Inflight Medical Emergency: Who Pays?

For air travelers, the classic theater usher''s cry, "Is there a doctor in the house?", has morphed into, "Is there a doctor on the plane?" Often there is, and we tend to assume that a physician will attend to a stricken fellow passenger, with the assistance of first aid-trained flight attendants, until the plane is on the ground. We think that it's part of the Hippocratic Oath for doctors to do so. In some people's eyes, Hippocratic came too close to hypocritical on a recent flight.

According to reports in the Asian media disseminated to the travel industry worldwide by eTurboNews, an Australian doctor, sent a bill for "services rendered" to Malaysia Airlines, for attending to three sick passengers on a flight from Melbourne to Kuala Lumpur. "I left my young family to attend to three sick passengers," Dr. Matilda Metledge was quoted as saying. Her unanticipated patients were two elderly travelers and "another passenger who was causing a disturbance," according to eTNews.

John Gullotta, chairman of the Australian Medical Association (AMA) public health committee, was quoted as saying, "Doctors whose travels are ruined by fellow passengers should be compensated. I myself had three recent flights ruined because I had to treat passengers. The airlines are taking doctors for granted." The AMA has suggested that doctors who declare themselves available on call during a flight be given an upgrade or be paid for their time while on call. By offering an incentive upfront everyone else can relax. It is a bit unfair to expect doctors trying to get away on holiday to be always available and render assistance. Obviously we have to do that as part of our Hippocratic Oath and sense of well-being, but the airlines have to take a bit more responsibility."

Again according to eTN, the airline reportedly had turned down the doctor's request for an upgrade but compensated her for her trouble with some toiletries and a pair of pajamas. I have no idea whether she requested an upgrade just for herself or for her whole family or whether the carrier paid the doctor's bill.

The eTN report also quoted Lorraine Long from the Medical Error Action Group, an Australian patient-advocacy group (acronym: MESSUP), who believes that treating sick people is a doctor's professional obligation: "Shouldn't a 'thank you' be sufficient?" Long reportedly asked.

An unnamed airline industry observer was quoted on the other side of the discussion, which seems as if it could also have been said by someone from the AMA. "The doctor's obligation is to the passenger, not to the airline. If there is any bill to be paid, it should be paid by the patient, just like going to the clinic back on the ground."