Managing Office Staff: What Podiatry Can Learn From The Airline Industry

Lynn Homisak, PRT

Some might argue right out of the gate that running a practice the way the airline industry runs their airlines might be a downright disaster, especially in the area of time management. I might have once agreed as I have had my share of delays. However, when you consider that a major airline like Continental (now United) had as of August logged in 6,000 flights per day and shows an overall 85 percent success rate with departures and an 82 percent success rate with arrivals during the months of May and June 2011, the airline’s reputation is not as bad as you might have believed.1

   Meanwhile, there is a reason why doctor’s appointments got the second highest rating of things people hate waiting for. Just try Googling “waiting in doctor’s offices” and you will see the less than complimentary posts and articles about this topic. Have we not learned after all these years of having such a bad reputation that people do not like waiting?

   I have flown over 1 million miles. When you live in Seattle and visiting medical offices is part of your consulting work, it is what you do. I cannot help but notice that despite their (sometimes unavoidable) delays and luggage complaints, the airline companies are successful at what they do best: flying planes. From a safety standpoint alone, given the ratio of air to ground accidents, their record is pretty impressive. states that the odds of being killed on a single airline flight are 1 in 9.2 million.2

   Short of having a small but vocal disgruntled group of customers who are directly affected by bouts of lateness and luggage misplacement, what exactly can the airline industry teach us about how to run our offices and specifically, how to manage staff? They implement what I like to call the Trilogy of H.R. Success: communication, teamwork and training. When you consider that all of these add up to greater efficiency, it is the ticket to airline success and if we let it, it can be the secret to podiatric success as well.

Pertinent Insights On Improving Communication And Teamwork

On a recent flight, I listened in to the radio frequency that allowed me to hear our pilots converse with not only the air traffic control tower but with pilots of other planes as well regarding the flight path activity. I tuned in just as they were about to land. What was mostly gibberish to me was actually a well communicated language that allowed expertly skilled individuals to guide these enormous “tubes with wings” filled with precious cargo up into traffic filled skies and down safely. Much of it, I will admit, I have taken for granted over the years. However, it wasn’t until I heard firsthand the precision of commands and essential cooperation that I realized how well it really works. It has to work since the consequences are severe.

   Ironically, that same night after I arrived at my destination (on time and with luggage in tow), I received an e-mail from one of my clients explaining a recurring troublesome incident with his staff. Besides the fact that their ongoing conflicts were irritating, the staff severely compromised productivity.

   There is no room for personality clashes in the flight team. There is no lying, “it’s not my job” comments, dysfunctional relationships or emotional breakdowns. They must work together as professionals to do what needs to be done. Given the large numbers of planes in the sky at any given moment, without clear communication, compliance and teamwork, there would be disasters of epic proportions and the flight teams know it. This is no small task and is filled with stress. They understand that a successful outcome occurs through cooperation and there is no room for quarrels, backtalk, disrespect or insubordination. They just do it, not part time and not just when it is convenient.


Ms. Homisak has only touched on a small portion of what has come out of aerospace engineering. The Crew Resource Manual (CRM) was used as a resource for the writing of Atul Giwandi's The Checklist Manifesto. Many of us are aware of the use of checklists in the OR prior to beginning a surgical case.

The CRM has also been used in developing heuristics and algorithms for anesthesiologists in dealing with OR crises. Doctor Gaba et. al. at Stanford have developed a simulation program (think flight simulation) for anesthesiology residence programs at Stanford and Mass General for instance.

Another resource developed from CRM, Operations Management and In Extremus Psychology is the text, Crisis Management in the Acute Care Setting. It is quite comprehensive and helpful in improving quality of care and patient safety.

Thank you Ms. Homisak for your interesting article.

Jim DiNoivs

Add new comment