I just have to comment on the discussion about anesthesiologists and
epidurals -- not only do anesthesiologists make buckets of money whenever
they do any procedure, but they also get to play the role of the high and
mighty who magically relieve pain.  So their reputations, as well as their
pocketbooks, are on the line, when people suggest that what they do has
negative side effects.  Only if they are so busy that the lack of
anesthesiologists is holding up surgery schedules will they look for how to
curtail their offerings -- probably not even then, they'll just work
overtime and charge more for it!  Or hire another partner.

I had a long an enlightening (for me, probably not for her) conversation the
other day with the media relations/marketing director for one of our local
hospitals -- the one that does some charity work, and has as part of its
religious mission to help the indigent.  Now I realize that hospitals must
make money, especially ones that provide some free care to the community,
but this woman was going on and on about how wonderful the hospital was, how
many lives they saved, etc., through their "free" prostate cancer screening
program.  Last year they offered free prostate cancer screenings to the
community and did just over 700, at a cost to the hospital of $10 per person
for the "kit" plus personnel costs for 8 people.  She was acting like $7000
was an enormous amount of money to spend.  And she was telling me about
several men who had discovered prostate cancer through this screening, had
come in for surgery, and were alive today because of it.  My response was to
ask "How many surgeries of this type does it take for the hospital to recoup
the $7000 for the screening?  The rest of the necessary surgeries identified
are then pure profit."  She was taken aback and said she had "No idea."
Then she went on to talk about their mammography screening program, which
isn't free, and how many people's lives they save with early detection.  And
I, being on the warpath, asked how much money they spent getting the word
out to the community that breastfeeding helped protect both child and mother
against breast cancer.  Well, of course, she had to say nothing, as they
don't do any breastfeeding promotion -- and I said "So, it appears as if you
really aren't interested in the health of the community, you're only
interested in activities that result in people using your services, such as
the mammography center, and of course surgery."  Again, she just sort of
looked at me.  I hastened to assure her that I didn't see anything wrong
with trying to make money and, as a side-effect, saving people's lives, but
that I did object to the hospital claiming to do all this stuff out of the
goodness of their hearts, when they ONLY did health promotions that brought
money into the hospital, and did little to nothing in terms of prevention.
She then went off on a tangent about trying to get everyone to buy or rent
one of their "Lifeline" buzzers (I've fallen and I can't get up) that dial
911 with the push of a button for use with the kids -- to prevent SIDS!  I
pointed out that co-sleeping and breastfeeding were much better preventative
measures, and that if the mother was sleeping with the baby, then the mother
would wake up if the baby was in trouble.  Sigh.

The original reason we were talking was that she very graciously loaned me
the hospitals materials for their ad campaigns that use a "guilt approach"
for healthy-promotion behaviors -- I'm having slides made to use for a
presentation on guilt that Cathy Liles and I are developing (actually, she's
doing most of the work).  One is for the mammography screening and shows a
little boy hugging his mother and the slogan is "Do it for them."  How about
one for breastfeeding that shows the same thing?

I also have a public service announcement from the Texas Department of
Transportation and the Ad Council that say:  "If you don't buckle you child
up in his car seat every time you go somewhere, he won't be disappointed.
He'll be crushed."  Note that it doesn't say he will be at a *higher risk*
of injury in case of an accident, it just says "He'll be crushed."  Now try
to imagine the flack we would get if we did a breastfeeding promotion
campaign like this:

"If you don't breastfeed your child for two years, he won't be disappointed.
He'll just have life-long health problems, and won't be as bright as he
might have been."   Whaddya think?

Kathy D.