President's Message

David White, MD, CCFP, FCFP, President

Docs on a plane

“Is there a doctor on the flight?” This announcement jolts one out of a movie, novel, or fitful doze. For me, it is accompanied by a mixture of anxiety (“Will I know what to do?”), a sense of purpose (“They need me.”), and ethical duty (“I mustn’t just sit here quietly!”)

Summer brings travel for many physicians, and my year as President includes a lot of flying. Over the years I have responded to this announcement several times. I have been able to manage these situations with the basic skills that are the backbone of daily work as a family physician: Take a careful history, do as competent an exam as possible under the circumstances, consider the context, and muster the available resources to improve the patients situation. 

Airplanes on long flights typically carry generous resources—defibrillators, IV equipment, emergency medications. There is also medical back-up. Commonly there are several volunteer care providers on larger flights. It’s a relief when the responsibility can be shared.

Once I had to treat a young man who had been bitten by a scorpion that had hitched a ride in the jeans he changed into during the flight. I spoke with the airline’s on-call physician and sent a picture of the scorpion. It turned out to be a less-worrisome type; an oral antihistamine helped ease the local reaction. On the other hand, the prospect of having to use some of that equipment is daunting. Fortunately, I have never needed the defibrillator. However, I can attest that starting an IV midflight is extremely challenging. 

The biggest decision is whether the patient’s condition warrants diverting the flight to the nearest airport. I have not faced that situation, although the question has been raised. For any major problem it is important that emergency medical personnel are available at the destination to take over treatment. If in-flight treatment has been even moderately successful, the patient may need some convincing that they require a proper reassessment in a standard medical setting.

I wish all my colleagues a happy, restorative, and healthy summer season. If you are travelling, I wish the same for your fellow passengers. And if they need your assistance, I wish you well.

David White, MD, CCFP, FCFP

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