Tuesday, January 03, 2012

New York - Presbyterian Hospital Trustee Advocated Novel Cardiac Procedure - "Reach In, Rip Out Their Heart, and Eat It Before They Die"

The dominant theme of Health Care Renewal has been how problems with the leadership of health care organizations have lead to our current state of health care dysfunction.  We have discussed examples of ill-informed, mission-hostile leadership rewarded with excess compensation, exhibiting impunity in the face of alleged misbehavior, and at times descending into corruption.  The cause of these problems is doubtless multi factorial.  However, one possible cause is that rather than exercise stewardship and hold leadership accountable, those in charge of governance of health care organizations, that is, boards of directors or trustees, have instead infected the organizations with the amoral culture now dominant in much of the business world, especially finance.  We have discussed, most recently here and here, how the boards of health care corporations often include heavy representation of leaders of finance, including many of those who seemed responsible for the global financial collapse, great recession, or whatever we will end up calling it. 

I recently stumbled upon a particularly graphic example of the sort of predatory culture that now exists on the boards of health care organizations.  (More on how I did so later.)  Below is an embedded YouTube video of a speech made by a current Trustee of New York - Presbyterian Hospital (who has been on the board since 2007).  He is Richard Fuld, the former CEO of Lehman Brothers, whose continuing role on the hospital board, despite his failed leadership of one of the financial firms whose bankruptcy ushered in the global financial collapse, we discussed first here.

Just to underline it once more, Mr Fuld, referring to short sellers of his company's stock, said he "what I really want to do is I want to reach in, rip out their heart, and eat it before they die." 

Can there be a more stark reminder of what has gone wrong with the governance of health care?  Can anyone watch this video and argue that Mr Fuld ought to be on the board of a hospital system?  Why is he still on the board in January, 2012, when this video was released in October, 2011?

While I suspect not many other hospital system board members have been videographed displaying equally brutal sentiments, there are likely others with similarly barbaric tendencies.

So, on a more positive note.... The boards of hospitals, hospital systems, medical schools, and their parent universities ought to be populated with people who take their stewardship roles seriously.  They ought to be people who understand, agree with, and support the organizations' mission, and their dedication to patient care and teaching.  They ought to understand what good leadership of health care organizations entail.  Needless to say, they ought to be of good character and above any ethical reproach.  In short, they ought to be the opposite of the sort of person displayed in the video above.

It should now be obvious that grievous problems with the leadership and governance of health care organizations are principle causes of the dysfunction in our health care system.  True health care reform will require wholesale changes in health care leadership and governance.

PS - In case the video above seems too short on context, see the one below:


Seven Signs said...

Masters of the Universe care not one whit. Other than the threat of hell, why would they care? I'm sure they think their good works make up for their bad.

The message of Seven Signs of Ethical Collapse is that once all seven signs are there, collapse is inevitable. Now that our government has become involved with the bail outs and kid gloves of the wall street fallen, we are all on the hook now.

Making a deal with the devil never works out. We are all culpable now.

Anonymous said...

How much is a baby’s life worth? $6,642 according to Glaxo. Via Pharmalot


we learn that GSK was fined $93,000 in the death of 14 babies. The parents, illiterate and living in poverty were given 28 page documents to sign with no advocates present to explain the risk.


“The issue has caused a stir India, for instance, where some 1,700 people who participated in trials died between 2007 and 2010, according to the drug regulatory agency, although no autopsies were not peformed to determine the causes of the deaths. In 2010, 22 families of the dead were compensated by drugmakers, ranging from $2,000 to $20,000, The Washington Post writes (read more here).”

These, and other instances, have resulted in a call for closer supervision of overseas drug testing. This will be of little or no comfort to those who have lost children.

While we in business often use graphic and inappropriate analogies, we have to now ask: Has the rhetoric grown out of proportion to our desires, and as a result the win at all cost mentality, is not causing injury to others, but death? The answer appears to be yes.

With no personal responsibility, and companies receiving legal settlements that do not lay the blame at their feet, it seems that even death is allowable in the drug testing business.

I could not help but be struck that through history we seem to devalue those who are not like us. Religion, ethic background, disability, and education, are just some of the reasons we devalue the lives of others. Doctors, above all else, take an oath to look beyond all of these factors in the care of their patients. Doctors, past and present, seem to be the very first to look at these differences, and finding the patient in some way not meeting their standards, willing to not only inflict pain, but cause the death of the very ones they are charged with protecting.

Steve Lucas

Afraid said...

Very thoughtful comment Steve, thank you. It could well be that doctors are the secret to correcting the healthcare problem. Why is it do you think that a society of concerned doctors has not replaced the AMA?

Roy M. Poses MD said...

Afraid, and others -

See also relevant comments just added to this post:


Maybe there are now a few doctors and other health professionals out there who see the need to form some sort of organization.

InformaticsMD said...

Steve Lucas wrote:

Doctors, above all else, take an oath to look beyond all of these factors in the care of their patients.

See this comment that I just discovered today on an old post about IBM Watson and cybernetic medicine for another sign of a debased culture that has permeated our society.

-- SS

Anonymous said...


Thank you for the kind comment. I think Roy’s follow on comments to his last post along with Dr. Carroll’s post hit on the main issue.


There is so much money in our system, twice as much per person as in any other developed country, that the ability to act criminally with no consequences has attracted a corporate culture that will hold on to power at any cost.

On another blog some time ago we took the AMA’s numbers apart and one doctor came up with 10% as the number of practicing doctors who belong to the organization. Yet the AMA has an outsized influence on the practice of medicine in the US through controlling the coding system and follow on payment and practice guidelines.

There are good doctors. The problem is they have been so beaten down by a system that they do not see a way out. Survival becomes their prime motive and playing the game in the mistaken belief that they:

Do not have a choice


Are not harming their patients.

Wasting resources in the hope of making a small token amount through excessive testing and medication leaves those in need standing on the outside looking in, where they can only hope to receive some type of care.

What we need is a political solution supported by doctors, not doctors organizations, or the medical industrial complex. These latter two will always act in their own self interest and we will continue the same upward spiral of cost and lack of access that is the current plague of this country.

Steve Lucas

Healthcare IT solutions said...

Thats an excellent post Steve.I appreciate your point of views regarding the organization members. The people associated with healthcare should be dedicated towards their job.As its People whom they have to tackle and not machines unlike other jobs, their major approach should be to take every possible action for benefiting the patients.