is an obstetrician-gynecologist and can be reached on Twitter @nariheshmati.

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