Every day, patients lie on operating tables not knowing if the person about to cut them open has done it before.
The doctor may have spent years studying and practicing. But has he or she worked with an ambulance crew, specialized surgeons, nurses, an anesthesiologist and a worried parent before?
In some cases the answer is no — they learn that on the job under close supervision.
But a consortium of Wichita hospitals, schools and government entities plans to change that.
They're in the early stages of planning a $14 million Mid-Continent Regional Center for Health Care Simulation where medical professionals could practice real-world scenarios on high-tech mannequins with the same types of teams who work together in real ambulances, emergency rooms and labs.
"It's another way for patients not to be the guinea pigs," said Kathy Neely, the chief nursing officer at Wesley Medical Center who has been involved in early planning efforts.
It will take roughly $8 million in donations from foundations and individuals; about $5 million from taxpayers and hospitals and about a million worth of gifts and cash from the medical industry.
But if it works, Wichita-area doctors and educators say patients could count on better care when they're rushed to the hospital and seconds mean the difference between life and death or long-term disability.
"This is truly for the general community as much as it is for the medical community," said Paul Uhlig, a heart surgeon who is the chair of the proposed simulation facility's steering committee. "It's about better patient care."
Uhlig and others quietly started planning about two years ago. He said he intentionally began working on building trust among competing schools and hospitals before making the proposal public.
It's a tough time to raise money, he said, but this is a unique opportunity that has wide-ranging benefits.
And the idea has generated a lot of support.
The proposal has the initial endorsement of professionals at the University of Kansas School of Medicine-Wichita, Wichita State University, Butler Community College, ITT Technical Institute, Newman University, Wichita Area Technical College, Sedgwick County, the Wichita Business Coalition on Health Care, Wesley Medical Center, Via Christi Health and McConnell Air Force Base.
Those entities and probably a few more would share the facility and work side by side in it, Uhlig said.
In the past decade, medical simulation has reached new levels.
High-tech mannequins can mimic the physiological reactions of a real person, from the effect of a small change in the dose of intravenous medicine to the trauma of a gushing jugular.
Virtual-reality software can show the image of an arm on a screen and on a separate device mimic the feeling of pushing a needle into a normal arm or one that has been badly injured.
"If you're the patient or the injured personnel on the highway or any building in Wichita, (the benefit) is having more and more people in our medical community who have practiced all of these things and can respond quickly," said H. David Wilson, dean of the KU Medical School.
The medical simulation field started in labs at Harvard, Stanford and other schools more than 20 years ago.
But they now speckle the map from Jacksonville, Fla. to North Dakota.
Health care professionals compare medical simulation to aviation training, where pilots practice and earn certifications in flight simulators.
Steen Mortensen, chief of rheumatology at Wichita Clinic, saw medical simulation in action during a Visioneering trip to Jacksonville.
He said it provides realistic practice that could help give new doctors more confidence when they start working with real patients.
"I certainly felt very jittery the first time I injected into someone to get a blood sample," he said. "It's invading another human, and it's a strange feeling."
But it has limitations.
Mannequins can mimic the body and actors can play the role of patients or the victim's relatives.
But there's no substitute for real human touch and the subtle body language that can convey pain and the emotion of dying, Neely said.
"I don't know that we'll ever capture that," she said. "And I don't know that we should."
Steering committee members propose putting the simulation center in a 33,000-square-foot former Wichita Area Technical College building along K-96.
It would have an emergency center with a mock helicopter pad to transition virtual patients from the chopper to the emergency room, where people could practice the procedures required for heart attack victims, people involved in bad car accidents, women giving birth and other emergency scenarios.
It would have surgical suites, intensive care units and reception centers for friends and relatives of victims just like real hospitals.
It would also have a theater for training seminars and small classrooms to discuss how trainees performed during virtual medical procedures.
The health care industry is the second leading industry in Wichita, and the steering committee says up to 9,496 students and professionals could eventually train there.
Uhlig, the chair of the facility's steering committee, said local schools and hospitals have some mannequins, but none has the money to support a full-scale virtual hospital.
He envisions Wichita's facility as a world-class center that trains medical professionals throughout the region.
Uhlig said the biggest obstacle to the proposal was probably building trust among competing schools and hospitals.
Money is the next barrier.
The group is applying to become a nonprofit.
But for now, it is working with the Wichita Community Foundation, which will collect donations.
Uhlig said he hopes that some wealthy individuals may help fund the center through large donations. But he also anticipates smaller donations of $20 or $100 from people who believe in the center.
The project will probably require taxpayer money, too.
"The challenge is always where's the funding stream, who the partners will be and the public sentiment toward it," said Tim Norton, a Sedgwick County commissioner who is on the center's steering committee.
He said he will encourage the county to start talks about helping fund the center.
"With the economy there's some tough times," he said. "Is this the right time to invest? Is it not? I guess we have to see what the ask is and what the partnership will look like."
Wilson, dean of the KU Medical Center, said the project is expensive, but it can save patients and hospitals money by providing better care by more experienced professionals.
"These are really life-saving measures that we practice here," he said. "Saving lives is important, but saving people who can go back and function the way they did beforehand is equally important, and some would say more important."