LAUSR

As healthcare professionals, we spend much of our time treating people with well-defined ‘illness’. In cardiology, we are sometimes fortunate (although it may not always seem that way) to have the benefit of large randomised controlled trials, guidelines from internationally recognised organisations and expert consensus statements to guide our practice and decision-making. The assessment of people who are generally fit and well and choose to have personal health checks provides a challenge when it uncovers abnormalities that might otherwise have gone undetected. However, at least in this scenario where the choice was that of the individual, if the abnormality is one that is potentially life-threatening, then this may somehow be seen as beneficial. But the reality is that often these findings are not of a life-threatening nature and the question as to what to do next causes difficulty for many physicians being asked how to treat these individuals. Now, apply this to individuals who have not chosen to have those health checks but have undergone them as part of an occupational screening process, where the outcome may well influence their ability to continue to practice their profession. This is even more difficult to deal with, and we start to get into the world of aviation medicine. This brings us to the content of this supplement. …