Last week a medical professional had a letter published in the Cape Times. In this he questioned the sanity of rules which allow for doctors working shifts of 30 hours plus, after the death of a young doctor in a fatigue-related crash. (Read the letter here).
Dr John Roos is a passionate advocate of CRM for the medical profession – I have worked with him at the recent ICEM (International Conference for Emergency Medicine) in Cape Town, where we co-presented an introductory workshop on CRM. Just from my anecdotal experience of the medical environment I am aware of the extreme demands on these professionals. Suffice to mention that medical malpractice is now the third largest cause of preventable deaths in the USA – in fact the statistics bear out the fact that you are much more likely to die unnecessarily in hospital than in an airliner:
According to the Western Cape Department of Health the regulations approved by the HPCSA (Health Professionals Council of SA) do allow for medical professionals to work shifts of up to 30 hours. (Article here).
Well, I am simply astonished at the Neanderthal system employed in our healthcare!
In Aviation we have been aware of the problem for decades. However, the fact that fatigue is a difficult concept to quantify has also been recognised for years. At a 2006 Paris conference on Aviation Safety hosted by the Flight Safety Foundation, IATA and the International Federation of Airworthiness papers presented pointed out how complex issues affecting pilot fatigue were.
Despite our best efforts at improving aviation safety, we are not out of the woods yet. Flight Global conducted a survey of Aviation Professionals a few years ago (Survey Results) and top of the list was fatigue among safety critical staff such as pilots, engineers and ATC’s.
This despite the fact that maximum hours for flight and duty are clearly defined and rigorously adhered to.
The next step is the legally required implementation of FRM and FRMS programmes, where airlines are required to actively monitor and manage pilots’ fatigue. This would imply identifying potentially fatiguing pairings and reporting on fatigue experiences.
Surely medical personnel must be involved in determining these parameters – yet they seem themselves impervious to the idea that doctors could possibly become fatigued.
So, I would rather fly than take the risk of being assessed or operated on by a fatigued medical practitioner! The stats bear me out.