Suzanne Gordon

Nursing in peril

HÉLÈNA KATZ | The global trend towards turning health care into a commodity and patients into customers is diminishing the quality of care, said an American journalist who writes on health care issues. Suzanne Gordon, whose recent lecture was sponsored by the School of Nursing, has written extensively about health care and is the author of Life Support: Three Nurses on the Front Lines. The book traces the work of three nurses at Boston's Beth Israel Hospital. Under a free market system where health care is treated as a business, training is not valued the same way it is in a system where patient care is the overriding concern, Gordon said. That has meant that nurses no longer have the time to properly act as mentors to each other and share knowledge acquired on the job. "Knowledge and training just isn't on their radar screen." Gordon, an adjunct professor in the School of Nursing, noted that some believe that commodifying health care turns patients into consumers and takes paternalism out of the health-care system by giving "customers" more choices about treatments and services. But Gordon argued that this way of thinking actually shifts the burden of responsibility for getting proper care onto patients and away from health-care providers. "It's pretty hard when you're having to tell a sick patient to go traipsing around to a lab to get tests done," she said. "But when the person is a customer, it doesn't matter [because] a customer bears the responsibility to get what they need." And that encourages a "blame-the-victim" mentality, she added. Shifting the onus of responsibility for getting the proper health care away from the providers and onto the shoulders of the sick is an added burden for patients. "People who are sick shouldn't be asked to fight for care," Gordon said. Claims that universal health care invites abuse by users are overblown, she declared. "The people who would rather go to the emergency ward instead of going to the movies are a minority," she said. By the time most people go see a doctor, they have been denying for a while that they have a medical problem. Borrowing sound business practices to improve health care delivery is a good idea, said Gordon, but nurses have an important role to play in challenging the commodification of health care, particularly the notion of patients as customers. It's important for nurses to speak out against deteriorating patient care rather than trying to adjust to the changes in the health-care system, Gordon said. "At some point adaptation perpetuates noxious circumstances."