Monday, August 28, 2006

Accountability in the Cockpit

Grossman, Richard. "Flying Makes me a Better Doctor," Readers Digest. August 2006, pg 207.

Keywords: accountable, friendship, love,

Doctors are known to be terrible pilots. They don’t listen because they already know it all. I was lucky: I became a pilot in 1970, almost ten years before I graduated from medical school. I didn’t realize it then, but becoming a pilot made me a better surgeon.

I loved flying. As I flew bigger, faster planes, and in worse weather, I learned about crew resource management, or CRM, a new concept to make flying safer. It means that crew members share the responsibility to listen and speak up for a good outcome, regardless of rank or seniority.

I first read about CRM during my surgical residency in 1980. Not long after than, an attending physician and I were flying in bad weather. The controller had us turn too late to our final approach. The attending physicians was flying; I was safety pilot. He was so busy because of the bad turn, he had forgotten to put the landing gear down. He was a better pilot--and my boss--so it felt odd to speak up. But I had to: Our lives were at stake. I put aside my intimidation and said, “We need to put the landing gear down now!” That was my first real lesson in the power of CRM, and I’ve used it in the operating room ever since.

CRM requires that the pilot/surgeon encourage others to speak up. It further requires when challenged, the doctor doesn’t overreact, which might prevent colleagues from voicing opinions again. So when I am in the OR, I ask for ideas and help from others. Sometimes they are reluctant. But I hope that if I continue to encourage them, someday someone will keep me from “landing gear up.” Maybe you’ll be the one to benefit.

--Richard C. Grossman, DO is a facial plastic surgeon from Colleyville, Texas.

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