Factory hospitals

Twenty years ago, the American farming industry experienced a dilemma: How to grow more soybeans, corn, or wheat from a limited amount of farmland, raise more cattle and hogs in a shorter period of time, fatter and ready for slaughter within months rather than years?

(Image courtesy Wikipedia)

The solution: Synthetically fertilize farmland for greater crop yield; “factory farms” for livestock in which chickens or pigs are crammed into tiny cages that leave no room to turn, cattle packed tightly into manure-filled paddocks. As author Michael Pollan put it in his candid look at American health and eating, The Omnivore’s Dilemma:

To visit a modern Concentrated Animal Feeding Operation (CAFO) is to enter a world that for all its technological sophistication is still designed on seventeenth-century Cartesian principles: Animals are treated as machines—“production units”—incapable of feeling pain. Since no thinking person can possibly believe this anymore, industrial animal agriculture depends on a suspension of disbelief on the part of the people who operate it and a willingness to avert one’s eyes on the part of everyone else. . .

Pollan goes on to argue that the cultural distance inserted between the brutal factory farm existence of livestock and your dinner table permits this to continue:

“. . .the life of the pig has moved out of view; when’s the last time you saw a pig in person? Meat comes from the grocery store, where it is cut and packaged to look as little like parts of animals as possible. The disappearance of animals from our lives has opened a space in which there’s no reality check on the sentiment or the brutality . . .”

The same disconnect has occurred in healthcare for the heart. The emotional distance thrust between the hospital-employed primary care physician, the procedure-driven cardiologist, the crammed-into-a-niche electrophysiologist (heart rhythm specialist) or cardiothoracic surgeon whose principal concerns are procedures—with an eye always towards litigation risk—mimics factory farms that now litter the landscape of the Midwest. The hospitals and doctors who deliver the process see us less as human beings and more as the next profit opportunity.

The “factory hospital” has allowed the subjugation of humans into the service of procedural volume, all in the name of fattening revenues. Never mind that people are not (usually) killed outright but subjected to a succession of life-disrupting procedures over many years. But whether livestock in a factory farm or humans in a factory hospital, the net result to the people controlling the process is identical: increased profits.

The system doesn’t grow to meet market demand, but to grow profits. The myth that allows this growth is perpetuated by the participants who stand to gain from that growth.

See hospitals for what they are: businesses. Despite most hospitals retaining "Saint" in their name, there is no longer anything saintly or charitable about these commercial operations. They are ever bit as profit-seeking as GE, Enron, or Mobil.

Comments (8) -

  • Jenny

    11/9/2008 2:48:00 PM |

    Dr. Davis,

    Have you read the book, Hippocrates' Shadow? You have a lot in common with the physician who wrote it and I think it would be very productive for you to contact him and discuss strategies together.

    I blogged about the book in detail at my Diabetes Update Blog a few days ago.

    We patients can't do much about this, but physicians working together could.

  • Zbigniew

    11/9/2008 8:43:00 PM |

    adequate analogy Smile, but what we get here is a gloomy picture with little hope - while thanks to blogs like yours we may be more lucky than those poor animals.

    So the punchline should be something like "educate, read, b/c if everyone takes care of themselves then everyone will be taken care of"

    best regards,

  • steve

    11/10/2008 2:35:00 PM |

    would be interested in your views of Crestor study, and statins in general: when should they be used, etc?

    thank you

  • Anonymous

    11/11/2008 12:31:00 AM |

    Thanks Jenny, for mentioning the book, Hippocrates'Shadow. This sounds very interesting and I can hardly wait to find a copy.  
    Another great book is "How Doctor's Think, by Jerome Groopman,M.D.
    Dr. Davis, I appreciate this wonderful blog and your excellent advice. You restore some of my lost confidence in the medical profession.

  • puddle

    11/11/2008 3:30:00 AM |

    Thank you, again.  And again.

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  • [...] (11)  http://www.newsobserver.com/2012/04/22/2016905/north-carolinas-urban-hospitals.html (12)  http://blog.trackyourplaque.com/2008/11/factory-hospitals.html (13)  http://online.wsj.com/article/SB10001424127887323829104578623720451833006.html (14) [...]