Pilots Give Docs a Lesson in Respect

A couple nights ago, PBS aired a top-notch "Nova" documentary about the deadliest airplane crash in history. It happened in 1977 on the Canary Islands when two 747s collided on the runway, killing 583 people.

A possible contributing factor was a flight engineer's apparent unwillingness to challenge the captain when things started to go wrong. The engineer may have simply been intimidated.

Pilots changed their culture after the crash, trying to eliminate an oppressive hierarchy that prevented the less-experienced from daring to question their superiors.

In recent years, there's been an effort to bring pilots into hospitals to teach doctors how to pay attention to -- and respect -- their underlings, so nurses and others will feel encouraged to speak up when something is wrong.

Here's what Dr. Robert Wachter told UCSF Magazine a couple years ago:

Physicians are largely stuck in the swashbuckling, go-it-alone mindset, and things won't get much safer until we begin adopting some of the lessons from aviation and other safer industries.

Of course, pilots have one hell of an incentive to create safer systems -- sitting in the front end of the plane, they die first. Lacking that incentive, the medical profession has focused more on progress and technology than on ways of delivering care safely.

I just sent a message to Wachter, who's been spearheading these efforts, to see what's new. Are doctors getting the message? I'll report back in this blog once I hear from him.