Why airlines hope physicians aren't on board during medical emergencies

Physicians and other clinicians are called upon to help passengers during in-flight medical emergencies, but airlines often prefer the guidance of on-the-ground consultants in order to avoid diversions, according to Bloomberg.

A medical emergency occurs once every 604 flights, with 7.3 percent leading to diversions that ground the plane, according to a study The New England Journal of Medicine. While it is standard protocol to first find out if a medical professional is on board before calling a consultant, a diversion can cost as much as $200,000, and airlines look to avoid these diversions whenever possible.

Passenger clinicians are more likely to recommend diversions, so airlines rely on contracted consultants on the ground, who are less likely to recommend such action, to guide pilots. Though the final decision rests with pilots and dispatchers, they rely heavily on the advice of consultants.

"It's fairly expensive to divert an aircraft, and so a captain has to take into account a whole host of issues," Jose Nable, MD, an assistant professor at Washington, D.C-based MedStar Georgetown University Hospital, told Bloomberg.

Paulo Alves, MD, global medical director of aviation health for Medaire, which provides in-flight consulting for over 100 airlines, acknowledged that his consultants recommend fewer diversions than on-board clinicians, but said these passengers are often overly cautious.

"If the model was not financially interesting for [airlines], then they wouldn't hire us," Dr. Alves told Bloomberg. "Doctors, they tend to recommend diversions more than we do, because of course they don’t want to assume the long-term responsibility."

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