Summary
The analogy between aviation and healthcare highlights the potential benefits of adopting a more standardized and integrated approach to healthcare delivery, with healthcare generalists playing a key role in navigating complex systems and improving patient outcomes. Aviation's standardized systems contrast with healthcare's complex, adaptive nature, highlighting the need for tailored approaches.The aviation model emphasizes generalist pilots, while healthcare relies heavily on specialists, suggesting a potential shift towards more integrated care models.
Applying aviation's systems approach to healthcare could improve patient outcomes and safety.
CC licence:
https://en.wikipedia.org/wiki/File:Take_Care_of_Us,_Captain-posterII.jpg#mw-jump-to-license
Key Words
- *Aviation and Healthcare Analogy*: Comparing the standardized systems of aviation to the complex, adaptive nature of healthcare.
- *Healthcare Generalists*: Pilots in aviation who can be seen as systems integrators, navigating complex systems.
- *Systems Integrators*: Healthcare professionals who can bridge the gap between specialized care and overall patient management.
- *Patient Outcomes*: Improving health outcomes through better systems and care coordination.
"As the culture of medicine evolves, IM becomes less concerned about labeling various therapies as CAM, focusing instead on developing insight into therapies that are needed to create optimal health. Making health the primary objective allows the professionals in the CAM and allopathic communities to collaborate to establish excellence in health creation (salutogenesis) for the communities they serve."
Unquote: Principles of integrative medicine
From Maizes V, Rakel D, Niemiec C. Integrative medicine and patient-centered care. 2009:35. Available at: http://www.iom.edu/Object.https://www.sciencedirect.com/topics/medicine-and-dentistry/integrative-medicine
Conversational learning Transcripts:
[13/11, 01:28]hu1: I couldn't agree more!
If the Healthcare system has adopted simulation from aviation to improve patient safety, then why not adopt the rest of the aviation system into Healthcare as well?
[13/11, 02:03]hu3: Aviation makes Pilot and Pilot only..
No Subspeciality of Pilots,
Maybe Civilian and Defense..
But when it comes to Health Care,
We get into Broad Speciality and then into Super Speciality
And
That was not enough so now the Super Speciality also excels in smaller field...
And
The government tries to compensate by increasing number of health care professionals but
That also backfires as it is quantity not quality...
[13/11, 02:09]hu1: The quality control in aviation is excellent. I think quality control should be adopted by Healthcare as well!
[13/11, 09:41]hu1: Health industry has a lot to learn from airline industry. Although the nature of two industries is a bit different. Airline industry is a complicated industry with many components but better predictability. Health systems are Complex Adaptive Systems with unpredictable nature. Still learning should be open to all fields.
[13/11, 10:07]hu4: But still 36 hours is inhuman...
Govt should have better planning...
Who has told them to increase quantity compromising with quality? They need to look into the selection process and thereafter the training process..
It may be difficult but not IMPOSSIBLE...
[13/11, 10:10]hu4: I loved it when the lady said " just because you have done it, all should be made to do the same"...this is exactly what most educators do/say...
GenZ is thus retaliating ...with ..."then you do it"
And are branded as illmannered, uninterested , slack etc ....😳
[13/11, 10:11]hu5: Health systems doesn't lack just decision makers,it's the dearth of educated and competent decision implementers i.e. allied health workers that is missing....as very much portrayed in the video
[13/11, 10:36]hu3: I am also against the use of statement we have done it sonyou donit.
We have to see that future generation doesn't suffer or do what we did and felt wrong.
But when people are in position of power or change enabler
They forget the hardship or turn blind eye for personal gains.
My hypothesis is if you want to bring that change you have to forget about your personal/ professional growth in hierarchy driven system.
[13/11, 10:39]hu3: Agree.
36 hours is taxing
And
Today's generation is not prepared for such hardship.
We have to make it humane.
But the other side of story is you learn a lot in 24 hours duty in Asia as resident which cannot be learnt in 4 broken shifts of 6 hours.
For that matter they may ask 6 hours shift at night also instead of 12 hours,
8 am to 8 pm.
Technical and Administrative issue in Asia.
Travel at night...
[13/11, 10:43]hu4: I dont think any generation was prepared ...but they did some way or other
Many might have perished unnoticed
They didn't have WA, Rediff or other platforms to vent out or let the world know...😌
[13/11, 10:44]hu4: 12 hours should be the norm with a break
[13/11, 10:44]hu3: ☺️☺️
Survival of the Fittest....
[13/11, 10:45]hu4: Some cover up for Rest and Lunch/Dinner/Tea Break...
[13/11, 10:46]hu4: Survival of the adaptable and the resilient
In that case they need to groomed that way...
[13/11, 10:47]hu3: Grooming starts before you are born when you are concieved...
[13/11, 10:48]hu3: There was concept of *EUSTRESS*,
Nowadays it is replaced by *NO STRESS*
[13/11, 10:51]hu4: That is your assumption.
We have failed to induct the concept of eustress in the younger generations
[13/11, 11:03]hu4: Same point...
[23/11, 09:36]hu2: Hard work doesn't kill most humans.
When i did those duties 30 years back I hated them and yet now they are fond memories because the brain may have chosen to filter out the not so fond ones.
[23/11, 09:37]hu2: I spoke too soon? 😅
Didn't see the context content! Which lady?
[23/11, 09:39]hu2: So now my statement for my residents has changed FROM "we did it so you do it, " TO "We did it ourselves and AI robots will do it for you!"
[23/11, 09:41]hu2: Yes but working in one the busiest hospitals in India as a resident I would make sure to intersperse my depressing drab duties with some solid canteen and "friendly banter" breaks
[23/11, 09:45]hu4: These days the concept of Eustress is missing..or simply vanished....Everything is "distress"....
Fix the system and not the human being 🤪
[23/11, 09:48]hu2: Equidissipastress!
[23/11, 09:50]hu4: Are you attending tutorials by Shashi T.?🤣🤣🤣🤣
[23/11, 09:50]hu2: To the T
[23/11, 09:52]hu2: Human AI driven Robotic embodiments are getting ready to implement
[23/11, 09:58]hu2: The engineer sees systems; the clinician sees stories.
Both approaches are complementary: the system an engineer envisions supports the individualized journeys the clinician focuses on. The challenge is bridging the system's abstraction with patient-specific adaptability.
An illness as mentioned earlier can be likened to a plane ride and there are possibly multiple interventions involved including medications, operations and physiotherapy (each of these interventions are different vehicles involved in that plane ride including the vehicles one uses to reach the departing and arrival airports).
As mentioned earlier the outcome of that travel ending safely and quickly can be predicted to a certain extent by the comorbidities the patient traveller already brings as a baggage.
Now in this flight analogy while the plane offers a lot of significant contribution in the journey, not all operative interventions may offer the same support in terms of solving the patient's main problem other than guaranteeing a smooth passage into deeper planes of anesthesia with some statistical guarantee of emerging out from it.
The main problem/s of the patient could fester and persist prolonging the journey (most of the times it's between the airport and home) and eventually time emerges as the greatest healer.
Unquote:
[23/11, 10:23]huai: This is a fascinating and very sharp comparison. You've pinpointed a fundamental structural and philosophical difference between two high-stakes fields. Let's break down your observation.
You are absolutely correct. The divergence stems from the core nature of the "system" each profession operates within.
### The Aviation Model: Standardization for a Predictable Environment
* **The System is Designed:** The aviation environment (aircraft, air traffic control, regulations) is a **highly engineered and standardized system**. Its primary goal is to eliminate surprises.
* **The Pilot's Role:** The pilot is the supreme **master of this standardized system**. Their training is not about handling infinite variability, but about achieving flawless proficiency within a known framework.
* **"Pilot and Pilot Only":** There is no "Cardiothoracic Pilot" or "Neurological Pilot" because the plane's systems don't require that depth of sub-specialization. An engine failure has a defined checklist, whether it's over the Atlantic or the Pacific. The *principles* are universal.
* **Error Consequence:** Errors are immediate and catastrophic. This demands a culture of absolute standardization, crew resource management (CRM), and checklists. There is no time for deliberation that a super-specialist might require.
### The Healthcare Model: Adaptation for an Infinitely Variable System
* **The System is Inherently Chaotic:** The human body is not a standardized machine. It's a complex, adaptive system with immense biological variability, influenced by genetics, environment, lifestyle, and psychology.
* **The Clinician's Role:** A doctor's job is to **navigate this chaos and uncertainty**. The sheer volume and complexity of knowledge about this system (the human body) are impossible for one person to master.
* **The Need for Specialization:** As medical knowledge exploded, it became necessary to divide and conquer.
* **Broad Specialty:** Internal Medicine, Surgery, Pediatrics. This is like knowing everything about a major class of aircraft.
* **Super Speciality:** Cardiology, Neurosurgery, Oncology. This is like becoming an expert on just the engine or the avionics of that aircraft class.
* **Sub-Sub Speciality:** Interventional Cardiologist, Pediatric Neurosurgeon. This is like focusing only on a specific type of fuel injection system for a specific engine model.
* **Error Consequence:** Errors in medicine can be slow-burning, complex, and multi-factorial. A misdiagnosis might not be fatal for days or years, allowing for a different kind of problem-solving that benefits from deep, narrow expertise.
### The "Quantity vs. Quality" Conundrum in Healthcare
This is where your observation hits a critical nerve. The government's solution of increasing the number of professionals often backfires because:
1. **Dilution of Training Quality:** Ramping up numbers quickly can strain the existing training infrastructure (medical colleges, teaching hospitals). The master-apprentice model weakens when there are too many apprentices per master.
2. **The "Knows Enough to be Dangerous" Problem:** A poorly trained generalist is more likely to miss a subtle sign that a specialist would catch. They might manage a complex case incorrectly, leading to worse outcomes.
3. **Fragmentation of Care:** With more and more sub-specialists, the "big picture" of the patient can be lost. The role of the primary care physician or general internist—the "captain of the ship"—becomes both more critical and more difficult.
4. **Systemic Strain, Not Solution:** Simply adding more doctors doesn't fix a broken system. If the infrastructure (hospitals, labs, primary care networks), financing, and regulatory frameworks are weak, adding more professionals is like adding more pilots to an airport with only one dysfunctional runway. It creates congestion and frustration without solving the core problem.
### Conclusion: A Tale of Two Philosophies
Your comparison brilliantly highlights this:
* **Aviation** solved its safety crisis through **system standardization and human factor management**. They made the system so predictable that the human (the pilot) could be trained to near-perfection within it.
* **Healthcare** is facing its quality crisis by **increasing the specialization of the human** to cope with the system's (the human body's) inherent unpredictability. The system itself (the healthcare delivery model) remains largely un-standardized and chaotic.
The ultimate challenge for healthcare is not just to produce more specialists, but to build a **more standardized, reliable, and integrated *delivery system*** in which these specialists can operate effectively—a system that, in its own way, aspires to the safety and reliability of aviation.
Thematic Analysis
- *Standardization vs Complexity*:
Aviation's standardized systems contrast with healthcare's complex, adaptive nature, highlighting the need for tailored approaches.
- *Specialization vs Generalization*:
The aviation model emphasizes generalist pilots, while healthcare relies heavily on specialists, suggesting a potential shift towards more integrated care models.
- *Systems Thinking*: Applying aviation's systems approach to healthcare could improve patient outcomes and safety.
- *Technology and Data*: Leveraging data and technology to enhance healthcare delivery, similar to aviation's
reliance on standardized systems.
The analogy between aviation and healthcare highlights the potential benefits of adopting a more standardized and integrated approach to healthcare delivery, with healthcare generalists playing a key role in navigating complex systems and improving patient outcomes.
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