Saturday, January 24, 2015

Japan: Shortage of pilots felt as ‘doctor copters’ take off

The number of flights undertaken by “doctor helicopters” in fiscal 2013 hit a record of more than 20,000, according to the Japanese Society for Aeromedical Services.

The doctor helicopters, or air ambulances, carry doctors and nurses with medical equipment to places where medical help is required or transport patients in cases of emergency. The helicopters have achieved significant results such as improving the patient survival rate by offering prompt primary care and shorter transportation time, and are also expected to be utilized in case of large-scale disasters. On the other hand, there are issues triggered by the increasing demand, such as costs and a shortage of pilots.


In December last year, a hotline call from a fire department rang at Nippon Medical School Chiba Hokusoh Hospital in Inzai, Chiba Prefecture. A helicopter was requested for a man in his 60s, in Ichihara, who was suspected of suffering a stroke. Staff including a doctor and a nurse ran to a heliport. Three minutes later, the helicopter took off, and another 18 minutes later, it landed about 37 kilometers away in a school field in Ichihara. The patient, who had been carried to the schoolyard by ambulance, was put in the helicopter and transported to a medical institution in the city, receiving primary treatment.

The hospital introduced the doctor helicopter in October 2001. It was mobilized 1,053 times in fiscal 2013, or about 2.3 times as often as in fiscal 2002. Takanori Yagi, 44, a doctor at the hospital, said, “Patients’ lives and whether they suffer any permanent damage depend on how soon doctors can treat to them.”

In April last year, Yagi hurried to the scene where Sakiko Kawabe, 20, a university sophomore, had an accident while riding her motorcycle to a part-time job. The doctor treated her as she complained of abdominal pain in the helicopter as it returned to the hospital. Though Kawabe’s internal injury was serious, it was treated successfully thanks to surgery conducted without delay. She has recovered sufficiently to go about her daily life without difficulty.

Kawabe looked back at that time, saying: “If it had not been for the helicopter, I might have died. The emergency staff who requested the helicopter and the doctors at the hospital saved my life.”

43 helicopters in 36 prefectures

The government began considering introducing doctor helicopters following the 1995 Great Hanshin Earthquake, in which land traffic networks were disrupted, according to HEM-Net, a Tokyo-based nonprofit organization that promotes an emergency medical network of helicopters and hospitals. Trial operations started in 1999, and the helicopters went into full service in 2001.

A survey by HEM-Net shows that the introduction of doctor helicopters raised the patient survival rate by more than 30 percent compared to conventional emergency care involving transport over land, and the number of patients who fully recovered increased by about 50 percent. Currently, 43 helicopters are deployed in 36 prefectures. According to the Japanese Society for Aeromedical Services, which promotes the introduction of doctor helicopters, the number of flights undertaken in the nation soared from 2,302 in fiscal 2002 to 20,632 in fiscal 2013.

Akitsugu Kohama, 76, chairman of the society, said: “The number of flights mobilized has been increasing as the necessity of doctor helicopters becomes widely recognized, and as coordination between fire services, which request helicopters, and medical institutions, as well as cooperation among neighboring prefectures are facilitated.”

More pilots urgently needed

Such growing demand for doctor helicopters raises a new issue.

The central and prefectural governments pay annual operational costs of up to about ¥200 million per helicopter, and hospitals entrust their helicopter operations to private companies. In many cases, however, the increased number of flights means greater fuel costs, and companies cover the excess.

“The business is operated at a loss, but we continue it, considering the public interest,” said an employee of a flight company.

The supply of pilots for doctor helicopters is also tight. As doctor helicopters, which sometimes must land in urban areas, need to be operated with a high level of skill, pilots are required to have at least 2,000 hours of flying experience, according to guidelines by the All Japan Air Transport and Service Association Co. It also costs more than ¥10 million to acquire a helicopter pilot’s license. These factors contribute to a shortage of young pilots.

“There will likely be a growing shortage of pilots due to a lot of postwar baby boomers reaching retirement age and such,” said a person in charge of doctor helicopters at the association. “It is essential that a system to train young pilots gets established.”

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