1. Airline Medical Departments
Dr Elizabeth Wilkinson,
Head of British Airways Health Services
AMDA, Dallas, 5th May, 2018
AMDA 2018

2. Conflict of interest
Full time employee of British Airways Views presented are my own

3. Background 2016 Bauer Lecture : Adapt or Perish!
2017 ATMC panel: Airline Medical Departments – Adapt or Perish!

4. Background >4 Billion pax in 2017 ( yr on yr increase since 2011)
Airline medical departments can contribute to flight safety, productivity, cost efficiencies and engagement
IATA has 280 member airlines in 120 Countries
111 contacts
79 have some form of medical support
19 non-medical, 44 in-house + 16 external
= 21% coverage ( of which 73% in-house)

5. What can airline medical departments do?
Occupational health Aviation Medicine Passenger health Primary care Contribute to the Business Plan

6. Airline Medical Functions
Qantas
USA
Qatar
Virgin Australia
Contractor UK BA
Pre-Employment Assessment
Periodic Health Assessment
Care of Air Crew
Health Supervision of Work Environment
Health and Safety Education
Accident and Emergency Services
Aircraft Accidents
Immunisation
Advice to Management
Others: Pax health
Care of ground crew
Wellbeing
Primary care of staff/families
In-house: Outsourced: No involvement:

7. What models exist
Full spectrum from nil to comprehensive in-house provision
In-house vs contractors / providers
Strategic vs delivery/transactional
Aviation medicine support vs occupational health delivery
Strategic outsourcing

8. USA Historically most of the large US airlines had medical depts.
Huge change in last yrs (mergers/chap 11 etc)
Period of downsizing to minimal staff
Now,
Small teams
Major advisory role (travel health, pax support)
Contract management
Very little screening/clinical work in-house
Use of external consultants and providers
? Glimmer of hope: ‘Tide may be changing’

9. Europe Legacy airlines tend to have in-house medical depts.
Some have large teams ( mostly due to regulatory requirements)
Cover OH, Av Med and pax care
No primary care
Cost-conscious and business focused
Out-sourcing considered at some point
Low cost airlines/ smaller airlines may have contracts ( with consultants or providers)
In–house strategic and delivery role
smaller teams
and much more focus on cost

10. Middle East Growing, with diverse workforce
Large medical depts with in-house model
Provide OH, Av Med, and Pax care
Most provide 100% of their crew licensing medicals
Most provide primary care for staff +/- families
Becoming more cost conscious

11. Asia Pacific (1)
Most of the larger airlines have in-house medical depts
One airline has been through cycle: in-house comprehensive service pre > most services outsourced to provider > mainly in-house for Av Med 2017
In-house medical team providing av med support, pax support and management advice/support
with out-sourced services eg OH and primary care
=> Strategic outsourcing and segregation of OH and Av Med

12. Australasia Larger airlines have similar model
In-house medical team has advisory and strategic planning role
Focus on critical risks
Manage contracts
Pax support
High risk/complex OH and Av Med cases seen in-house
Routine screening medicals are outsourced

13. Summary
We work in a challenging and ever-changing industry Most airline medical depts have had to adapt to continue to meet the business needs There are different models successfully in place across the globe Finally, change is here to stay So we do have to Adapt or Perish!

14. My thanks Thank you and any questions
To the many people who gave me background information:
Pat, Barbara, Claude, Nomy, Brinio, Horace, Tim
ATMC panel: David, Ian, Alex, and Simon
Thank you and any questions