Delta -- discrimination against a black female doctor inflight

[Micca]

I'm not certain what happened in this case, but I do know that when you're dealing with anyone associated with an airline, TSA, or anything related to an airport, your chances of getting lousy treatment increase exponentially irrespective of gender/race/age. etc. I hope they can work things out.

 

[Pea-n-Me]

Ok after digging around a little bit, it is interesting to find out that the FAA has a 1998 Aviation Medical Assistance Act.

I thought this article summed up nicely what the responsibilities are, and yes, flight attendants are required to check credentials - and further, can refuse the help if ID isn't shown.

This is from the Journal of Emergency Services (separated, for clarity):

http://www.jems.com/articles/2010/06/handling-flight-medical-emerge.html

"Despite these generous protections, EMS providers must continue to follow the standards expected of Good Samaritans.

EMTs and paramedics who choose to volunteer in an in-flight emergency may be required to show identification to the cabin crew indicating their level of training at the time of the emergency.

Air carriers may choose to refuse assistance if identification isn't provided.

EMS providers should only work within their scope of practice and not perform interventions or treatments they haven't been trained to do.

Whenever possible, an attempt should be made to contact the ground-based physician services the airline may utilize on a regular basis.

Based upon this, I am wondering a couple of things. One, was she able to produce her medical ID? And two, was the type of emergency it was consistent with her specialty of OB/GYN? These are two things I can think of that may have influenced the FAs decisions in going with the other provider.

 

[sam_gordon]

I thought this article summed up nicely what the responsibilities are, and yes, flight attendants are required to check credentials - and further, can refuse the help if ID isn't shown.

Based solely on the excerpt you listed, that's not the case...

http://www.jems.com/articles/2010/06/handling-flight-medical-emerge.html

"Despite these generous protections, EMS providers must continue to follow the standards expected of Good Samaritans.

EMTs and paramedics who choose to volunteer in an in-flight emergency may be required to show identification to the cabin crew indicating their level of training at the time of the emergency.

Air carriers may choose to refuse assistance if identification isn't provided.

EMS providers should only work within their scope of practice and not perform interventions or treatments they haven't been trained to do.

 

[Poohlove]

I think OP needs to edit the thread title.

 

[roseaster]

Yup, it's definitely racism - couldn't possibly have been because the doctor looks like she could stil be in high school. Nope, racism - the only viable conclusion anytime there's any sort of misunderstanding between 2 people of different races.

At least this doctor does acknowledge that race was only one of the possibilities.

My goodness, where do your kids go to high school? That woman looks nothing like a high school student.

 

[Pea-n-Me]

Based solely on the excerpt you listed, that's not the case...

It may just be the way that particular piece is written.

I think, then, we would need to look at the exact wording of the FAA document as well as each individual airline's policies, to see what their normal procedures are [for checking credentials in an emergency].

The way it read in the article in the OP, it sounds as if Delta does check credentials.

At any rate, directly from the FAA 1998 Aviation Medical Assistance Act:

"Finally, the bill includes a ‘‘Good Samaritan’’ provision to protect those who help in a medical emergency. The provision protects an individual (such as a passenger, pilot, or flight attendant) from legal liability for helping in a medical emergency unless that indi- vidual is guilty of gross negligence or willful misconduct. The provision also protects the airline from liability for the negligence of a passenger who volunteers to help in a medical emergency but only if (1) that passenger is not an employee of the airline and (2) the airline in good faith believed that that passenger was qualified to provide that help (such as where the crew believed that the passenger was a doctor, nurse, or was otherwise experienced in dealing with medical emergencies)."

I guess the question is, how do airlines know whether someone is, in fact, a medically qualified individual?
Do they have a duty to ask for credentials?

The word from medical journals seems to be that credentials are generally checked as part of that "good faith" effort.

From the College of Emergency Physicians

The Federal Aviation Administration (FAA) suggests that a good faith effort be made to "check the credentials of passengers holding themselves out as medical specialists. Barr noted that in many cases paramedics and nurses are more likely to carry verification of licensure or certification than physicians.

from Academic Life in Emergency Medicine

The flight crew must make an effort to determine if the provider is a “medically qualified individual.” The AMAA defines “medically qualified individuals” as anyone who is licensed or otherwise qualified to provide assistance including physicians, nurses, physician’s assistants, and paramedics. The flight crew is asked to make a good-faith effort to verify credentials, which can include asking for proof of licensure. Airline policy will dictate what type of proof is required."

From KevinMD:

"After I roused the passenger who had momentarily lost consciousness, a flight attendant wanting to see my credentials intercepted me. Mildly annoyed, I quickly obliged by presenting 3 state licenses that I happen to carry in my wallet. But, what ran through my head was “this passenger could arrest while I take the time to produce said credentials.” It also momentarily made me question whether I should be helping this passenger (mind you this was very momentary). I was not carrying liability coverage as I was in between clinical jobs.

I noted that she did not ask the other male (paramedic) at the scene to produce credentials. However we were soon able to carry on."

From a FA training program:

2- Request medical assistance via PA- verify credentials or qualifications

It does seem to be the standard. As of right now, I cannot find airline policies.

 

[Pea-n-Me]

Forgot to also say that, no doubt, FAs get the names of "volunteer" passengers so they can include it in their official report to the FAA about the inflight emergency, for which statistics are tracked.

 

[Pea-n-Me]

This is an interesting article out of the UK. I think it shows that the issue of asking for credentials is murky, probably in many of the airlines.

https://www.sundaypost.com/news/uk-...sick-passengers-if-they-dont-have-medical-id/

"Airlines ban doctors from saving sick passengers if they don’t have medical ID

Plane passengers who suffer medical emergencies at 30,000 feet are being put at risk of dying because of safety rules which prevent doctors from helping.

A number of major airlines have revealed they would only allow trained medics to help in an in-flight emergency if they can prove their credentials.

The step leaves desperately ill people to be treated at the hands of less experienced cabin crew and comes despite soaring numbers of incidents.

One highly-experienced doctor told The Sunday Post how a passenger died on his flight after he was told he couldn’t help because he wasn’t carrying medical ID. And with medical experts insisting doctors are not required to carry any proof of their qualifications, critics have called for an immediate review of in-flight emergency protocol.

Frank Brehany, director of consumer rights group Holiday Travel Watch, said: “I’m shocked to hear that a doctor who could have helped the crew’s ability to deal with an emergency was refused and it raises questions about how airlines deal with medical emergencies. It would be fairly evident if the doctor is directing the crew themselves that they have or have not got medical qualifications. It’s common sense that there’s a lesser chance of someone passing themselves off as a doctor.

“There’s a better chance of a medical volunteer being qualified to use their skills rather than relying on a crew member who is not as qualified.”

The Sunday Post was alerted to the situation after we revealed last month how trainee Dundee doctor Craig MacLean, 22, saved his first heart attack victim while flying with KLM to the Middle East. His case prompted a highly-experienced anaesthetist, who asked to remain anonymous, to contact us to reveal he had found himself responding to a call for help only to be told to sit back in his seat if he couldn’t provide official proof of his medical experience. Tragically, he said the sick passenger died after he was forced to stand aside.

Insiders claim airlines have put in place the rules to minimise the risk of being sued by the family of patients who don’t survive emergency treatment.

Dr Nicole Trask from The London School of Anaesthesia has responded to three in-flight medical emergencies while travelling as a passenger. She said many airlines now demand identification from doctors before they’ll let them treat people.

She said: “I believe if a medical professional answers a call to help they should be able to act without providing proof of their credentials and qualifications. Firstly it’s exceedingly unlikely they will be carrying such evidence on their person in an off-duty situation. Secondly they have an ethical obligation to answer that call. If that person is not allowed to fulfil that ethical duty it is bound to weigh heavily on their conscience and potentially put lives at risk.

“Increasing numbers of airlines are making use of ground-based doctors but I believe the presence of an on-board medical professional helps no end as crew members have, at most, basic first-aid and resuscitation training depending on the airline.”

Dr Jean Turner, a retired GP, and former director of Scotland Patients Association, said: “It’s a shame that this doctor was not allowed to help. I think the general public would assume that it’s better to have a doctor step in. It could also be good for the crew involved.”

Thanks to increasing flight numbers, there has never been so many dramas in the skies. It was recently revealed how the daughter of Virgin tycoon Sir Richard Branson helped save the life of a fellow passenger after they suffered a heart attack on a flight to Antigua.

Qualified doctor Holly Branson, 32, administered oxygen to Paul Norbury and checked his blood pressure after he fell ill 45 minutes into the journey. She also spoke with ground-based doctors and agreed with them to divert the plane so he could be taken to hospital after deciding he was suffering a mild heart attack.

Many in-flight medical “emergencies” are minor conditions that are exacerbated by altitude, stress and fatigue, such as dizziness, fainting and gastric problems. Other conditions may be self-induced, for example by mixing sedatives with alcohol. But possible heart attacks and strokes often require the plane to be diverted which can prove very expensive.

Major airlines have contracts with ground-based medical teams, such as MedAire in Arizona, which provide in-flight advice by satellite phone or radio link to more than 100 airlines. Turkish Airlines, Lufthansa and Austrian Airlines all allow doctors to register their details in advance, so cabin crew will know where they are sitting.

Last year airline cabin crew dealt with heart attacks and strokes linked to pressurised cabins, blood clots and multiple in-flight births despite stringent rules on when pregnant mums can fly, among many countless worrying examples. It’s estimated healthcare professionals are available in 78% of in-flight medical emergencies.

Would the airlines ask for your help?

THE Sunday Post contacted several major airlines to ask them if their cabin crew would encourage people with medical training to assist in an in-flight medical emergency. We also asked if they would ask for proof they were a medical professional and what kind of proof they would need to see.

Ryanair said medical volunteers would need to produce “a valid ID for authentication” but did not state what ID they would accept. Aer Lingus said cabin crew members would be “instructed to check for ID including such detail as they are medically qualified via a medical licence /hospital ID”. However, other airlines did not fully clarify their position on the need for ID. Emirates said it uses MedLink a service providing cabin crew with a direct communication link with ground-based doctors who can provide advice on how they and any medical volunteers should proceed. However, the airline did not explain what its position is regarding medical volunteers.

British Airways said staff would take steps to ensure medical volunteers are appropriately qualified to assist but didn’t state what proof, if any, they would look for. Jet2 said crew would need to be “suitably satisfied” that volunteers were qualified medical practitioners but did not state whether they would ask for ID when we asked them about this. easyJet acknowledged that “most of the time a medical professional will not be carrying their medical identification or qualification documentation with them”. However, it said cabin crew could still establish someone’s professional status by other methods, including discussing details about their current medical role and place of employment.

All the airlines contacted stated that their staff are trained to deal with medical emergencies.

MEDICAL DEFENCE UNIONS WOULD PROTECT DOCSTHE issue as to whether doctors are legally protected to intervene in the event of airline emergencies is a grey area. The Medical and Dental Defence Union of Scotland explained that it indemnifies its members against any legal liabilities which might arise out of Good Samaritan acts anywhere in the world. These acts are defined as “the provision of medical and dental services in emergency situations outside the scope of an individual’s normal contractual obligations or clinical practice”. Similarly, the Medical Protection Society a UK-wide professional body said it would “assist doctors with concerns arising from a Good Samaritan Act performed anywhere in the world”. Both organisations stated that they are not aware of any requirement for doctors to carry forms of identification showing their medical qualifications. There is no known global unified code which sets out the legal protection that would be afforded to doctors who intervene in emergencies on an aircraft."

 

[MinnieMouse84]

From Dr. Cross' facebook post:

A couple mins later he is unresponsive again and the flight attendant yells "call overhead for a physician on board". I raised my hand to grab her attention. She said to me "oh no sweetie put ur hand down, we are looking for actual physicians or nurses or some type of medical personnel, we don't have time to talk to you" I tried to inform her that I was a physician but I was continually cut off by condescending remarks.

Then overhead they paged "any physician on board please press your button". I stare at her as I go to press my button. She said "oh wow you're an actual physician?" I reply yes. She said "let me see your credentials. What type of Doctor are you? Where do you work? Why were you in Detroit?" (Please remember this man is still in need of help and she is blocking my row from even standing up while
Bombarding me with questions).

I respond "OBGYN, work in Houston, in Detroit for a wedding, but believe it or not they DO HAVE doctors in Detroit. Now excuse me so I can help the man in need". Another "seasoned" white male approaches the row and says he is a physician as well. She says to me "thanks for your help but he can help us, and he has his credentials". (Mind you he hasn't shown anything to her. Just showed up and fit the "description of a doctor") I stay seated. Mind blown. Blood boiling. (Man is responding the his questions and is seemingly better now Thank God)

Assuming she's telling the truth, there's no doubt that this was discrimination. I don't know whether it was because of her race, gender, age, or a combination. Whatever the reason, it's unacceptable.

 

[donaldbuzz&minnie]

Shameful!

It would have been one thing if the FA had immediately said, "Thank you so much, Doctor. I'm required to ask for your credentials before I can allow you to treat a patient. Do you happen to have them on you?" But, "put your hand down, we are looking for actual physicians..." NO.

 

[gwynne]

Ok after digging around a little bit, it is interesting to find out that the FAA has a 1998 Aviation Medical Assistance Act.

I thought this article summed up nicely what the responsibilities are, and yes, flight attendants are required to check credentials - and further, can refuse the help if ID isn't shown.

This is from the Journal of Emergency Services (separated, for clarity):

http://www.jems.com/articles/2010/06/handling-flight-medical-emerge.html

"Despite these generous protections, EMS providers must continue to follow the standards expected of Good Samaritans.

EMTs and paramedics who choose to volunteer in an in-flight emergency may be required to show identification to the cabin crew indicating their level of training at the time of the emergency.

Air carriers may choose to refuse assistance if identification isn't provided.

EMS providers should only work within their scope of practice and not perform interventions or treatments they haven't been trained to do.

Whenever possible, an attempt should be made to contact the ground-based physician services the airline may utilize on a regular basis.

Based upon this, I am wondering a couple of things. One, was she able to produce her medical ID? And two, was the type of emergency it was consistent with her specialty of OB/GYN? These are two things I can think of that may have influenced the FAs decisions in going with the other provider.

Actually from reading about the incident it appears the flight attendant was quite busy talking down to the physician. Sit down sweetie, put your hand down...etc.
I don't think the flight attendant ever got to the point of discerning whether the physician's specialty was relevant. And honestly, I'm not sure I want a flight attendant to do that. I would hope that physicians on the flight would respond and then they (as actual medical professionals) would sort it out.
I would think in an actual emergency having a couple of physicians working together would be better than the flight attendant deciding who she thought was the one most qualified.

 

[Pea-n-Me]

Actually from reading about the incident it appears the flight attendant talked over the physician. Sit down sweetie, put your hand down...etc.
I don't think the flight attendant ever got to the point of discerning whether the physician's specialty was relevant. And honestly, I'm not sure I want a flight attendant to do that. I would hope that any and all physicians would respond and then they (as actual medical professionals) would sort it out.

Not sure if you've ever been in a position of responding to a true medical emergency, but I'll tell you this, it's not a time for pleasantries. It's stressful.

From MinnieMouse54's post above (which was posted in the OP article, as well), there was apparently a time that they did have a conversation, however, we've only heard one side of it. And Delta is saying something different than she is.

I am merely trying to figure out what the policies are. I have little doubt the FA was stressed out. I know I was myself, also, two weeks ago when someone died on me and I had to resuscitate. And that was in a hospital, with lots of other providers around me. I imagine it's a lot worse on a plane.

 

[gwynne]

Not sure if you've ever been in a position of responding to a true medical emergency, but I'll tell you this, it's not a time for pleasantries. It's stressful.

From MinnieMouse54's post above (which was posted in the OP article, as well), there was apparently a time that they did have a conversation, however, we've only heard one side of it. And Delta is saying something different than she is.

I am merely trying to figure out what the policies are. I have little doubt the FA was stressed out. I know I was myself, also, two weeks ago when someone died on me and I had to resuscitate. And that was in a hospital, with lots of other providers around me. I imagine it's a lot worse on a plane.

Stressful, no doubt. But I think some professionalism is called for. Once someone lapses into "sit down sweetie", effective communication in an emergency isn't happening.

I'm not sure why you are wondering, but yes, I've been involved in some actual emergencies and stressful situations. And for me, in those moments of true crisis, I really work hard to remain calm, listen and think about what I am saying. It can make a big difference in how everything turns out.

And I am sorry about your patient. That must have been very difficult. Loss is always hard.

 

[Hikergirl]

Stressful, no doubt. But I think some professionalism is called for. Once someone lapses into "sit down sweetie", effective communication in an emergency isn't happening.

Very true. Even if this turns out to not be actual discrimination the FA should be reprimanded for her treatment of the doctor. The article says there were 3 people on board that were doctors, I wonder about that third one. Were they male or female, and I wonder how they were treated when they said they were a doctor.

 

[wilkeliza]

Interestingly when I was a CM I remember them telling us directly not to ask for assistance from guests passing by and to try to do what 911 dispatch was telling us to and unless we were told by 911 to ask for a doctor not to. I believe it was because Disney could be heals liable if a guest was allowed to touch someone in distress and it went wrong. IDK what is actually about it but I did have to call 911 one time for a woman who passed out and hit her head and it was bleeding. Paramedics were 2 minutes away and 911 dispatch was very clear don't roll her over, try to support her neck as is and do not move her. Some lady comes strolling up saying she is an ER nurse and starts screaming at me to roll her over and pul an credit card in her mouth so she doesn't bite off her tounge. 911 is telling me no no don't do that she isn't seizing there is no need to. I was short and direct not to touch this woman on the ground that I was capable of handling it but this other person felt they were better. I was so happy once the paramedics arrived to take over.

 

[Pea-n-Me]

Stressful, no doubt. But I think some professionalism is called for. Once someone lapses into "sit down sweetie", effective communication in an emergency isn't happening.

I'm not sure why you are wondering, but yes, I've been involved in some actual emergencies and stressful situations. And for me, in those moments of true crisis, I really work hard to remain calm, listen and think about what I am saying. It can make a big difference in how everything turns out.

And I am sorry about your patient. That must have been very difficult. Loss is always hard.

Naturally. You can be calm and professional yet still very focused on a task at hand.

And thanks, but no loss, since we successfully resuscitated. But in those moments adrenaline is pumping and that physically causes a flight of fight response, where you're not able to do much else, let alone have a big conversation with someone. I asked because I'd wondered if you'd ever experienced that when you were responsible for saving someone's life before. FAs are in a difficult predicament up there. I'll cut her some slack. Should she apologize? If she said what is claimed she said, sure. But we're really only hearing one side of this. I'd like to hear the other side too. Maybe we will in the coming days.

 

[low-key]

If someone needs medical attention right now, and someone says there a Doctor, I let them look rather they black, white or purple

 

[sam_gordon]

Would there be any reason for a doctor to make themselves known to FA before the flight? Is it possible the older doctor had shown his credentials at some other time? I know I'm reaching, but genuinely asking.

 

[Pea-n-Me]

Would there be any reason for a doctor to make themselves known to FA before the flight? Is it possible the older doctor had shown his credentials at some other time? I know I'm reaching, but genuinely asking.

I think some MDs use their credentials in their everyday lives, and some forms ask for them.

 

[Cantw8]

I think she should receive an apology but I'm not even sure of that. Why in the world should she be compensated? Compensated for what?