The Joy of Nonessentials

“We’re all in this together.”  Oh, how I have come to hate this phrase, which is less an expression of communal goodwill than a euphemism for “we get to take your stuff and tell you what to do.” 

Arizona’s two major health systems, Banner Health and Dignity Health, are putting this into practice with the very folks we might have mistakenly thought they depend upon:  physicians and nurses.  Due to sudden shortages, “mask usage has been curtailed so severely that administrators are yanking masks off workers’ faces, according to private messages among Banner employees…Banner is also telling its health care workers to disinfect and reuse certain equipment, like masks and goggles…”

At Dignity Health hospitals, “doctors are changing the way they take care of patients in order to save protective equipment…They are now potentially limiting contact with patients suspected or confirmed to have COVID-19 to hospital intensivists …”  “Non-ICU doctors are having ‘pre-discussions’ with the unit’s intensivist to decide whether non-ICU doctors should see patients in the ICU who have or might have COVID-19 … They determine together whether a patient’s condition warrants additional patient contact.”

If this doesn’t hit you as hilarious, then you have worse problems than COVID-19.  How many of these two corporations’ hospitals were unprepared for their last JCHAO pre-inspections?  Which of these systems directed their CEO’s to give the finger to CMS over monies wasted on EHR’s, core measures, and hiring additional administrative personnel even as the nursing shortage grows nationwide?  Which of these systems looked at their stated core missions, and then limited hospital administrator pay in order to keep extra stock for a rainy day?  So far, we should bet the answer is a cheery “None!” across the board.

“One of Banner’s internal guides for Arizona health care workers, titled “Usage Guide-Tier 1 Conservation” and updated Wednesday, told health care workers that they cannot wear personal protective equipment, or PPE, in hallways.”  Was that due to infectious concerns, or – as the text states – for “conservation”?  Because you big health systems don’t have enough and were never going to have enough, you want overburdened staff to waste extra time hopping in and out of PPE, or simply doing without and increasing their potential exposure?

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Banner’s “COVID-19 Healthcare Worker Monitoring and Return to Work Guide” is advising workers with cough, shortness of breath, or fever to follow up with their local PCP’s…who are of course shuttering up, a pattern seen coast-to-virusy coast. 

What is the actual purpose of health care in a mixed-economy, crony corporatist nation?  Is it to care for the sick, or as in this hilarious “Yes Minister” clip  is it to provide the appearance thereof?  As has been chronicled and predicted on this site for years, the nation has lain itself wide open for major health crises by wasting probably hundreds of billions and untold man-hours on wasteful mandates and centralized control that contributes not a bit to actual patient care.  Politicians, bureaucrats, and the entitled scream about preserving their awful systems, while lobbyists and the blackest greed keep the Big Health CEO’s and administrators fat and rich, while shorting those who are actually trained to provide actual care.  If anything, these days should be a call for health care to return to the individual physician and patient, and a screaming caution against relying on large, impersonal organizations.  

In retrospect, rotten demonstrations like those of Banner and Dignity should probably have been expected, and are the just due of a society that gave away individual health care to those guaranteed to have the least interest in it.

Because after all, “we’re all in this together.”

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at AuthenticMedicine.com . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption. 

  3 comments for “The Joy of Nonessentials

  1. Harrietta Christodoulos
    March 28, 2020 at 10:35 am

    great article. so many good points,

  2. Rick
    March 25, 2020 at 12:18 pm

    Oh Pat, so many truths in one narrative. Thanks!
    I am having a hard time controlling my anger.

    • March 25, 2020 at 10:00 pm

      I hope that by, “controlling my anger” you meant that you are using it to help change the situation.

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