By James O. Breen, M.D.
December 6, 2023
Recently, I came across an article in Becker's Hospital Review celebrating the newest crop of "Diversity, Equity and Inclusion officers" in health systems across the country. Among other vital tasks to the health of the nation, these newly deputized C-suite denizens are "instituting training sessions" and "improving hiring practices" in order to "uplift diverse populations" and "enhance health equity."
The tenor of the article called to mind a quote from the joyful Catholic apologist and distributist G.K. Chesterton: "[No society can survive the socialist] fallacy that there is an absolutely unlimited number of inspired officials and an absolutely unlimited amount of money to pay them."
As a physician and a Catholic (not necessarily in that order), I find that the antics of the self-anointed thought leaders in healthcare give me much reason to shake my head. Our professional elite class (in medicine as in nearly every other discipline) has been infected with a dangerous ideological contagion that is harder to cure than a rare, exotic infectious disease-the sort of condition, let's say, that is characterized by symptoms of memory loss, visual disturbances, behavior change, and (eventually) death. There's been a lot of this sort of thing going around in healthcare leadership circles these past few years.
The fallacy of our modern-day medical soothsayers is in insisting that the prevailing model is capable of delivering "healthcare" that is efficient, cost-effective, "patient-centered," and will produce "equitable" health outcomes across all demographic and identity groups, for every condition, all the time. This utopian ideal is just slightly out of reach, but it is attainable if only we grease the sprockets and lubricate the timing belt of the highly sophisticated Healthcare System (and let us not forget topping off the fluids with the $1.9 trillion, or 29 percent of net federal outlays, designated for healthcare spending).
In this context, the overgrowth of middle management in "healthcare"-exemplified by the proliferation of "Diversity, Equity and Inclusion" officers-underscores Chesterton's point to a T. The DEI mentality is only the latest egregious example of how healthcare organizations have become distracted by the shiny objects and bright ideas of prevailing ideological trends (in this case identity politics) and have completely abandoned the notion of holistic attention grounded in the human dignity of each individual person presenting for care. In essence, the reductionist notion that some individuals are more "diverse" than others completely discounts the beautiful uniqueness that is inherent in each person's condition as a child of God.
Of course, we are told that the sages at the forefront of the "medical equity" movement are merely trying to "right past wrongs" in the name of "social justice." It is sad that it never occurred to them that this exercise in preferentialism for "the oppressed" over "the oppressors" would have unintended consequences that have contributed to the bankruptcy of trust in the medical profession. Indeed, the consensus among medical leaders is that acquiescing to "equity" is merely another example of medicine's emptying itself of its past injurious biases and prejudices. After all, any medical professional worth his salt ought to check his moral hang-ups at the door of the exam room, so as not to appear judgmental, and in so doing be better able to provide exceptional customer service.
The inconvenient fact for authorities setting the norms in medicine is that there happen to be two moral agents in every doctor-patient relationship (namely, the doctor and the patient). Editing the language of healthcare to rename "pregnant women" as "birthing persons," advocating for the promulgation of harmful medical treatments for adolescents in the name of mystified gender ideology, and hitching their horses to the cart of unfettered abortion access in the name of "reproductive justice" (while blotting out the humanity of the unborn), are the antithesis of their idealized kind of medical care devoid of values-based bias. The manufactured consensus of medical specialty societies and journal editors who support such social engineering neglects to recognize the existence of numerous physician-constituents who are rather partisan to Judeo-Christian ethics and Hippocratic principles, thank you very much.
So, how can the wisdom of G.K. Chesterton inform our current predicament? In other words, what would G.K. Chesterton say about American healthcare today if he were a doctor?
As a starting point, I believe that he would rightly call out the misguided priorities in the prevailing utilitarianism of today's healthcare. Rather than orienting the entire enterprise around the human being in need of care, today's prevailing healthcare enterprise is focused on metrics-measurements of efficiency, cost-savings, clinical outcomes, and customer service. Ironically, the burgeoning public expenditure on healthcare (which increasingly pays venture-capitalist-sponsored private provider networks to deliver care in accordance with governmentally-defined metrics) means we get the worst of both socialist bloat and regulation, and monopolistic uber-capitalism-and we pay more for it year after year. (As Chesterton once said, "Big Business and State Socialism are very much alike, especially Big Business.")
In short, I believe G.K. Chesterton would declare that a commonsense Catholic medical response needs to put human dignity at the center of its work without compromise. To do so, it must be rooted in community and responsive to local needs, in accordance with the principle of subsidiarity. Such a response would also need to be open and made available to people of all walks of life and socioeconomic positions, in keeping with the principle of solidarity. This form of solidarity, when based on local needs and conditions, would look a lot like the humanitarian charity of old, when doctors felt oath-bound to care for the vulnerable and call them by name, rather than see them as a faceless amalgam of public-welfare beneficiaries.
In deference to the Catholic social principle of responsible stewardship, Chesterton would agree that a Catholic medical practice ought to exercise prudence in its use of financial resources and human talents, carefully allocating these God-given gifts to enhance the care of those whom it serves. Of course, this last point is well-nigh impossible under the wasteful pressures of insurance company and governmental regulation and coercion; for this reason, a Christian medical witness ought to remain independent of the influences of such public and corporate payers which can hold sway over the way it carries out its mission of evangelization and healing.
In sum, a Chestertonian approach to medical care requires the application of high doses of caritas and common sense. Our modern House of Medicine is built like a house of cards—newer regulatory fixes delicately balanced on top of yesterday's solutions, which addressed the unintended consequences of previous years' policies. The further the healthcare system becomes abstracted from the telos of medicine—that is, its intended purpose to alleviate suffering and restore human flourishing—the harder it becomes to return to the pragmatic principles of the Hippocratic profession. In the words of Chesterton, "[T]he upshot of this modern attitude is really this: that men invent new ideals because they dare not attempt old ideals. They look forward with enthusiasm, because they are afraid to look back."
In our confused (and confusing) times, an authentically Catholic medical model such as I just described is sorely needed. Moreover, I write to tell you that it is already beginning to take shape. A nascent coalition of Catholic primary care physicians is in the making. The Benedict Medicine Consortium is forming as a nexus of support for physicians who wish to practice in accordance with the principles of Catholic Social Teaching; it also offers guidance for individuals and families in search of excellent medical care that honors Catholic teaching.
Much as the classical Catholic education movement (à la Chesterton Schools Network) has created a vibrant alternative to the morally impoverished public school offerings, the Benedict Medicine Consortium intends to reinvigorate primary care practice with the wisdom of Christian principles based on common-sense pragmatism and financial sensibility.
Contrary to popular thinking, routine primary care is most accessible when it is decoupled from the inflationary tendencies of insurance-based payment systems and instead responds to the needs of the people it serves. Such economic independence from Big Business/Government also confers protections to conscience rights of both doctors and patients, allowing for the practice of a kind of medicine that honors transcendent beliefs even when these are not fashionable by worldly standards.
In the face of the madness of the prevailing healthcare system, people of faith who value common sense are in dire need of a countervailing force in medicine. The development of a community of physicians and those in search of authentic Catholic primary care are an antidote to the falsehoods being promoted by modern secular medicine. Thick Christian communities buoyed by faithful primary care practices serve as the lamp on the lampstand. They call out and shine light on the absurdities of our upside-down postmodern society by reminding the world of the wise words of G.K. Chesterton: "Fallacies do not cease to be fallacies because they become fashions."