It’s been two months since my birthday, and I’m still enjoying my favorite present. It was from my husband. He gifted me a digital subscription to the New York Times. The articles are largely well-written, and I already feel smarter now that I’m not limited to 10 free articles per month (per browser).
But I think a recent oped whiffed on the opportunity to contextualize an important issue. The article was called, The Business of Health Care Depends on Exploiting Doctors and Nurses. The author, Dr. Ofri, wrote about the unreasonable demands health care workers shoulder due to mushrooming admin and patient expectations. Administrators (and patients) can get away with these demands because doctors and nurses feel duty-bound to care for their charges no matter what. The subheading hinted at what I think is the real story: “One resource seems infinite and free: The professionalism of caregivers.”
This article is a case of missing the forest for the trees. It is true that health care administrators need to accept and respond to the evolution of the field. Electronic medical records and increasing medical complexity are both game-changing. Old practices are no longer sufficient. But this is just the trees. If you step back, you can see that doctors and nurses are in a forest, and they’re not alone.
Just ask any daycare worker if they feel like their pay is commensurate to their work? Just ask any teacher if they’ve ever felt burnt out from chronic workplace stress? Just ask any mother if she’s neglected herself to care for her kids?
There is a pattern here. Our communities depend on people who provide professional-caliber caregiving, despite chronically poor or absent compensation. Instead of accounting for these caregiving resources in our economy, we count on caregivers’ humanity to cover the balance.
It strikes me that the problem Dr. Ofri notes runs parallel to another trend in healthcare. Doctors are, increasingly, female. This underscores another, central part of our forest: Caregiving is gendered. Caregiving work is disproportionately performed by women.
Health care administrators may shift their expectations around electronic medical records. They may reduce caseloads to account for the medical complexity involved. I hope they do both. But I doubt anything will really change for doctors and nurses until we, as a society, reckon with the way we undervalue caregivers and “women’s work.”
Exploitation of caregivers is a bad habit in health care and everywhere; We need to knock it off.
This essay also appeared on Medium.