A Competitive Environment, Is it really worth it? by RN FP-C

Today I look back at the number of accidents in our industry and I wonder how we got to this point as a profession? How did we let things get so out of hand that we could conceivably fly a multi-million dollar aircraft into terrain and kill everyone onboard including the patient or patients and then just replace the aircraft, hire new crews and call the deceased heroes and go on as business as usual?

I had the unfortunate opportunity the last year to attend a flight crew member’s funeral and I cried like a baby when the bagpipes came by with the empty helmets. I knew this person and I had even taken patients from her when she worked for a ground service as an extra job. Attending that funeral was one of the saddest moments I have experienced and I actually felt ashamed that our profession had let things get this bad. I did some soul searching myself after the accident and I had to decide if this job is worth the risk. I have been taught throughout my career that we should only take a calculated risk if there is a greater probability of saving someone’s life than losing our own. What does that mean? We do a flight risk assessment, we check the weather, we check the aircraft before each flight, and we assure we are ready to fly mentally and physically. So the question remains, why are we taking the risk and crashing in bad weather at night? My thought is that it is due to capitalism at its best.
We welcome competition in most fields because it has several positive effects for the consumer including decreased cost of service or product, more efficient service provided, and better customer service. What about air medical services and competition? Is competition a factor in these accidents? Would we as an industry be willing to admit this as a factor? Let me propose the following scenario and please think about it honestly.
Provider 1 is a for profit service that has just opened a new base a few months ago and the flight volume is down. The crews have done promotional events and worked hard to get the flight volume but it is not coming in. Nobody will confirm the number of flights the base needs to make to stay open but they know the number is around 24 per month. They have 16 flights and could use the flight. The weather is marginal around the area and forecasted to go down later. The weather is flyable right now when the tones drop for an inter-facility transfer. Your dispatch center states the flight was declined for forecasted weather by another service. Your service accepts the flight and the ending is only able to be arm chair quarter backed in the morning because we don’t know what happened because you all died.
This might strike a nerve with you and you may even be in denial and say this does not happen but look at the crash records and you will see they speak for themselves. A question that goes through my mind is when are we as an industry going to put our colors and our pride aside and start really trying to take an active role in preventing this situation. We are letting our lives be put on the line for a profit. We all have different reasons for doing this job. For some people it is the adrenalin rush and yet others are in it for the patient interactions and opportunities to provide advanced care. I understand that it is expensive to operate an air medical program and you have to pay the bills to operate. Yes, hear comes the process of capitalism at its best. If you have a company that is providing a service and doing a good job, why do we continue to open new bases right on top of each other decreasing flight volume for each other and causing undue risk taking to make the numbers? Welcome to America my friend. This is the reason a lot of mom and pop stores are no longer around. It works both ways as I am not picking on the non-profit versus the for profit companies. We are both constantly trying to open new bases and get the business from the competing company. I think it is time for something to be developed in regards to some type of certificate of necessity for the need to operate more air medical programs. In a time of government over regulation I know this may sound crazy, but I really think there is a certain amount of pressure to make these flights and make the numbers whether you want to admit it or not we all have to pay the bills to operate but at what cost?