Ten Ways to Increase Flights

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"Well, the problem is that they contradict themselves.  The very
premises of
'appropriate flight requests' and increasing the number of flights are
antipodal given that we already fly more people than need to be flown."

Your logic is flawed, and you're smart enough to make me believe it's
intentional.  Unacceptable overtriage does not rule out unacceptable
undertriage.  Adhering to triage rules may as easily increase
appropriate uses as eliminate dangerous ones.  In Maine, we still
encounter cases where steadfastly ignorant providers delay or deny
flight transport in cases which scream for it.  Unsurprisingly, most of
these providers are critics of air medicine generally.  

Further, speaking hypothetically (wink), one might even imagine systems
in which properly triaged patients are transported by substandard
competing services -- at the expense of the system, and occasionally the
patient.  In a free market, a superior service can (and should, without
delay) bury inferior, dangerous competitors.  These tools can't hurt.

"It depends on the definitions use.  From the sound of it (both the
'amputated' portion and what is on the website) their definition of
'worthy'
is that they have bribed, coddled and done everything short of fellating
the
local ground EMS providers.  I read nothing there that made me believe
their
definition of safe is anything more than passing the required
inspections
and being able to launch.  #2 is a wishy-washy sort of statement without
any
real teeth....more or less just a reminder to be polite and
professional."

There is no hope, nor dignity, in responding to this baseless, tasteless
bullshit.  

"It's possible, but since they give no evidence to that end, the
reasonable
judgment is that they are simply working to increase profits since every
one
of the measures is geared solely to that end.   If they were trying to
improve things, there would be clauses for encouraging medical review of
the
calls to assure only those patients who need to be flown are flown."

Let's not pretend that ThinkThroughTools is anything more or less than a
coaching and consulting agency.  They've found a niche in air medicine,
and they're trying to offer a service at a reasonable profit.  

Smart hospitals dump millions of dollars into just this sort of service
amplification every year, without any explicit or implied clinical
goals.  It's up to the hospitals to do good work; they hire consultants
because healthcare in general is late to the competitive market mindset,
to its undoing.  That you're not finding evidence of distinct programs
in safety or triage or medical necessity is in large part a result of
these being beyond the scope of the service.  But it's certainly also
because you've already judged the company to fit your paradigm.  

References to safety and appropriateness are not hard to find throughout
the web site -- if you look, and indulge them a modest moral or ethical
benefit of the doubt.  It's strategically effective but intellectually
lazy to paint them as money-grubbing sleaze balls on zero evidence.
There's a promising future in politics for you.

"By the way, it's not reflexive nor is it empirical.   I dislike their
stance."

"This is not helping.  Increasing the number of flights will only serve
to
increase the death toll unless we completely overhaul the mindset of an
entire industry."

Your Honor, I have nothing else for this witness.

Pret

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