Airline Compensation for Doctor Assisting with In-Flight Medical Emergency?

Do Airlines Compensate Doctors Who Assist on a Flight with a Medical Emergency? Or should they at least help cover costs to get the doctor's own travel back on track if the flight is diverted to cope with the medical emergency the doctor is assisting with?

TravelSort reader Pat writes:

“I wondered what compensation airlines provide to doctors who respond to a request “Is there a doctor on board”? I was flying on American Airlines flight 2449 from YYZ in Canada to Miami, and planning to connect to AA 2554, from Miami to Belize. Sitting next to me was a nice young couple, on their honeymoon, going on the same schedule.

One hour out, a passenger suffered a heart attack, and the young man, a doctor, responded to the request whether a doctor was on the flight. As the traveller had no pulse, the plane made an emergency landing at Dulles airport, and the patient was removed from the plane.

After a long delay the plane continued on to Miami, arriving three hours behind schedule, which meant that their connecting flight to Belize were missed. This was a pain for me, but these things happen. However, I felt extremely sorry for the doctor and his wife.

I felt that American Airlines did not respond in the way I would have hoped. AA booked, but didn't pay, for their hotel or food in Miami, and when they changed their return flight by one day so they would have a full seven night honeymoon, the airline charged them a change fee!

I felt that having come to the rescue, the least the Airline should have done, was to have a customer service agent at the gate to thank him for his assistance, and to tell him that they had booked a flight the next day, complimentary hotel, with meals, and were there if there was anything else they could help them with. It was as though nothing had happened – he in effect saved their passenger's life!

In talking to them the next day I learned that this was the fourth time that he had responded on a flight to a passenger in need (usually with a blood sugar control problem).

As a frequent flyer I would like to feel that, were I to need help on a flight, a doctor would respond. But I felt that American treated this doctor as though his help was not important to the airline.

He also told me the next morning, when I learned that they had charged him a change fee, that on a previous flight where he helped they said they would be sending him a “gift” as thanks. The promised gift never arrived.

So I think it would be really interesting to know if and how other airlines thank medical people who come to help. After all they are volunteering to help in a way that, because of the environment, is stressful and risky.

I do not see why any medical person would get out of their seat other than they have to live with their conscience.
This young couple will not ask the question (they are staying at a resort near me, and I have offered them a complimentary couple's massage at the resort and spa that I am lucky enough to own here in Belize). But I would be interested if there is anything I could tell them. I think it would make a great blog, as we frequent flyers often hear the request for a doctor and very much appreciate their willingness to be a Good Samaritan.”

First, let me say a heartfelt thank you to this doctor and all doctors who respond to medical emergencies on a flight. While I've never needed aid nor know anyone who has, there are certainly many in-flight medical emergencies each year, and I'm sure those who have been helped or have had a family member or friend who has been aided are incredibly grateful for the medical assistance, which, apart from a few jurisdictions, doctors are not legally obligated to provide. Let me discuss some of the issues surrounding doctors' medical assistance and compensation (or lack thereof) that airlines provide.

What Happens If No Doctor is On Board the Flight and a Medical Emergency Occurs?

Most airlines use ground-based medical services such as MedAire, the Mayo Clinic's Aerospace Medicine program, or the airline's own medical department. This is one of the first things a doctor or medical professional volunteering to assist with an in-flight emergency should ask, if s/he volunteers: does the airline have a ground-based medical service that can be called to assist, and also to coordinate medical services for the patient upon landing, either the scheduled destination, or if the decision is to divert, the emergency landing destination.

Is a Doctor Legally Obligated to Respond if a Crew Member Asks “Is There a Doctor Onboard?”

In most jurisdictions, no, a doctor is not legally required to assist. But in French, Quebec, and similar jurisdictions based on the Napoleonic Code, there is a legal duty to rescue a stranger.

But most doctors are drawn to the profession by a desire to help others, and separate from any legal duty, there's the moral and ethical obligation for doctors embodied in the Hippocratic Oath, in particular “I will remember that I remain a member of society, with special obligations to all my fellow human beings.”

Good Samaritan Laws and the U.S. Aviation Medical Assistance Act of 1998: No Compensation or Payment to Be Protected from Liability

One of the reasons (or excuses) airlines can make about not providing anything except perhaps an oral “thank you” to doctors who volunteer to help with a medical emergency is that the U.S. Aviation Medical Assistance Act of 1998 and most other Good Samaritan type laws, which provide a certain amount of protection from legal liability only apply when a physician is providing free emergency aid. In the case of the Aviation Medical Assistance Act, you are not liable for adverse patient outcomes as long as you don't engage in any willful misconduct or commit gross negligence.

That changes if you're paid for your services; you are then no longer shielded from liability. But also keep in mind that even with this protection, there is nothing to stop a U.S. passenger from suing you, even without merit. And that can be a real disincentive for U.S. doctors already operating in a very litigious society, since being sued, even if you ultimately prevail, can be a huge burden financially and in terms of time.

What About In-Kind Gifts from an Airline?

The Aviation Medical Assistance Act doesn't speak to non-monetary gifts, such as a seat upgrade, frequent flyer miles, a bottle of wine, etc. Doctors who want to completely avoid any risk of voiding the AMAA or Good Samaritan protections against liability should avoid taking anything other than a thank you letter.

So American Airlines Shouldn't Cover Hotel Cost for a Doctor Who Assists and Has to Overnight Due to the Diverted Flight?

I have to say, given the doctor's assistance, and the fact that the hotel night is obviously not something the doctor wanted (I'm sure he and his wife would have infinitely preferred to have gotten to their honeymoon destination as scheduled) it's hard to see the cost of an airport hotel as compensation. And after all, American Airlines DOES cover overnight hotel costs when the travel disruption is due to something under the airline's control, such as schedule changes due to a maintenance or flight crew issue.

And the flight change fee is truly galling–how hard would it be to waive that to permit the doctor and his wife to return a day later? Flight change fees are waived when the airline materially changes your flight time, and it's such a small amount for the airline.

Does American Airlines Ever Provide Something to Doctors Who Assist with an In-Flight Medical Emergency?

It at least used to; there are several accounts from FlyerTalk of doctors receiving AAdvantage or other frequent flyer miles and other small gifts for assisting (although as far as I know, none that had a hotel stay covered due to a diversion and missing their original connecting flight):

-25,000 AAdvantage miles for helping an intoxicated, hyperventilating passenger (ckeegan04, Flyertalk)

-15,000 AAdvantage miles (moki1)

-Delta: choice of $200 voucher or 3000 SkyMiles; American: bottle of wine once, just a thank you the second time (GeneralVeers)

-Upgraded to Business Class on Delta flight (MSPeconomist)

How About Other Airlines?

While I'm not familiar with all airlines, a couple that I do know about, Turkish Airlines and Lufthansa, do encourage doctors to register in their programs, and provide a small frequent flyer bonus to do so. Lufthansa has its “Doctor On Board” program that provides 5000 Miles & More miles (assumed to be a one-time grant) for registering, and providing your medical specialty. Lufthansa also covers legal liability for doctors treating medical emergencies on board, excluding wilful misconduct.

Turkish Airlines has its “Smiling Doctors” program, which also provides a one-time grant of 5000 Miles&Smiles miles for registering, after a doctor's first Turkish Airlines flight.

If you're a doctor and have ever had to provide emergency medical assistance during a flight, what was your experience, and did the airline provide anything beyond an oral or written “thank you” for your services?

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