You hear a lot from the cup-is-half-empty crowd these days about the U.S. healthcare system, and certainly there is a lot to be concerned about. The ranks of the uninsured continue to grow, malpractice is driving some good doctors out of medicine and patient safety continues to be a challenge in the nation's hospitals.
Personally, however, I find the negativity a little relentless, when there are so many positives about healthcare that merit attention.
One of these is the men in the funny hats. I refer to the Shriners, also known (though mostly among themselves) as the Ancient Arabic Order of the Nobles of the Mystic Shrine. Most people, including many health professionals, are only vaguely aware that the Shriners support medically related charities, but they can teach us much about alternative methods of healthcare delivery.
Today's Shriners are not privy to the secrets of working in stone, as were their ancient ancestors, who were Freemasons. In fact, they are not tied to any particular profession, denomination or even religion. A general belief in a supreme being is the only theological litmus test prospective members have to pass.
As for why Shriners wear strange hats or drive comically small cars in parades -- let's just say that every organization needs its symbols and pageantry. Despite their enigmatic rituals, Shriners are not members of a secret society, and contrary to rumor they do not sell Shrine-related insurance products.
Here's what the Shriners really do -- and what they deserve to be better known for: Shriners maintain 22 hospitals for children located throughout the U.S., Canada and Mexico. Eighteen of these hospitals specialize in orthopedics, three specialize in burn care and one specializes in burn, spinal and orthopedic care.
These hospitals provide state-of-the-art medical care to children with orthopedic deformities, diseases or injuries, such as clubfoot, scoliosis and the orthopedic problems caused by cerebral palsy. In addition, some of the hospitals treat patients with "healed" burns who need reconstructive surgery or rehabilitation.
In addition, Shriners Hospitals for Children is actively engaged in research, searching for the cures and improved treatments of childhood diseases and burn injuries. Major players in pediatric medical research, they have a combined annual research budget of $28 million for 2005.
The 2005 research program includes 135 projects concentrated at five of the orthopedic hospitals and the four burn hospitals. Projects include developing a model to test treatments for Legg-Perthes disease, a degenerative disorder of the hip joint, and an effort to determine the specific cause of a genetic form of dwarfism.
In addition, researchers at the Tampa, Fla., hospital have developed a new biomaterial for tendon and ligament reconstruction that may significantly reduce surgical recovery time. One of the most exciting projects is a burn treatment program to grow a cultured skin substitute that could increase the survival rate of those with severe burns -- even patients with a 90% total body surface injury.
Shriners hospitals also are major teaching centers and are affiliated with some of the top medical colleges and universities in the country. The hospitals have cured or substantially helped more than 770,000 children over the past 80 years. This year, Shriners Hospitals will provide about $600 million in medical care to children, or about 1.7 million per day.
Besides state-of-the-art care, research and teaching, what characterizes Shriners Hospitals? Since 1922, when the first Shriners hospital was founded in Louisiana, treatment has been provided free. That's right -- free care for all who are admitted based on medical need. Children from infancy to their 18th birthday are eligible for admission if treatment would be beneficial. No insurance money or government funds are used for any medical care or services provided by Shriners hospitals.
When it comes to indigent care today, health professionals are indoctrinated to think that government programs such as Medicaid or community-run indigent-care programs are the only options available to pay for services for those in need. Both physicians and hospitals often overlook alternatives like the Shriners because they are so conditioned to rely on government-funded programs for assistance. The Shriners show that there is another way.
Their hospitals are funded by gifts, bequests and contributions; an annual hospital assessment paid by every Shriner; and charitable fundraising events such as the Shriners Circus. The Shriners show us that with a high degree of commitment, private citizens still can find solutions to societal problems that don't depend on government largess.
Which brings me back to the funny hats. Shriners wear them proudly at events and certainly aren't above cramming themselves into miniature cars or dressing in flowing robes if it boosts participation or donations. But don't let the somewhat retro trappings of a fraternal organization fool you. The Shriners are cutting edge when it comes to providing healthcare with a conscience. As a healthcare professional (and non-Shriner) I honor what they do and hope to see their example both better known and better emulated.
William Schumacher is an emergency medicine physician and CEO of the Schumacher Group, Lafayette, La.