Out Loud Blog

What in the world do pilots have in common with dentists? Well, according to a dental professor at the University of Michigan and two pilot-dentists (there’s a new phrase for you), if dental office staff implemented a similar checklist of safety procedures used by airlines, they could drastically reduce human errors.

Pilots and dentists both engage in highly technical work that requires teamwork. And both are subject to human error where small, individual mistakes may lead to catastrophe if not addressed early. That means that dentists might benefit if they used the same type of safety procedures that pilots currently use.

Russell Taichman, U-M dentistry professor and director of the Scholars Program in Dental Leadership; Harold Pinsky, a full-time airline pilot and practicing general dentist; and David Sarment, a pilot and former U-M dental faculty member coauthored a study that focused on adapting airline crew resource management (CRM) principles to dentistry.

According to the researchers, airlines implemented CRM about 30 years ago after recognizing that most accidents resulted from human error. While implementing similar CRM checklists in the dentist’s office might represent a major culture shift that will be slow to catch on, the researchers think it could help – and that it’s inevitable.

“It’s about communication,” Pinsky said. “If I’m doing a restoration and my assistant sees saliva leaking, in the old days the assistant would think to themselves, ‘The doctor is king, he or she must know what’s going on.’” But if all team members have a CRM checklist, the assistant is empowered to tell the doctor if there is a problem.

At each of the five stages of the dental visit, the dental team using a CRM system would be responsible for checking safety items off a codified list before proceeding. Pinsky said that while he expects each checklist to look different for each office, the important thing is to have the standards in place.

Studies show that CRM works, the researchers added. Six government studies of airlines using CRM suggest safety improvements as high as 46 percent. Another study involving six large corporate and military entities showed accidents decreased between 36 and 81 percent after implementing CRM. In surgical settings, use of checklists has reduced complications and deaths by 36 percent.

Many other industries, such as hospitals, emergency rooms and nuclear plants look to the airline industry to help craft CRM programs. Dentistry, however, hasn’t adopted CRM. Sarment pointed out that in his practice, “Using checklists makes for a safer, more standardized routine of dental surgery.”

This study will appear in the August issue of the Journal of the American Dental Association.

When I learned that Dr. Frank Ryan, plastic surgeon to the stars, died Aug. 16 after driving his car off a cliff in Malibu – an accident his ex-girlfriend claims may have been caused by texting – I immediately thought of the people in my own life who have been known to text while behind the wheel.

Just this past weekend, I listened as text messages pinged my friends’ phones – messages sent by other friends who were currently driving to meet us. Like any safety editor worth her salt, I made a point to tell my friends just how dangerous texting while driving is. That includes writing new texts, reading incoming texts, searching through the inbox, checking e-mail, trying to look up contacts, or (God forbid) playing games like Farmville while driving.

But safety concerns aren’t limited to texting behind the wheel. Research shows that talking on a cell phone – and it makes no difference whether you’re using a hands-free set or not – can be as distracting as driving drunk.

Let me say that again. Having a cell phone conversation while driving can be as dangerous as driving drunk.

I’m no stranger to the allure of using a cell phone in the car. When your phone rings and it’s sitting right next to you, it’s so tempting to pick it up. How bad could it be? You’re still watching the road. Maybe you even slow down a little to compensate. It’s something you’ve done countless times before. Other drivers might not be able to handle both a cell phone conversation and safe driving, but you are just fine.

And that right there is the problem. According to David Strayer, Ph.D., the director of the University of Utah’s Applied Cognition Lab, we overestimate our abilities as drivers. Even if we hear that talking on a cell phone while driving is unsafe, we believe that we can handle it.

But we can’t. And it’s killing us.

When I spoke to Strayer several months ago for the June feature story, “Why We Need to Hang Up On Our Distracted Driving Addiction,” he told me:

“You don’t instantly crash on the road while talking on the cell phone. And you don’t instantly crash when you’re drunk, either … In the long run, if you do it enough, you’re going to put yourself at risk.”

The only defenses I have heard for driving while chatting on the phone come from people who just plain don’t want to give it up. That’s understandable. Calling a friend for last-minute directions, or checking off that birthday call to your mother-in-law, or reading the hilarious text message from your spouse can be convenient, time-saving or entertaining. But it’s still dangerous behavior that puts you and other motorists at risk, whether you believe it at the moment or not. (And if you’re about to argue that you need to conduct important business calls in the car, let me point out that research shows the quality of your conversation abilities also decreases while you drive – so it would be better for your business to wait until you’re safely off the road, too.)

I’ve witnessed so many drivers’ unsafe acts that I’m considering refusing to take calls from people who are driving. Try to do this, though, and you’ll be labeled a major stick in the mud (even for a safety editor). So maybe it’s the perception of cell phone use while driving that needs to change.

To make our roads safer, to keep our friends and loved ones from driving off a cliff because they are texting, we might have to treat this more like drunk driving after all. If you’re in a car and the driver starts texting, ask them to stop. Tell them how unsafe it is. Same with making phone calls. You wouldn’t want to be in a car with a friend driving drunk, would you?

Distracted Driving Resources:

http://www.distraction.gov

National Safety Council March 2010 white paper, “Understanding the Distracted Brain: Why Driving While Using Hands-Free Cell Phones is Risky Behavior.”

University of Utah’s Applied Cognition Lab research

University of Utah’s Applied Cognition Lab driving simulator studies (scroll down)