There’s an old saying, ‘Nurses eat their young.’ Traditionally, the first year on the job is a trial by fire, and the necessary process of sorting out the new grads who should be doing something else is compromised by the hazing that was tolerated for too long. Medical workers are supposed to be sensitive and compassionate in their work, and most are. A few are meaner than a rabid weasel, or seem so when they hit someone at a vulnerable time. In a bad system, a medical professional can do awful things.

Phyllis Dewitt was a nurse manager at Proctor Hospital in Peoria. Proctor had a ‘self-funded’ employee insurance plan that made the hospital responsible for claims up to $250,000 each year. Dewitt’s husband was terminally ill with prostate cancer, and his decision to continue treatment rather than go into hospice care was costing the hospital big money.

Things came to a head in early August 2005 while Dewitt was on a hospital-approved vacation with her family and her husband’s sister on Lake Shelbyville, more than 21/2 hours away. When Davis called and asked Dewitt to come in for a meeting on one of her vacation days, the nurse refused.

Davis alleges that during the phone call Dewitt threatened to resign and was loud and critical.

Dewitt says she had to raise her voice to be heard over the sound of the boat’s motor and several noisy children. She insists she never suggested giving up her job—the source of her family’s health insurance—or lashed out at Davis.

The next day, Davis called to tell Dewitt she was fired.

I just can’t get over this. Dewitt’s colleagues knew that she was taking a vacation with her dying husband. She might have wanted a leave of absence to spend time with him, but she had to work to provide the insurance. They had the indecency to call her on her time off and demand she come to work–and then they fired her. What makes people behave like this?

This reminds me of Michael Moore’s movie, ‘Sicko’ where a doctor who worked for an insurance company tells about getting congratulations and a bonus for finding an excuse to deny a patient an organ transplant that might have saved her life.

In many ways our current health insurance system is the worst of all worlds. It’s expensive, leaves many uncovered, and doesn’t reward prevention.

There’s no system we can sustain that won’t have to practice triage. We cannot, and should not, try to provide every treatment for every person. I believe this in the abstract, but I would not easily accept it if it were me or someone I loved who was triaged out. But what we should strive for is a system that is transparent, fair, evidence-based, and constructed to do the most good for the most people.
Instead we have a money-driven system that practices financial triage, and turns otherwise decent people into cogs in a broken machine.