Faith in Medicine
Just due to all of this, all that’s happened in 2020, I’ve been thinking a lot about our faith in medicine. With the COVID-19 vaccines, the medical and scientific community developed an effective vaccine to a novel virus in less than nine months. It’s astounding; it’s moon-landing level significant to me; it’s a marathon of the human mind.
But what shadows this great advancement is a legitimate, largely self-inflicted, crisis of faith in medicine. There remains a strong phalanx in the United States unwilling to get the COVID vaccine. There are carcinogens in our sunscreen. There is lead in our tea. This is the decade of Theranos selling fake blood tests, of John Oliver pranking medical correspondents, President Donald Trump lying about hydroxycholorquine because he had stock in the manufacturer’s company.
This is a blog about consumption and its perils, and it’s written by a data analyst who has worked for a few healthcare companies. This gives me a privileged vantage point to discuss this crisis. I have both a personal background in the medical field and a powerful anti-consumerist perspective. This blog loves talking about scammers and hucksters, about how advertisers lie, and every example above, from Holmes to Trump, is an example of a self-marketer or hustler realizing that people will pay an arm and a leg for a healthy body, making people with bodies a particularly lucrative mark. So. I’m the right one to talk about this. This is my beat.
And alongside all of these hucksters are the people that trusted them. There are good-faith, naive and honest people in the world of healthcare who, pressured by money and profitability, have done harm.
Let me give you an anecdote, a story from my time working in healthcare.
A Parable of a Rural Hospital
In my work, I meet and talk to a lot of C-Suites, the CEOs, CFOs, COOs, CNOs (that’s Chief Nursing Officer), and CMOs (Chief Medical Officer) of large hospital systems.
This is a fictionalized account of an actual meeting I had with a C-Suite. The dialogue I have amplified for comedic effect, and I have shifted the facts around just enough so that you could never identify the hospital systems in question.
In a meeting with the CEO of a large rural hospital system, whose location I will not disclose, the CEO showed us a picture of a large and beautiful hospital, backed by snowy mountains. “This is our cross-town rival,” he said. (Hospitals in America are private enterprises, and fight with one another to gain market share, to make sure as many patients go to their hospital as possible. So of course there could be cross-town rivals, just like a rest stop with a Chevron and a Shell facing each other, like Netflix and Hulu.) “It’s a beautiful hospital they built this year, thirty miles away from our main health campus. And there’s something very special about our rival’s hospital, something that makes us worried about our prospects of staying competitive in this region. You see, this hospital uses echolocation sensors spread throughout the emergency room to track the position of needed medical supplies, of every syringe and every roll of gauze available in the hospital, so that nurses can look down at their iPhones and immediately identify the closest EKG, dental pick, you name it. This new hospital even was designed by leading acoustic engineers to make sure that the sound used by the echolocation devices can flow smoothly through the building, uninterrupted. These were acoustic engineers that used to work for Pink Floyd, The Beatles, real stars in their world and not inexpensive. We want to do the same, but we want you to join our enterprise and design even more sophisticated echolocation sensors for us. With your help, and the help of acoustics engineers we’ve contracted from Boeing, we could make the modern Smart Hospital.”
My company did not build hardware, like sensors, and so we politely declined this offer.
I think about this CEO often. It was, in my mind, an utterly bonkers, parodic scenario. There was such enmity and envy in the CEO’s voice when he described this rival hospital. He was pissed off that he didn’t have this new toy, and he would do anything to get it.
Echolocation in hospitals is a real thing, and yes, it is used for materials management.
Materials management concerns itself with making sure that a hospital has all of the medical equipment it needs, from EKGs to dental picks as our CEO said. Materials management is incredibly difficult in hospitals. Hospitals are big places, and there are many chemicals and instruments you can stick into a person’s body, and so things get lost, misplaced and mislabeled all of the time.
Certainly, better materials management means less waste, fewer errors, which is unimpeachably good. We know that it’s reduce, reuse, recycle. I’m glad hospitals take this seriously.
But, oh how it contrasts with the materials management disaster that is the US military: the US military can’t keep track of $1 billion dollars in weapons and can’t be bothered to check which warehouses hold their stockpiles of rations and armaments. The army is paid so much that it doesn’t even care about materials management. They have no need to be frugal, to get better at materials management. Hospitals, on the other hand, need to ration every single syringe, and are willing to spend massive amounts of money in order to become more frugal. They, unlike the military, can’t afford to not know what’s in their warehouses.
Instead of properly funding healthcare, we have created a system where war can be done wastefully but where our hospitals need to scrimp as much as possible.
You can understand that envy then in that CEO’s voice. Sure, the CEO we met with wanted to have this new toy, but you can understand why. If his hospital doesn’t turn a profit, it will go bankrupt. It will disappear. This crosstown rival is not just someone to envy, it is an existential threat to his health system, and the healthcare of the patients he looks after, and he’s already counting every syringe because he doesn’t know if he can buy more.
I don’t believe that the CEO ever got his echolocating hospital. Shortly thereafter, the COVID-19 pandemic began. For those unaware of the financial aspect of healthcare, hospitals paradoxically lost money during the pandemic. So, there was no money to buy his echolocating hospital. The CEO would layoff a number of his hospital system’s staff in June of 2020.
All of this is inevitable in a privatized healthcare system, in a world where hospitals behave like businesses rather than the necessities that they are. Hospitals go bankrupt. Doctors get laid off. Money bosses healthcare around, and I don’t believe that that’s to the benefit of our patients.
It’s not just medical science that we’ve lost faith in, it’s the entire practice of medicine in this country. In both cases, money is to blame. That CEO and his amazing echolocating hospital was the perfect example of a healthcare industry primed to accept hucksters and magic thinking into our homes and hearts.