Your Flight Doc: A User's Manual

Flying Safety, June, 2001 by Tom Luna

A good, involved, Flight Doc is a boost to the physical and emotional health of your flying squadron. This translates into improved safety and a reduced DNIF rate. This in turn leads to improved aircrew/sortie generation and mission accomplishment. Do you educate, train and support your flight surgeon? Have you made them part of your team? Do you go to bat for them when they need it? Bottom line: Is your Flight Doc "on board"?

The modern flight surgeon came on line in World War I. In that conflict, only 2% of in-theater aircraft losses were due to combat damage; 8% were due to mechanical/logistics problems, and a whopping 90% were due to human factors. Flight surgeons quickly became critical to flight safety through careful attention to human factors and the thankless task of enforcing medical standards. Even today, roughly two-thirds of all class A flight mishaps, and over 90% of fatal flight mishaps, are due to human factors. The role of a fully-engaged, operational flight surgeon is as critical today as ever.

Is your Doc active in the squadron? Are they active in flight (or asleep / catching up on paperwork in the back)? Do you make your Doc an active and integral member of your crew? Staff meetings? If you want to get the most out of your Flight Docs, you need to take an active role in helping them to be fully educated and trained in your operations and to have an active role in your unit. In order to do this, flight surgeons need to spend time with your flying unit--flying, training, attending meetings and social events, and sometimes just hanging out in the squadron. They also need to spend time with the life support crew and maintainers. Flight surgeons need to be familiar with, and fly all mission profiles in, your aircraft in order to put an operational "face" on their academic training in flight medicine and human factors. If you don't have any multi-place aircraft, you'll need to get them in whatever simulator you have available. This all takes some effort on your part. If you do this right, you can then use their advocacy to proactively address human factors issues like fatigue, scheduling, stress and ergonomics, as well as go to bat for your squadron on medical standards and preventive medicine issues.

Does your Doc spend time in the squadron, or does the Doc get buried in patient care? If continually buried in the clinic, they cease to be operational Flight Docs and are reverting to primary care providers. Many people don't realize that Aerospace Medicine is a preventive medicine specialty, not a primary care specialty For instance, primary care for aircrew dependents is performed for the peace of mind it provides to the aircrew and the insight it provides the Flight Doc into the stresses the aircrew is under at home; it is done first and foremost for safety and prevention reasons. The excellent care received by dependents is truly essential--but it is an added benefit to its purpose of aircrew safety and preventive medicine.

A longtime rule of thumb has been that flight surgeons should spend only about 50% of their day in direct patient care. They should spend the rest of their time on operational, occupational, preventive medicine/public health and administrative medicine (usually in support of their aircrews ... you generate a lot more medical paperwork than nonaircrew!). Patient care is important, but there are many providers at the local medical treatment facility (MTF) trained to provide primary care as their chief duty. Only flight surgeons can provide the operational medicine critical to flying units, and the bulk of that occurs not in the MTF but on the flightline. Operational medicine and flight safety programs should not suffer due to primary care pressures.

Historically, most senior medical staff at base level had flight medicine training. Several years ago, however, medical leadership opportunities were broadened. This was a big step forward in many ways, but unfortunately there was a concomitant loss of flightline knowledge for our base-level medical leaders. Nowadays, in many cases, they may have little understanding of what flight surgeons do and are responsible for. In some cases, they may need you to explain to them how important flight surgeons are to your operations.

Do you ensure your Flight Docs are an active part of your squadron staff meetings? Do you ensure they engage on deployment planning and scheduling issues? Do you get their advocacy on life support and ergonomic issues? Can you count on your Doc to give you the pulse of your unit when you need that? With proper care and feeding from you, your Flight Doc will be a fully-engaged aircrew generator and safety proponent.

Is your Flight Doc on board?