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Nearly all of us have heard this question come over the PA system on a flight "Is there a doctor on board?" Usually we are sending good thoughts to the sick or injured passenger, but who is thinking about the doctor? According to an article written in 2007 by Matthew Prout, MD and Jeffrey R Pine, MD inflight medical emergencies occur more often than you may think.

Inflight medical emergencies occur at a rate of 20 to 100 per million passengers, with a death rate of 0.1 to 1 per million [3-6]. The precise incidence of inflight medical emergencies is unknown because there is no uniform or required reporting system, and flight crews do not routinely report minor inflight medical incidents that do not require ground medical support [1].

Researchers in France studied medical assistance provided during commercial airline flights by analyzing eleven years of Air France flights between 1989 and 1999. Medical assistance was needed 380 times per the carriage of 350 million people. The researchers concluded that we must evaluate the effectiveness of current practice and modifications of equipment and protocols for patient management.

So, the doctor on board the airplane called to help the injured or sick passenger may not have the best equipment available. And, aviation medicine is a field unto itself. The human body behaves differently at 30,000 feet and air quality issues may arise. Despite all of these obstacles a doctor on a plane will do their absolute best to help the injured or the sick. The question is, "are they appreciated?"

Dr. Henry Coopersmith, a Canadian resident who also happens to be a lawyer, says "no." Dr. Coopersmith is suing Air Canada after he spent an entire night caring for several passengers aboard an Air Canada flight bound for Paris. After the experience, Air Canada offered him a mere 10,000 miles (no free ticket) and told him that he was ethically bound to help the passengers. Dr. Coopersmith is seeking to change the way airlines compensate doctors who respond to inflight medical emergencies. I hope that Dr. Coopersmith is successful.

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