Is there a doctor on board?

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Siggy said:
The catch is how long would it take to divert and land the plane. Does it really matter if you get on the ground 10 minutes earlier?
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probably not but if it was YOUR call to get to the ground 10 min later and something bad happened, how much does that matter to a jury?

dunno
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aProgDirector said:
You may be protected by the Good Sam laws for medical care, but she can sue you for her ankle fracture from your dog injuring her...



This is a very bad idea. To repeat what's already been on the thread, taking ANY compensation completely voids any Good Sam protection you have. Afree flight, seat upgrade, or a free drink coupon, or a free pillow -- it doesn't matter. Once you take anything, you are no longer a Good Sam. You are being paid. And your med mal may or may not cover you.
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if you are providing the care to the passenger, but it's the company that rewards you, does that still nullify the law?

I guess that makes sense, we are paid by a 3rd party most of the time when we give care

medmal sucks

my whole thing is that in some ways you are damned if you do, damned if you don't, and the best thing I saw in this thread was to make sure there's no "duty to act" thing that might bite you in the ass
 
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Crayola227 said:
probably not but if it was YOUR call to get to the ground 10 min later and something bad happened, how much does that matter to a jury?

dunno
Click to expand...
Sure... and every consult should be done stat... you know... just in case something goes wrong that the subspecialist could have fixed.
 
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Siggy said:
Sure... and every consult should be done stat... you know... just in case something goes wrong that the subspecialist could have fixed.
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Everyone always wants a stat consult from us... "We need to get this guy to the rehab floor stat--it's a matter of life and death--our social worker and/or case manager will kill my intern if we don't find a dispo for this guy!"

I remember working with a psychiatrist once who was on a flight and they asked if there was a physician on board. He looked around and didn't see anyone getting up to answer the call, so he did, hoping the guy wasn't having chest pain or something. It turned out a kid had a bloody nose (simple enough). After he got off another passenger came up to him and asked him what happened, and that he was EM physician. The psychiatrist was really pissed the other physician didn't volunteer because at the time of the call they had no way of knowing what the medical issue was, and the other guy was a freakin' EM physician!
 
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gutonc said:
You don't "have" to turn it down. But if you accept it, and they later go on to have a serious complication from that event...no matter how amazingly you performed at the time...you have now established a doctor/patient relationship with them and you are potentially legally liable. Since you would be practicing 3rd world medicine in a first world (OK, fine...American) legal climate, most of us would say that they'd have to offer you a 6-7 figure "gift" to make it worth accepting it.

Now, as to whether or not you can accept a "token of appreciation" from the airline, I think that's a little more up in the air (I crack me up). But the way airlines treat their customers these days, unless you deploy a stent across a 99% occluded LAD in row 29 and prevent them from having to divert that plane to Akron for the STEMI, the most you're likely to get is a free drink and a credit for a free checked bag on your next flight.
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Currently overseas and granted, this was on an internationally bound flight, but a US based airline, we got a bit more than that from the airline. Well, maybe more of an upgrade, ie. Bottle of champagne and upgraded seats on our return trip which I am very much looking forward to next week.
 
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From an Australian point of view: there's an affirmative duty to assist. Even medical students--anybody with medical training--are required to identify themselves and offer assistance within their scope of training. In fact, there's a famous case of a radiologist who passed an MVA in rural Australia without stopping. Instead, she drove straight to the nearest hospital to get help. The patient later died. She was successfully charged with negligence because, as a doctor, she could have provided some basic level of care that might have saved the patient.

Here's a discussion on the case: http://lawyerslawyer.net/2014/02/03...ing-a-crash-not-to-stop-and-offer-assistance/

I'm bringing this up because I was on a trans-pacific flight to the US from Australia. A call goes out: "Is there a doctor on board"? As a fourth year medical student, I keep my mouth shut. 10 minutes later. "We need anybody with medical training." Okay. I should say something. I page the attendant and say, "I'm a fourth year medical student and I can offer some basic assistance if nobody else is available." "Okay, come see what you can do." I go to the first-class cabin and see a flight attendant performing VERY poor chest compressions with the AED unopened. I think, at least I can help with this. Before I do anything, the chief flight attendant yanks my arm and asks, "Can I see you liscence"? "I'm a senior medical student with ALS training." "Well, you can't be here." Oooookay. I stand there very conflicted. But the patient soon regains consciousness, and I just walk back toward my seat. It was a very weird experience.

Americans, your med-mal laws are FREAKIN' WHACK.
 
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lymphocyte said:
From an Australian point of view: there's an affirmative duty to assist. Even medical students--anybody with medical training--are required to identify themselves and offer assistance within their scope of training. In fact, there's a famous case of a radiologist who passed an MVA in rural Australia without stopping. Instead, she drove straight to the nearest hospital to get help. The patient later died. She was successfully charged with negligence because, as a doctor, she could have provided some basic level of care that might have saved the patient.

Here's a discussion on the case: http://lawyerslawyer.net/2014/02/03...ing-a-crash-not-to-stop-and-offer-assistance/

I'm bringing this up because I was on a trans-pacific flight to the US from Australia. A call goes out: "Is there a doctor on board"? As a fourth year medical student, I keep my mouth shut. 10 minutes later. "We need anybody with medical training." Okay. I should say something. I page the attendant and say, "I'm a fourth year medical student and I can offer some basic assistance if nobody else is available." "Okay, come see what you can do." I go to the first-class cabin and see a flight attendant performing VERY poor chest compressions with the AED unopened. I think, at least I can help with this. Before I do anything, the chief flight attendant yanks my arm and asks, "Can I see you liscence"? "I'm a senior medical student with ALS training." "Well, you can't be here." Oooookay. I stand there very conflicted. But the patient soon regains consciousness, and I just walk back toward my seat. It was a very weird experience.

Americans, your med-mal laws are FREAKIN' WHACK.
Click to expand...

Who carries their license around wtf
 
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lymphocyte said:
From an Australian point of view: there's an affirmative duty to assist. Even medical students--anybody with medical training--are required to identify themselves and offer assistance within their scope of training. In fact, there's a famous case of a radiologist who passed an MVA in rural Australia without stopping. Instead, she drove straight to the nearest hospital to get help. The patient later died. She was successfully charged with negligence because, as a doctor, she could have provided some basic level of care that might have saved the patient.

Here's a discussion on the case: http://lawyerslawyer.net/2014/02/03...ing-a-crash-not-to-stop-and-offer-assistance/

I'm bringing this up because I was on a trans-pacific flight to the US from Australia. A call goes out: "Is there a doctor on board"? As a fourth year medical student, I keep my mouth shut. 10 minutes later. "We need anybody with medical training." Okay. I should say something. I page the attendant and say, "I'm a fourth year medical student and I can offer some basic assistance if nobody else is available." "Okay, come see what you can do." I go to the first-class cabin and see a flight attendant performing VERY poor chest compressions with the AED unopened. I think, at least I can help with this. Before I do anything, the chief flight attendant yanks my arm and asks, "Can I see you liscence"? "I'm a senior medical student with ALS training." "Well, you can't be here." Oooookay. I stand there very conflicted. But the patient soon regains consciousness, and I just walk back toward my seat. It was a very weird experience.

Americans, your med-mal laws are FREAKIN' WHACK.
Click to expand...
If this ever happens again, proof of ACLS training probably would have been sufficient.

I carry a copy of my CA license with me (they sent me a pocket card) but the other state I'm licensed in doesn't give out pocket cards. I don't bother carrying my ACLS card with me.
 
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it seems pretty ridiculous to demand someone rendering help to show a license. If they want to decline trained help, then so be it. You'd think that would be more of a liability to the airline if there's a bad outcome---forcing someone who could help "save" a patient to leave rather than let them help.
 
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The airline is helping protect themselves from liability by asking. They don't want someone to sue saying they allowed a non professional to provide medical care. It's a litigious world we live in.

Sent from my Nexus 4 using Tapatalk
 
This entire thread is ridiculous. Not because of what anyone has said, but because we've had to say any of it.

In a rational world, it would go down like this:
'Overhead Page': "If there's a doctor on board, please ring your call button.
"Hi, I'm Dr. Gutonc, how can I help?"
"Mr. Jones in 11D is having chest pain"
"Let me see what I can do. Bring your medical kit and, if you have a doc on call on the ground please get in touch with them now."
...a bunch of stuff happens...Mr. Jones lives or dies in spite of anything you did or didn't do (because that's how things work in the real world)

The end. Maybe you get a first class upgrade on your next flight...or 10K FF miles...or a free drink...or nothing. And both you and Mr. Jones (or his decedents) would move on with your lives, recognizing that the world keeps on spinning.
 
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gutonc said:
This entire thread is ridiculous. Not because of what anyone has said, but because we've had to say any of it.

In a rational world, it would go down like this:
'Overhead Page': "If there's a doctor on board, please ring your call button.
"Hi, I'm Dr. Gutonc, how can I help?"
"Mr. Jones in 11D is having chest pain"
"Let me see what I can do. Bring your medical kit and, if you have a doc on call on the ground please get in touch with them now."
...a bunch of stuff happens...Mr. Jones lives or dies in spite of anything you did or didn't do (because that's how things work in the real world)

The end. Maybe you get a first class upgrade on your next flight...or 10K FF miles...or a free drink...or nothing. And both you and Mr. Jones (or his decedents) would move on with your lives, recognizing that the world keeps on spinning.
Click to expand...

Yea, but how would lawyers be able to make money if not for all you doctors doing harm on everybody?
 
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For those who subscribe, EM:RAP also had a good review of in-flight medical emergency procedures in their May 2015 episode, in the Lin Sessions. The gist: if you offer or render care aboard an American-flagged aircraft, you are covered under a separate, federal law called the Aviation Medical Assistance Act, not the Good Sam laws of whatever state or city you happen to be flying to, from or over. That law gives "licensed medical providers," which are defined as physicians, nurses, PAs and paramedics, very broad immunity from tort for caring for an ill or injured person aboard an airliner, excluding gross negligence or willful misconduct. On an American-flagged airliner, you do not have a duty to respond, but if you are flying on a craft registered in a nation where such a duty does exist, you may well be on the hook. (Most EU nations do have a duty-to-respond law, as does Australia.) It's not a bad idea to check the local law if you're planning air travel overseas.

Also, of note: Accepting a small gift from the airline - not the patient - does not invalidate your protection under AMAA. That extra slice of cake or free seat upgrade from United/Delta/American/whoever will not open you up to multi-millions in tort liability. Just don't let the patient buy you a drink afterward (and really don't let him/her buy you a drink before...!)

From my own experience, I've responded to three in-flight emergencies, twice on Delta traveling to/from the EU, and once on KLM from the EU to East Africa. In all cases, I was put in touch with a ground medical controller, and I was asked for my name, address, employer, licensure (like most states, MI gives you that cute little wallet card with your wall-mount license) and given a modest in-flight credit for my assistance. (In two out of the three cases, I also found myself in the rather amusing position of offering to step aside for responding physicians, both of whom promptly said "no thanks, ER nurse beats dermatologist" and sat back down. Le sigh. :yeahright:)
 
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Traumahawk said:
For those who subscribe, EM:RAP also had a good review of in-flight medical emergency procedures in their May 2015 episode, in the Lin Sessions. The gist: if you offer or render care aboard an American-flagged aircraft, you are covered under a separate, federal law called the Aviation Medical Assistance Act, not the Good Sam laws of whatever state or city you happen to be flying to, from or over. That law gives "licensed medical providers," which are defined as physicians, nurses, PAs and paramedics, very broad immunity from tort for caring for an ill or injured person aboard an airliner, excluding gross negligence or willful misconduct. On an American-flagged airliner, you do not have a duty to respond, but if you are flying on a craft registered in a nation where such a duty does exist, you may well be on the hook. (Most EU nations do have a duty-to-respond law, as does Australia.) It's not a bad idea to check the local law if you're planning air travel overseas.

Also, of note: Accepting a small gift from the airline - not the patient - does not invalidate your protection under AMAA. That extra slice of cake or free seat upgrade from United/Delta/American/whoever will not open you up to multi-millions in tort liability. Just don't let the patient buy you a drink afterward (and really don't let him/her buy you a drink before...!)

From my own experience, I've responded to three in-flight emergencies, twice on Delta traveling to/from the EU, and once on KLM from the EU to East Africa. In all cases, I was put in touch with a ground medical controller, and I was asked for my name, address, employer, licensure (like most states, MI gives you that cute little wallet card with your wall-mount license) and given a modest in-flight credit for my assistance. (In two out of the three cases, I also found myself in the rather amusing position of offering to step aside for responding physicians, both of whom promptly said "no thanks, ER nurse beats dermatologist" and sat back down. Le sigh. :yeahright:)
Click to expand...

Curious, do you know of any case against a physician where this law was successfully used?

I was told in the past that this only covered the airlines, but in reading it, it seems to cover any passenger who is even somewhat qualified who renders assistance.

https://www.govtrack.us/congress/bills/105/hr2843/text/enr#compare=eh
 
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To my knowledge, there has never been a successful case where a physician (or any "licensed provider") was held liable for care rendered under AMAA. I suppose if the patient complained of excess flatulence from eating airline snack mix, and you as a psychologist (or I as an RN) decided to do a ballpoint pen cric in the aisleway and then left the patient lying there while enjoying a double vodka tonic up in First Class*, there would likely be a liability issue, but in general the odds of a passenger deciding to file suit, much less being successful in the pursuit, are so vanishingly low as to be a non-consideration.

Another consideration, not of professional liability but of contract of carriage: the airlines take a very, very dim view of passengers who misrepresent illness for personal gain. One of the patients I assisted turned out to be faking symptoms for purposes of securing a seat upgrade. (I suspected symptoms out of proportion to physical findings, but another passenger had actually overheard him discussing his plot with his seatmate and ratted him out to the chief purser.) The airline allowed the passenger to keep the seat for the rest of the flight, but slapped him with a bill for the full cash value of his ill-gotten First Class ticket upon landing, due and payable immediately. I suspect even the most shameless ambulance chaser might think twice about taking on a med mal case where the plaintiff had already been found at fault in a contract dispute arising from the same incident.

* hyperbole for humor's sake
 
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Does physician medical malpractice really not cover a good samaritan situation? This surprises me, because one of the selling points of pharmacist insurance is that it will cover advice/consultations we do off-duty, when we would not be covered by our work-place insurance. I would have expected private medical malpractice insurance to also cover such situations (obviously if one is solely relying on their workplace insurance, they wouldn't be covered.)
 
BidingMyTime said:
Does physician medical malpractice really not cover a good samaritan situation? This surprises me, because one of the selling points of pharmacist insurance is that it will cover advice/consultations we do off-duty, when we would not be covered by our work-place insurance. I would have expected private medical malpractice insurance to also cover such situations (obviously if one is solely relying on their workplace insurance, they wouldn't be covered.)
Click to expand...
Off-duty coverage is one of the big selling points of nursing malpractice insurance as well (that and "your employer will fire you and risk a wrongful termination suit, rather than defend you in a malpractice case"). I'm also surprised to hear that physician insurance does not routinely include this coverage. Seems like you should at least be able to purchase a rider policy to cover such events...
 
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we're always the most ****ed when it comes to legal liability

in fact, that is the main power of the MD in practical terms as far as anyone is concerned, you are able to assume the most legal liability in all things
 
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BidingMyTime said:
Does physician medical malpractice really not cover a good samaritan situation? This surprises me, because one of the selling points of pharmacist insurance is that it will cover advice/consultations we do off-duty, when we would not be covered by our work-place insurance. I would have expected private medical malpractice insurance to also cover such situations (obviously if one is solely relying on their workplace insurance, they wouldn't be covered.)
Click to expand...
Most physician malpractice insurance is tied directly to the practice environment. If you end up moonlighting at a different hospital or even volunteering at a sporting event, you either have to buy an additional policy or some kind of rider for that event. Or your employer has to provide it.
 
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Traumahawk said:
For those who subscribe, EM:RAP also had a good review of in-flight medical emergency procedures in their May 2015 episode, in the Lin Sessions. The gist: if you offer or render care aboard an American-flagged aircraft, you are covered under a separate, federal law called the Aviation Medical Assistance Act, not the Good Sam laws of whatever state or city you happen to be flying to, from or over. That law gives "licensed medical providers," which are defined as physicians, nurses, PAs and paramedics, very broad immunity from tort for caring for an ill or injured person aboard an airliner, excluding gross negligence or willful misconduct. On an American-flagged airliner, you do not have a duty to respond, but if you are flying on a craft registered in a nation where such a duty does exist, you may well be on the hook. (Most EU nations do have a duty-to-respond law, as does Australia.) It's not a bad idea to check the local law if you're planning air travel overseas.

Also, of note: Accepting a small gift from the airline - not the patient - does not invalidate your protection under AMAA. That extra slice of cake or free seat upgrade from United/Delta/American/whoever will not open you up to multi-millions in tort liability. Just don't let the patient buy you a drink afterward (and really don't let him/her buy you a drink before...!)

From my own experience, I've responded to three in-flight emergencies, twice on Delta traveling to/from the EU, and once on KLM from the EU to East Africa. In all cases, I was put in touch with a ground medical controller, and I was asked for my name, address, employer, licensure (like most states, MI gives you that cute little wallet card with your wall-mount license) and given a modest in-flight credit for my assistance. (In two out of the three cases, I also found myself in the rather amusing position of offering to step aside for responding physicians, both of whom promptly said "no thanks, ER nurse beats dermatologist" and sat back down. Le sigh. :yeahright:)
Click to expand...

Thanks for this nice summary. I'm happy to be wrong. Especially when the right answer is an improvement over my answer.
 
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BidingMyTime said:
Does physician medical malpractice really not cover a good samaritan situation? This surprises me, because one of the selling points of pharmacist insurance is that it will cover advice/consultations we do off-duty, when we would not be covered by our work-place insurance. I would have expected private medical malpractice insurance to also cover such situations (obviously if one is solely relying on their workplace insurance, they wouldn't be covered.)
Click to expand...
If you're a good Samaritan, malpractice really shouldn't be relevant as you 1) have no duty to the patient and 2) cannot violate a non-existent duty.
 
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Raryn said:
Eh, even if you're doctor, you could be a doctor of English literature. Or a pathologist. Unless they wanted a stat analysis of the themes of a piece of literature or an autopsy, both would be of roughly equal utility on a flight (unless the pathologist was still close enough to medical school to remember some basics, but even that...).
Click to expand...

Hey, hey, give us a little credit. I'm sure we could MacGyver up a microscope with someone's binoculars and make a red wine stain. All we'd have to do is cut into the patient's chest with plasticware to get a biopsy and render a diagnosis of ischemic changes consistent with early myocardial infarction, clinical correlation recommended. ;)
 
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ScubaV said:
Hey, hey, give us a little credit. I'm sure we could MacGyver up a microscope with someone's binoculars and make a red wine stain. All we'd have to do is cut into the patient's chest with plasticware to get a biopsy and render a diagnosis of ischemic changes consistent with early myocardial infarction, clinical correlation recommended. ;)
Click to expand...
Genius. And doesn't even require using a stethoscope. :laugh: :thumbup:
 
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ScubaV said:
Hey, hey, give us a little credit. I'm sure we could MacGyver up a microscope with someone's binoculars and make a red wine stain. All we'd have to do is cut into the patient's chest with plasticware to get a biopsy and render a diagnosis of ischemic changes consistent with early myocardial infarction, clinical correlation recommended. ;)
Click to expand...
The radiologist seated up in 1D would like to add: perfusion abnormalities not excluded on this study, consider follow-up imaging at 3-6 months if clinically indicated. ;)

QofQuimica said:
Genius. And doesn't even require using a stethoscope. :laugh: :thumbup:
Click to expand...
Oh, so many "The View" jokes, so little time... :whistle:
 
Talking about licensure, how about being in an airplane which is registered, flying from, over and to a country in which you're not licensed to practice medicine?
How would that pan out with lawyers?

I guess what matters is that you're registered somewhere, right?
 
gutonc said:
This entire thread is ridiculous. Not because of what anyone has said, but because we've had to say any of it.

In a rational world, it would go down like this:
'Overhead Page': "If there's a doctor on board, please ring your call button.
"Hi, I'm Dr. Gutonc, how can I help?"
"Mr. Jones in 11D is having chest pain"
"Let me see what I can do. Bring your medical kit and, if you have a doc on call on the ground please get in touch with them now."
...a bunch of stuff happens...Mr. Jones lives or dies in spite of anything you did or didn't do (because that's how things work in the real world)

The end. Maybe you get a first class upgrade on your next flight...or 10K FF miles...or a free drink...or nothing. And both you and Mr. Jones (or his decedents) would move on with your lives, recognizing that the world keeps on spinning.
Click to expand...
As mentioned you missed the part were Mr. Jones' family then seeks out someone to blame. Because in their real world Mr. Jones doesn't die he only lives unless someone did something wrong.

Sent from my SM-G900V using SDN mobile
 
MLT2MT2DO said:
As mentioned you missed the part were Mr. Jones' family then seeks out someone to blame. Because in their real world Mr. Jones doesn't die he only lives unless someone did something wrong.
Click to expand...
And you missed the part where I said "in a rational world". Which this clearly is not.
 
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Dr026 said:
Talking about licensure, how about being in an airplane which is registered, flying from, over and to a country in which you're not licensed to practice medicine?
How would that pan out with lawyers?

I guess what matters is that you're registered somewhere, right?
Click to expand...
Yep.

Last week, me with an American license, flying on a French airline, over international waters; didn't seem to matter to them as long as I had identification showing I was a licensed physician.
 
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Winged Scapula said:
Yep.

Last week, me with an American license, flying on a French airline, over international waters; didn't seem to matter to them as long as I had identification showing I was a licensed physician.
Click to expand...
Implant exploded at 35K feet on the way home from Cannes?

Kidding...I kid.
 
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gutonc said:
Implant exploded at 35K feet on the way home from Cannes?

Kidding...I kid.
Click to expand...
LOL...not sure. There were several physicians on board so by the time I got my identification out of the overhead, someone else had attended to the patient. It was pretty quite afterwards so most likely something minor.

Had a hypoglycemic diabetic flying home from Greece last year.
 
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Winged Scapula said:
LOL...not sure. There were several physicians on board so by the time I got my identification out of the overhead, someone else had attended to the patient. It was pretty quite afterwards so most likely something minor.

Had a hypoglycemic diabetic flying home from Greece last year.
Click to expand...
I long ago lost my pocket MD license. No way I'm bothering to get it back.
 
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cbrons said:
BAsed on this thread, I am surprised how much this seems to happen...
Click to expand...
It seems to happen on every international flight I take ;)

Then again, lots of things happen when/where I travel: synagogue bombing in Istanbul, earthquake in Morocco, subway bombing in Madrid, riots in Paris. I was there for all of them.
 
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Winged Scapula said:
It seems to happen on every international flight I take ;)

Then again, lots of things happen when/where I travel: synagogue bombing in Istanbul, earthquake in Morocco, subway bombing in Madrid, riots in Paris. I was there for all of them.
Click to expand...
You must live an exciting life. Maybe Dos equis will make a commercial with you now that Jonathan Goldsmith is retired.
 
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Winged Scapula said:
It seems to happen on every international flight I take ;)

Then again, lots of things happen when/where I travel: synagogue bombing in Istanbul, earthquake in Morocco, subway bombing in Madrid, riots in Paris. I was there for all of them.
Click to expand...
What a coincidence.......
 
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Winged Scapula said:
It seems to happen on every international flight I take ;)

Then again, lots of things happen when/where I travel: synagogue bombing in Istanbul, earthquake in Morocco, subway bombing in Madrid, riots in Paris. I was there for all of them.
Click to expand...
...
I would be careful about pointing this out - there is a pattern here that might raise some eyebrows!
 
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Or s/he might just be a card-carrying member of the International Academy of Black Clouds and Trouble Magnets. Lord knows my ID number is in the way low digits; we might even have crossed paths (along with several black cats and at least one broken mirror) at the last meeting...


Sent from my iPhone using SDN mobile
 
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Traumahawk said:
Or s/he might just be a card-carrying member of the International Academy of Black Clouds and Trouble Magnets. Lord knows my ID number is in the way low digits; we might even have crossed paths (along with several black cats and at least one broken mirror) at the last meeting...


Sent from my iPhone using SDN mobile
Click to expand...

Interestingly during residency I was actually a WHITE cloud. Seems just to be with travel I guess.
 
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Raryn said:
Somehow I doubt that a US Breast Surgeon is involved in any terrorist organizations... Or is that what WS wants us to think?
Click to expand...
But you see, I'm the unlikely suspect:

middle aged blonde WASPy looking, usually relatively dressed up

Yet often traveling alone, with a full passport; the latter two tend to raise questions although my interview for the Global Entry card was about 3 minutes in length so the TSA must have decided I wasn't too much of a threat to security.
 
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