From the desk of the EMD: Airlines and doctors

April 17, 2017

Everyone has heard, read about, or seen the video of the Louisville physician dragged off United flight 3411 in Chicago for failing to “voluntarily” get off the jet to make way for some United crew members. He refused to leave the plane as he told the law officers he had patients scheduled the next morning. I think we can all empathize with his situation. None of us want to have to cancel a clinic and upset our patients if we can avoid it. This was truly a fiasco and a public relations nightmare for United.

I had my own recent nightmare with the airline industry shortly before the United incident. It had to do with Delta, my hometown airline in Atlanta. In fact, you may have heard the old joke, "When you die, whether you're going to heaven or hell, you'll have to connect through Atlanta." During a trip to Washington, DC, where I was doing some lobbying and attending a meeting on biologics and biosimilars, there was a series of thunderstorms in Atlanta, which shut down the airport for over 5 hours. This led to massive flight cancellations for days by Delta due to computer problems with getting the airplanes and crews to the right cities. I was supposed to leave DC on a Thursday night, and got cancelled and rescheduled to Friday night. By mid-Friday afternoon, I was cancelled again and told I couldn’t get a seat until Monday! The Delta agent said there was nothing he could do about it, as Delta continued to cancel more flights through the weekend. He expressed to me that my best option was to rent a car and drive back home. Laura, the College’s travel agent at Uniglobe, tried to find me any flight to Atlanta without success. Nor could she find me a rental car in the DC area. She was able to locate one in Richmond, Virginia about 90 miles away. So I took an Uber to the Richmond airport, got the rental car, and started my 500-mile journey back to Atlanta. At least I didn’t get bloodied, lose 2 front teeth, and end up in the hospital.

There is a good news story with doctors and airlines. On a recent Southwest Airline flight from Atlanta to Houston, a retired Air Force colonel became ill. It just so happened that allergists who had attended the Academy meeting in Atlanta were on the flight. Of the physicians who helped stabilize the patient were three allergists, Andrew Grant, MD, FACAAI, a professor of internal medicine at the University of Texas Medical Branch in Galveston; Kristen Moore, MD, FACAAI, an allergist at Houston Allergy; and Lenora Noroski, MD, an allergist at the Texas Children's Hospital. One of the news stories quoted Dr. Grant, “I had a similar experience on the same airline where the patient had severe heart disease and died in-flight. I am glad that many physicians stepped up in this flight. That's what health care should be all about."

So why did I want to write about these three episodes?  Is there a lesson here for us as allergists? As physicians continue to merge into larger and larger groups and there is increasing consolidation in the health care industry, just like we have seen with the airlines, we must not lose our focus on the patient. As the airlines have become oligopolies, the customer is not necessarily number one, as we have seen. With all the bureaucracy appearing in medicine, overriding concern about cost issues, and remembering to check all the right boxes on our EHR, we have to make sure we don’t forget our mission as allergists—the care of the patient. As Andy Grant said “That's what health care should be all about.”