I can't remember where I read or saw this, but it struck me as the obvious key difference: In aviation, procedures and practices are developed in concert with experts in aviation maintenance, aviation engineering, various parts of system design, and the people who fly the darn planes. In medicine, the lobbyists, politicians, and software companies have political and economic incentives and communication structures quite divorced from the practiced expertise of actual end users, not to mention the people being treated. So you have all these 'best practices' being imposed that have little to do with the sorts of best practices health practitioners would do or want to do or what patients need.