"the panel"

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Dear all,
 
I am another doctor from Australia who has had a long association with helicopters and medicine and a close friend of Steve Walker.
 
I am an consultant anaesthetist (anesthesiologist to our USA friends) who still flies as one of a crew of 4 (pilot, crewman, paramedic and doctor) about 1 day a fortnight and have done so for 17 years. I also am heavily involved in dispatching helicopters about 1 day a week and in teaching retrieval medicine another day a week or so.
 
I do am saddened by the events that have occurred in the USA with the loss of numerous helicopters and crews and my heart goes out to those who have lost friends and workmates.
 
I am also a long-term sleeper on trauma.org and only occasionally comment.
 
Obviously this issue has ignited a cause that has been simmering in the USA for a long time and there have been some very forceful and forthright comments made on all sides that make it obvious to an outsider that "something is rotten in the state of Denmark" to badly misquote Shakespeare.
 
I feel it would be good to have an "enquiry/discussion/panel" but I wish to make a couple of points.
 
1/ As an experienced senior consultant doctor who has been heavily involve in this business for years, any "enquiry/discussion/panel" has to involve pilots, flight regulators, senior health officials and probably in the USA senior health insurance personnel as well as health (doctors/flight nurses/flight paramedics) personnel if it is to achieve anything other than be a talkfest.
All these other "non medical" areas have as much to do with the "operating environment" as health does and probably account for more of the "problems".
  
2/ It is very hard to lump "helicopters" together as a group. They can be used in a medical sense for
a/ rescue from cliffs or the sea etc
b/ short flights to the scene of acute trauma in congested cities in the hope of getting patients back to trauma hospitals ASAP.
c/ longer distance flights in rural settings because any hospital is a long way away.
d/ taking patients from a "small" hospital to a "bigger" hospital because they cannot get the care they require in the small hospital. 
The reason for their existence for each of these different "services" are different and the piloting, regulatory and medical background to them vary and they should be looked at separately.
In Germany for instance there are 3 separate systems to cover a/, b/, and d/ and the country is too small and the medical infrastructure too rich for c/ to really be very necessary.
The big debate in the USA seems to be around b/ and d/ and they are different animals and in my mind should be considered separately not together.
 
Dr Ken Harrison
 
 
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