Ah, for astonishingly safe!

While there are differences between airline travel and the provision of health care, the one has a lot to teach the other.  Note this interview of Patrick Smith in the New York Times.  Read this description and imagine if the same things were in place throughout the health care system.

Q. You say air travel today is astonishingly safe. Why?

A. We’ve engineered away what used to be the most common causes of catastrophic crashes. First, there’s better crew training. You no longer have that strict hierarchical culture in the cockpit, where the captain was king and everyone blindly followed his orders. It’s team oriented nowadays. We draw resources in from the cabin crew, people on the ground, our dispatchers, our meteorologists, so everyone’s working together to ensure safety. 

The modernization of the cockpit in terms of materials and technology has eliminated some of the causes for accidents we saw in the ’70s into the ’80s. And the collaborative efforts between airlines, pilot groups and regulators like the Federal Aviation Administration and the International Civil Aviation Organization, a global oversight entity, have gone a long way to improving safety on a global level. 

To bring this home:  Poorly designed systems, poorly functioning teams, and work-around laden work flows, aided and abetted by inadequate reporting of adverse events and near misses, kill the equivalent of a 727 jetliner full of passengers every day in America's hospitals.  If this happened for three days in a row in the airline industry, we'd shut down the airports and ground the flights until we figured out what went wrong and how to fix it.

If airlines are astonishingly safe, as suggested by Mr. Smith, hospitals are astonishingly dangerous.  I don't want to believe that the difference is the case because pilots have an additional incentive in that they go down with the ship.  I want to believe that doctors simply don't understand that their pledge to do no harm is not being fulfilled.