The Comparison

Posted on April 15, 2011


Two developments in the news this week to call your attention to. First up, the sudden resignation of Hank Krakowski, the head of the FAA’s Air Traffic organization. It was Hank’s job to see that the nation’s air traffic controllers are competent, at their post, and doing their job. His performance was seen as a dismal and embarrassing failure after five air traffic controllers across the country were recently caught falling asleep on the job. The latest incident was widely publicized.  In a strange twist of fate, a medical transport aircraft was involved in this latest event, which brings me to my next point.

Has any goverment official in charge of the quality of our nation’s healthcare system resigned over that industry’s dismal performance on patient safety? I’m not coming up with any names. Has anyone been reassigned? Demoted? Forced into early retirement? If its  happened the public hasn’t been told.  The Harvard School of Public Health released a report this week citing public opinion of the healthcare they receive is “average” at best. We’re talkin’ C- D range, not B+.

On Monday I began making the case for a change in how we, as patient advocates, treat the healthcare industry. For many years now there have been comparisons between healthcare and commercial aviation. Public safety was the common denominator. We’ve all heard the “jet airliner crashing every day” comparison to describe the daily death toll in hospitals. This comparison hasn’t served us well for a couple of reasons:

1) Jets don’t crash in secret. They fall from the sky and explode into a ball of flames. They leave debris. They are sensational. They attract immediate and widespread media attention. Crashes are random spectacular events. Deaths in hospitals are common. Needless deaths are easily concealed. News surrounding them is suppressed. Spun. Brushed off with a Hippa compliance reference. The Wall of Silence is the standard industry response to any stray reporter who does come to call.

2) The aviation industry genuinely cares about passenger safety. Why? There are other modes of transportation available to the public. If too many air traffic controllers are caught asleep in the tower or too many jets fall from the sky and explode in a ball of flames those passengers will choose another, albeit slower, way to get to their destination. Revenues fall. Companies fold. The healthcare industry has proven that it doesn’t care about patient safety or patient outcomes.  In fact, it welcomes adverse events, which generate considerable additional revenue. Patients aren’t passengers. They have limited choices. When you need a hospital, you need a  hospital. No time to comparison shop; you have to pray the staff knows what their doing and trust you’ll be okay. It’s a game of Russian Roulette.

Remember,  1 in 3 patients who enter a hospital for any reason will fall victim to an adverse event. That statistic would never-in-a-million-years be tolerated by the FAA. Hank Krakowski resigned yesterday because five employees failed on his nationwide watch. Five. I think I’ve made my point.