I’ve recently learned something important about the health care system.
I can almost hear you groan. We are so tired of hearing about health care that our first reaction to any helpful suggestion is extreme fatigue. We are bone weary. Exhausted. Numbed by the incessant regurgitation of numbers and findings by yet another government task force. We’re immune to the name-calling and finger pointing. Sick to death of excuses and buck-passing. We are almost at the point where we accept that the system is so dysfunctional that if we emerge alive after entering the portal of doom we feel as if we have won the lottery. That we have been lucky. Not cared for. Not heard. Not treated as a sick human being. Just lucky to make our way out of the hellhole.
I’ve learned what is wrong with the health care system from the patient’s perspective. Most of the debate that swirls around us focuses on the doctor’s perspective or the politician’s perspective or the nurse’s perspective. Those “in charge” are determined to be heard. Determined to build a system that accommodates their work schedules, their pension plans, their election plans, and their quality of life. The patient is incidental. A nuisance that must be accommodated. A weak and unimportant voice.
My knowledge, gained after a recent bout of illness in a city hospital, is that there is a physical, psychological and moral disconnect between patients’ expectations and the actual operation of the health care system. What does that mean? It means, for example, that a hospital’s prime objective is not to offer kind, efficient, respectful and purposeful care for a sick person. That might be what we are expecting.
We are sick and have put ourselves into the hands of those who are trained, and paid, to take care of us. But the current health care system is not constructed to deliver that care.
A hospital is not a benign entity dedicated to a patient’s wellness. It is a workplace. A social system. A stage where strong egos and God-like power play out their destructive dance. It is an institution where there are rules for rules. Where pieces of paper with today’s latest rule, complete with computer clipart, vies for attention with twenty-three other pieces of paper. Where nurses march through hospital wards looking for the miscreant that dared push the buzzer for help. Where doctors pass around patients like hot potatoes. Where drug-induced quiet is the ultimate objective. Where the only laughter allowed is from the staff gathered in a back room around take-out pizza or birthday cake. Where the question most often heard is not, “How do you feel?” but “Have you taken your break yet?” The hospital is a place where the sick must fit their bodily malfunctions into a small window of care where, if luck is on your side and the stars are aligned, your nurse is rested and fed, your doctor is focused and engaged, the budget has been approved for this operating quarter, the equipment is working, and your family have the good sense to be observers, not participants, in your well-being.
I am not hopeful that this will get better. It would take a revolution, and those who could rebel are sick, or are so scarred by their experience and grateful to be free that they vow never to tempt the stars again. To never dare press the buzzer.
And so the patient’s voice is not heard. It is not present at the debate. It is irrelevant.