Documentarians take a hard look at hospitals
Once upon a time, hospitals were the good guys.
They mended broken bones, took care of the injured without first asking about insurance cards, and occasionally performed medical miracles to renew our faith in healers.
Those days of hospitals portrayed as do-gooders, however, are gone—at least, if independent films are any barometer.
Outliers has noted a profusion of independent films about hospitals in recent years, and we set out to sample a few and see how the wind is blowing. And let us report: it’s enough to make one want to convert to Christian Science.
Readers of this magazine will note some dissonance between the sunny institutions portrayed in their inhouse hospital PR literature and the avarice, greed and careless medicine portrayed in these films. But whether that difference owes to a blindness to public perceptions within the hospitals, or to biases of the filmmakers, we’ll let the viewers sort out that question on their own.
‘Do No Harm’
Director: Rebecca Schanberg; run time: 55 minutes Of the three films reviewed here, “Do No Harm” hews most closely to the traditional notion of documentary filmmaking. It tells the story of two whistle-blowers, accountant Charles Rehberg and surgeon John Bagnato, whose battles with their local hospital, Phoebe Putney Memorial Hospital, in Albany, Ga., have been well-documented in this magazine and elsewhere.
Rehberg and Bagnato level devastating claims against their community hospital, using investigative reporting techniques to show, among other things, how board members were jet-setting at the Ritz-Carlton in the Cayman Islands using the hospitals’ offshore insurance captive, while the hospital garnished the wages of local uninsured residents who couldn’t pay their inflated medical bills.
“We kind of described it as a reverse Enron,” Rehberg says in one scene. “Where the public companies are constantly trying to finagle their financials to boost their apparent profits, the nonprofits actually have the other dilemma. They need to publicly look like they have less. It helps them when they go to the legislature, to look somewhat poor. And it helps them with their PR a lot to not look like they’re real wealthy. So they tend to look for places to put cash. The Cayman Islands is one of them.”
The film’s biggest weakness is its complete lack of perspective from the hospital. While the Phoebe hospital execs surely didn’t line up for interviews, they filed hundreds of legal records over the years laying out their side of the story, which could have been mined for information.
‘The Vanishing Oath’
Director: Ryan Flesher; run time: 74 mins. It’s impossible to review this film about systemic physician burnout without beginning with its most glaring shortcoming—the director and main character, physician Ryan Flesher, comes off as insufferably whiny.
Outliers nearly couldn’t get past the first 10 minutes of the film, as Flesher’s self-indulgence in making a film about his own hopelessness devolves into the kind of self-pity that is the death knell of any autobiographical story: “Basically, I’m a miserable wreck, and I’m never at ease,” he says early on.
The movie finds its footing in the candid interviews with five other physicians from across the country. They all look like decent people who anyone would love to have as their doctor, and yet these physicians describe the same burnout, disaffection and loss of ideals as Flesher as they talk frankly about how profoundly economics drives the healthcare system. Fourth-year medical student Sarah Schmickrath’s voice quavers as she talks about how her hopes crashed into the realities of modern medicine: “One of the reasons I went into medicine is because I really, truly did want to help people. And what I’m coming to realize, and why I was so disillusioned and still am sort of disillusioned, is that … the system is set up in such a way that that’s almost impossible. Even if you really care and you really want to help people, it’s extremely hard to do that in this system.”
It makes Outliers wish someone else would have directed the movie, and just used Flesher as an anecdote.
Produced by Transparent Health; run time: 50 mins. “Lewis Blackman” (full title: ‘ The Faces of Medical Error … From Tears to Transparency: The Lewis Blackman Story”) is the most likely of the films reviewed here ever to be played inside a hospital, and that was the makers’ intent: Transparent Health assembled the movie (the first in a series) with the explicit goal of educating caregivers about preventing medical errors.
The film is the most clinical of the three, but this strangely antiseptic feel works to increase emotional impact in some sections. Blackman’s mother, Helen Haskell, describes in even tones her harrowing experience in which her son went in for an elective surgery and bled to death in the hospital after a weekend crew failed to notice his worsening condition.
There’s a lot of blame to go around, but “Lewis Blackman” works to disarm the reflexive defensiveness of clinicians and administrators and make room for some genuine soul-searching.
“No one was in charge,” Haskell says. “No one seemed to be pursuing goal-oriented behavior. They were just performing task. They were not trying to achieve an end; they were not trying to put it together. This was simply a system that was operating for its own benefit. The patients were really incidental.”