Aviation and medicine have a lot in common. They both require the ability to master a body of knowledge and apply it in a disciplined way, to keep cool while working under pressure, and to sometimes rapidly adapt to a changing environment.

But can other lessons learned about behavior and performance in aviation be applied to medicine as a way to drive down incidences of malpractice? The answer appears to be yes.

A decade ago, the Journal of the American Board of Family Medicine (JABFM) published a study entitled "Aviation Model Cognitive Risk Factors Applied to Medical Malpractice Cases." The study noted that, since the 1980s, aviation accidents have decreased substantially by training pilots to avoid high-risk behaviors caused by cognitive errors.

"In the 1980s, the aviation community under the direction of the FAA found that 85 percent of all accidents and 52 percent of all fatal general aviation accidents were due to pilot error, specifically poor decision making or risk management," the researchers observed. "After 12 years of research and development, it was determined that most errors were cognitive in nature and were the results of attitudes, behavioral traps, stresses, and other influences."

The study evaluated 30 medical malpractice cases and identified risk factors in 59 percent of them using criteria for cognitive factors derived from aviation, namely the IMSAFE model — illness, medications, stress, alcohol (and other drugs), physiological and emotional — combined with medical team management and leadership. Thanks to pilots applying the IMSAFE model, aviation accidents have decreased by 50 percent since 1980, and there is reason to believe applying it to medicine could yield the same results.

The benefits could be enormous. Research released in 2013 from the Leapfrog Group shows that up to 440,000 Americans die annually from preventable hospital medical errors — more than 10 times as many killed every year in traffic accidents. Leapfrog notes just two types of hospital patient infections, catheter-associated urinary tract infections and surgical site infections of the colon, kill 18,000 a year.

In aviation, we have adopted various safety audits and systems over the years including flight operations quality assurance (FOQA), and hospitals have done the same as a way to institutionalize safety and prevent errors in things like electronic records, color coding and other redundancies. These are all worthwhile endeavors.

However, even the best systems cannot outcompensate the judgment of the individual practitioner. That judgment is a finely-honed instrument, and it is the practitioner's self-responsibility to know when he/she is out of tune applying standards such as IMSAFE.