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go to BBCworldservice.com slash podcasts. broadcasts. truth about success and failure in medicine, a series examining how and why organizations

succeed and fail, searching for lessons that might one day be of use to all of us.

Sometimes to save lives you need to risk lives. Getting that balance right is incredibly

difficult especially in medicine. In the first program of our series we are

looking at an industry in the United States that got that balance wrong.

In the hospital site request, Rhetowness Center to UW. In 2008, a new occupation was

a new occupation rose to the top of the list of the most dangerous jobs in the United States.

It was more dangerous than Atlantic trawler fishing, more dangerous than logging, or even steel working. It was being a crew member aboard a helicopter emergency medical service vehicle.

Now I'm standing on the helipad of the University of Wisconsin Hospital's Medflight Service.

I'm about to climb onto one of their helicopters to find out what it's like to do what is statistically one of the most dangerous jobs

in the United States. Yep. approximately 55 kilos. Every year in the United States, hundreds of thousands of patients,

many in need of urgent care, are attended by helicopter emergency medical service teams.

These flights provide vital access to specialist

medical expertise and save lives threatened by critical illness or injury.

But to reap the huge benefits that these services bring, the operating organizations and crews have

to manage significant risk.

Yet when compared with other countries, the US has an unenviably poor safety record.

So why is the US different?

What is it about the system of helicopter operation there

that leaves them vulnerable to a much higher rate of accident

...