As a healthcare compliance and enforcement defense attorney, I have historically tried to keep my feet on the ground.
But a few years ago, I began taking helicopter pilot lessons for the challenge and exhilaration of it all. I earned my license and now regularly fly a helicopter. As my passion for flying took off, I started to see parallels between my work and cruising 600 feet above the ground at 130 miles per hour. What became apparent is that the contours of today’s challenging and uncertain healthcare landscape are a lot like what I experience in the cockpit.
Those of us involved in healthcare are continually dealing with dynamic conditions. The reform law was passed and several of its elements were put into motion—and now there are ongoing efforts to repeal and replace its underpinnings. It’s tough to plan and to focus in such a turbulent environment. Even the best compliance professionals and pilots can’t predict the changing winds. But we continue onward, run our operations and fly. Here are the parallels:
• Flying the Aircraft. For me, the hardest thing to master was hovering a helicopter – they are inherently unstable, not unlike our healthcare system. While it is easy to fly “straight and level,” it’s harder to maintain a steady state. And when you turn, you can lose altitude and momentum. There are multiple inputs: The cyclic controls your direction, the collective controls lift and the dual pedals keep the helicopter from spinning in circles. While physically maintaining these four controls, a pilot sets the course, manages the avionics, talks on the radio and looks out for hazards and traffic. It’s extreme multitasking. This should resonate with compliance professionals, who are likewise charged with keeping complex systems aloft while simultaneously identifying, preventing and mitigating risk.
• Navigation. Before embarking on a journey, pilots need to know where they want to go and plan how to get there. They have maps, coordinates, time projections, weight and balance information and fuel burn rates at their disposal. They have to distill these data points into an achievable flight plan. In healthcare, we have similar data points: Work plans, risk assessments, reimbursement data, budgets, experience, trend analyses. Compliance professionals need to synthesize all of these information sources and plan well to keep from being drawn off course.
• Communication. In a helicopter, as in healthcare, it is as important to listen to others as it is to convey your position. Poor communicators don’t fare well in either realm. Pilots sometimes operate in controlled airspace, where an air traffic controller (a government contractor) is monitoring and authorizing every move. They also operate in uncontrolled airspace, where they are required to talk over the radio with fellow pilots without oversight. Regardless of the environment, they need to convey information clearly and accurately to ensure safety. It’s the same in healthcare. Sometimes we have mandates and clear standards that we need to uphold. But often we are in outlying areas and must use our best judgment without much help. In any event, we need to know the positions of the various stakeholders we serve, communicate well and avoid collisions.
• Weather. While pilots can be informed by the best briefings, radar, experience and direct observations, storms can nonetheless develop in an instant. At times, pilots can fly around them. But the conditions may also compel an unplanned diversion or landing. The safest decision may be to terminate the flight temporarily. With patience, however, pilots can eventually get where they want to go – they simply wait out the storm. It’s the same with healthcare compliance: we have to be patient and flexible, while not deviating too drastically from our overall mission and long-term goals. There may be delay or inconvenience, but we regroup and press on.
• Aerodynamics. Helicopters and healthcare organizations are complex machines with lots of moving parts. Pilots and healthcare compliance professionals must know how a system will behave in various conditions and anticipate operational difficulties. Healthcare involves multiple disciplines: compliance, legal, risk, human resources, quality, privacy and billing, to name a few. These components all have to work together smoothly to deliver high-quality outcomes for our patients. When one component begins to break down, there is a cascade effect. When one indicator flashes yellow or red, the whole apparatus can shake and the troubleshooting begins.
Pilots and compliance professionals need to have an array of skills in a variety of distinct disciplines. They apply those skills diligently and patiently in complex and dynamic circumstances as they endeavor to achieve their missions. Each flight or compliance journey can be rewarding and exhilarating. May you have fair winds so you can fly – and comply – well.
Frank Sheeder is a partner in Alston & Bird’s Dallas office. He represents members of the healthcare industry in compliance and enforcement matters. He is a former president of the Health Care Compliance Association and is a Private Pilot – Rotorcraft.
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