Patients have more of these tests in the hospital setting than at any other time, and these are typically ordered by the most junior doctor on the team with little to no direct senior doctor oversight. Overdiagnosis often starts with the basics – blood tests and other investigations. In looking at the question of overdiagnosis, we may still be falling into this trap.
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In medicine, although we are beginning to learn some of the lessons of aviation we still often come from a position of questioning how to get people to do the right thing, rather than looking at the systems that both make it more difficult to do the right thing, and subtly support them in doing the wrong thing. What he saw led to a simple solution that not only fixed the issue of Flying Fortresses being destroyed on the runway, but was also the beginning of the change in aviation from a ‘blame culture’ to a ‘just culture’.
Instead, he did something no-one else had – he got into the cockpit. But nothing changed: over a 22-month period 457 Flying Fortresses crashed after landing.Įxasperated, top brass hired a psychologist to work out what was wrong with the pilots. So the military took the usual approach: more pilot training, more checklists, more reprimands, and finally pilots were dismissed.
Inexplicably pilots were returning safely from successful missions, before suddenly driving the plane into the tarmac with its wheels still retracted, scraping along the runway before exploding into flames.Īs no fault was found with the planes, it was decided the problem was the pilots. Actually, one particular plane – the B-17 ‘Flying Fortress’ bomber. During WWII, the US Air Force had an issue – pilots kept crashing planes.
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