I had lunch last week with one of my dear friends, Lu Marchand, M.D. We met at Barriques coffee shop on Monroe St. in Madison, WI. Not having seen her in about three months, we had a lot to catch up on. Unlike me, Lu has attempted to live out her desire to explore alternative forms of medicine within the medical system. Specializing in integrative cancer care, she has been working with a team of cancer health professionals here in Madison. There are problems and frustrations unique to each path we have chosen. I enjoy meeting with Lu to learn about “the path not followed,” among other reasons. Trying to express her unique and vibrant personality in the medical system has often left her feeling stifled.
This time, as Lu detailed to me her life working within the hospital, our conversation followed a different path. In spite of her success in working with cancer patients on all levels of healing, the hospital decision makers continue to be hesitant about offering these services on a larger scale.
Setting my coffee down, I asked “Why can’t leaders in our medical system see things from a wide enough perspective to build a system around patients rather than their financial fears?”
Lu shook her head, disconcerted. “Hospitals plan services often on what will generate revenue, such as surgery and procedures, and essential elements such as attention to nutrition, movement, emotional and spiritual well-being are usually considered secondary.”
“Oh?” I queried.
We can pause for a moment and think about how we ourselves might go about such a process. We would begin with a brainstorming session on the idea “How can we build the best hospital in the country?” closely followed with, “What do patients and families who stay in our hospital need? How can we build a hospital that will truly serve their needs, such that every parent in the country will want to bring their loved one to our hospital?” Sounds like a good way to begin planning a hospital, doesn’t it? Apparently I am behind the times. Here is my summary of Lu’ description of thinking of the medical leadership:
Our health care system rewards surgery and procedures. Hospitals, in their design, function and priorities, calculate what will contribute to the bottom line of finance. Support services to keep patients as healthy as possible as they enter our hospitals for their conventional care are not seen as important or cost efficient. They may be seen as necessary, but since they do not generate sufficient revenue, they are seen as secondary, or less important. Patients and families fall through these huge cracks in the system, and don’t receive the care that leads to total well-being and healing. A quick fix is offered, but this approach misses the mark toward true health.
Do they think about designing a hospital from the point of view of what people really need? Apparently not a lot of thought is given to that. This brings out what we know and love about a level one diagnostic
system: people and feelings get lost, transformed into diagnostic codes, which in turn translate into dollars perconventional intervention such as drugs, surgery or procedures. Voila a health care system run by accountants.. Our health care doesn’t need leaders; it merely needs those with the skill to tally insurance pay-outs and capitations.
I respect the need for hospitals to remain in the black. Nevertheless, in the long-run, such dumbed-down thinking, with service reduced to its least common denominator, can’t be good for business. Our medical system remains shrunk within its own impoverished imagination. The only reason they get away with it at
all is because people are slaves to “free medicine,” willing to accept anything the system feeds them if they don’t have to pay for it. As Lu explained, many people view alternative therapies as out of reach because most are out of pocket expenses, and they view expensive conventional therapies such as medication or surgery as relatively “free medicine” since insurance (if they are fortunate enough to have insurance * and these numbers are rapidly shrinking) will pay for these therapies, but not other more alternative therapies that are less costly and at times, more effective.
Ours is not a system that serves patients. It’s a system that serves bean counters.
