The Fit Student—Disease is Profitable

Two nights ago, I had a dream that I worked as a med student in a hospital.  In that dream, I walked with my supervisor outdoors across a sprawl of hospital towers.  I asked my supervisor what three unusually large towers housed.  She said they housed the people with chronic diseases.  The patients, she said, lay bedridden, writhing in pain.  It was where they went to die.

In real life, I had an undiagnosed chronic disease I cured through healthy living.  It’s now a year and six months since I diagnosed myself with two years left to live.  Had it not been for fitness and nutrition, I might today be bedridden in a hospice.

But in that dream, I longed to make the dying healthy again.  I would feed the patients pure nutrition, not hospital food.  I’d get the patients moving in any place but a hospital bed.  “We’re killing them here,” I said.

Author Dr.  Marty Makary says, “I felt disillusioned.  It seemed as if, despite all the book knowledge I had gained, nearly half of the patients I saw in the clinics had problems for which modern medicine had nothing to offer except phony names for diseases we didn’t understand.  The other half of the patients seemed to be sick because they were obese, smoking, or not taking care of themselves—preventable problems” (Makary, location 1988, 60%).

I often marvel over youth who vow to become doctors or nurses.  You know, the children who helplessly watch their mothers pass from cancer and who then vow to find a cure.  I too now have a taste of that drive to heal.

But I don’t know what I can do to help.  At least, not yet.  Not only do I feel helpless, but so do many nurses: “The problem … was just that no one felt comfortable speaking up.  Nurses complained that the equipment was antiquated, the rooms were small, and the trainees were in over their heads.  Yet staff didn’t feel they had the right to do anything about these matters for themselves” (location 600, 18%).

In my view, hospitals need better focus on diet and fitness to heal those dying of chronic diseases.  So, why haven’t hospitals figured this out?  It could be that hospitals profit from your sickness: Dr.  Clifton “put the pieces together ….  Hospitals profit from bad medical care.  He realized that hospitals get more money for each complication, X-ray, and extra patient day in the ICU” (Makary, location 444, 14%).

My doctor saw me at least once a month or so.  She ran countless tests.  But ever since she told me to exercise and eat well, she never sees me.  I wonder if she regrets getting me healthy the natural way.  Author Marty Makary says, “[U.S.] hospitals explicitly pressure their doctors to do more procedures and see more patients in order to make more money” (Makary, location 2053, 62%).   In fact, “one highly cited study showed that approximately half of all cancer patients received chemo or radiation treatment the same week as their death” (Makary, location 2064, 63%).  So, why bother with unnecessary—yet painful—chemotherapy drugs? “I’m convinced that few of the patients … know that drug companies pay doctors for meeting sales targets” (Makary, location 2087, 63%).

Long ago, I met a doctor who was fired for speaking out against the health care system.  I’d see him speak at the university about “transparency.”  I never understood what he meant, exactly, by transparency.

But since reading the book by Dr.  Marty Makary, I now know the value: public statistics.  Hospitals would surely improve if held accountable by public stats on

  • those dying during hospital procedures,
  • those readmitted,
  • those who had the wrong body part operated on,
  • those given unnecessary operations,
  • those infected by instruments left inside their post-surgery bodies (Makary, n.d.).

You get the idea.

So, who pioneered public statistics in health care?  Dr.  Mark Chassin “decided to do something radical – make heart-surgery death rates public” (Makary, location 480, 14%).  What did he find? “The first year that New York’s hospitals were required to report health-surgery death rates, wide variation was found—the death rate by hospital ranged from 1 percent to 18 percent—confirming long-standing rumors that quality of cardiac surgery was wildly variable among hospitals” (Makary location 490, 15%).  And then those public statistics brought real change: “Instantly, New York heart hospitals with high mortality rates scrambled to improve ….  The result of the release of this data? Big, broad improvements in mortality, statewide” (location 501, 15%).

Public statistics seem to improve hospital accountability: “With universal transparency, hospital leadership would also develop a fast-moving protocol by which to conduct crackdowns whenever new problems come to light.  Sunlight, it is often said, is the best disinfectant.  But under our current, largely unaccountable system, hospital problems, out of sight and out of mind, just pile up until they get so out of hand only a major, punishing scandal can hope to remedy them” (Makary, location 622, 19%).

So, if any of your loved ones have chronic diseases, don’t watch them fade.  Instead, get them fit and healthy—and speak out about transparency.  With transparency, hospitals might adopt the best care possible for people with chronic diseases.

On a final note, “next time you’re seeking care, inquire which compensation model is used to pay the hospital’s doctors.  You may be surprised what you learn” (Makary, location 2087, 63%).  In other words, disease may be profitable.

Lastly, this was the path I was headed, and these are the people I long to help:

Makary, Marty, MD.  (E-book).  Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.  New York: Bloomsbury Press.