When a medical emergency occurs onboard a flight, what do airlines do if there is no doctor onboard? As it turns out, often the same thing they do when there is a doctor onboard: consult with professionals on the ground.
An interesting article from Bloomberg asserts that airlines may even LIKE it when no doctor is onboard:
A medical emergency sets in motion a high-altitude calculation with human lives in the balance. While pilots are the ultimate decision-makers, airlines have earth-bound medical consultants that help bypass on-board volunteers — reducing expensive emergency landings, but with the potential of providing expert decisions in real time.
Take the story of Lewis Christman. He suffered from an acute pancreatitis attack aboard a United flight from Chicago to Rome in 2016. For seven hours, he writhed in pain in a fetal position on the floor. Upon landing in Rome, he was transferred to hospital and spent the next few months in and out of hospitals.
He’s now suing United for failing to divert. A doctor onboard had recommended the aircraft divert, but the captain chose to continue to Rome. This case may hinge on whether United contacted any medical consultants on the ground. Was this cost/benefit analysis made with improper weight given to the cost of a diversion, which can run as little as $10,000 and as much as $200,000?
A company called MedAire Inc., based in Arizona, offers in-flight medical advice to 100+ airlines. Interestingly, only 1.6% of medical emergences in which MedAire is consulted on have led to diversions.
Paulo Alves, Global Medical Director of Aviation Health at MedAire, told Bloomberg:
If the model was not financially interesting for them, then they wouldn’t hire us. Doctors, they tend to recommend diversions more than we do, because of course they don’t want to assume the long-term responsibility.
How often do medical emergencies occur onboard an airplane?
According to a 2013 New England Journal of Medicine study, one out of every 604 commercial flights in the USA encounters a medical emergency. Of that, 7.3% of flights are diverted.
CONCLUSION
It is never an easy case, is it? On the one hand, there is a desire to divert, even if nothing else but for an abundance of caution. On the other hand, when a diversion is not necessary, the airline loses a massive amount of money, other passengers become stranded or delayed, and a ripple effect across the network ensues.
Perhaps taking the decision from an onboard doctor and instead using that doctor as someone who collects data or follow telephone instructions is indeed a better path. Companies like MedAire or STAT-MD provide specially-trained doctors within minutes to address the specific incident onboard.
Doctors are protected from liability for providing medical consultation and assistance onboard a plane (by federal law). Even so, the onboard drama often compels them to err on the side of the caution. For that reason, airlines prefer to consult ground-based help. That makes sense to me.
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A diversion will have as just as much of an inconvenience for the onboard medical professional (doctor, nurse, paramedic, emt) as for other passengers. So while the medical professional is more likely to err on the side of caution, they would not recommend a diversion for no reason.
Depending on the length of time left in the flight, the time difference in diversion vs. proceeding to destination & requesting priority landing may not be significant (this comment is NOT directed at Lewis Christman’s case).
I guess it just depends on what you value more, time and money or human life
@christopher welcome to the real world. Time and money is more important than human lives….as long as their lives aren’t of those who you personally care for.
I don’t know that the word of an employee from a company whose business is based on being the inflight doctor to airlines can be considered definitive. I think it’s excessive to say airlines don’t want doctors on board.
The real reason we use Medlink is because it gives us a reliable way to get professional medical advice. Even more importantly to the bean counters if we follow their advice the company assumes liability for what happens after that point. So if the airline gets sued for not diverting then Medlink is the one on the hook.
I can’t speak to United’s procedures but I would shocked if they were not similar to our own. When ever their is a medical issue on board the FA’s collect information and pass that to the flight crew who relays it to MedLink on the ground. If Medlink says continue I’d need a very strong incentive to disregard that advice and my incentive would certainly be communicated to them. If they say divert we divert period. A licensed MD on board telling me I need to divert would be very difficult to ignore and I would be quite surprised given the limitations of doing diagnosis by radio if Medlink ignored that recommendation to command a multi hour continuation.
The one exception would be an obvious and immeninently life threatening emergency (think heart attack or stroke) with a diversion airport nearby. In that case there will be an immediate medical emergency declared followed by an immediate diversion. In that case the flight crew is going to be far to busy getting the airplane down and basic notifications made to make a radio call to Medlink.
But in the end as aid said it’s about liability and using Medlink transfers that liability from the airline to them.
Diversions should be a life or death decision. I was on a flight earlier this decade that diverted when a passenger went into cardiac arrest. They absolutely made the right decision to divert and the man was resuscitated.