A corporate board, on the other hand — whether it governs a hospital, a pharmaceutical company or an insurance giant — is legally required to give priority to stock holders over patients. When it comes to matters of health – which is to say life, death, and disability – it seems obvious to me that corporate boards are the least desirable level at which decisions about patient safety should be made. Decisions like increasing product sales at the expense of patient safety.
How are we to protect ourselves from the emotional hazards of the practice of medicine? How are we to stand with our patients through the very worst while avoiding depression, significant stress reactions, and even substance abuse or addiction?
In order to attain the corpore sano required by today’s fanatical health and hotness community you have to devote two or three hours a day to honing the body beautiful so that it contains no lumps, bra overhang or bits that have to be sucked in when you walk past a mirror. This involves lunges, squats, curls, lat pulldowns, pushups, bench presses and eventual death from exhaustion unless you are of that rare elite who are truly in The Zone.
The obsessive pursuit of health is itself unhealthy. We can locate ourselves at the enjoyment of health end of the spectrum or we can pursue disease. There are many influences in our lives that lead us unconsciously to pursue disease. To consciously choose the enjoyment of health we must recognize and resist these influences.
To be fair, many of these experts may be true believers, people who want to do everything they can not to miss anyone who could possibly benefit from diagnosis. But the fact that there is so much money on the table may lead them to overestimate the benefits and ignore the harms of overdiagnosis. These decisions affect too many people to let them be tainted by the businesses that stand to gain from them.
She goes on to discuss some of the issues involved in getting pharmaceutical companies to develop desparately needed new antibiotics. In particular, she explains the need to create a stockpile of new antibiotics that everyone will agree not to use for many years. (If we did use them, resistance would develop almost immediately.) This will mean some people (thousands? tens of thousand?) will die during the waiting period, when they could have lived. (Good luck on that one.) Someone (the government? foundations?) must agree to pay the pharmaceutical companies for all those years of waiting. And the US – for various reasons – will have to do this first.
The top 1 percent have the best houses, the best educations, the best doctors, and the best lifestyles, but there is one thing that money doesn’t seem to have bought: an understanding that their fate is bound up with how the other 99 percent live. Throughout history, this is something that the top 1 percent eventually do learn. Too late.
