Jump to content

Whistleblower alleges Dallas kidney transplant programs favored wealthy patients


Recommended Posts

Posted

https://www.texasstandard.org/stories/whistleblower-lawsuit-kidney-transplants-parkland-health-ut-southwestern-dallas/?utm_campaign=feed&utm_medium=referral&utm_source=later-linkinbio

Quote

Patrek Chase, kidney transplant program director at Parkland Health in Dallas, claimed that patients at his hospital – which generally serves a poorer population – were passed over for a healthy organ in favor of patients at UT Southwestern Medical Center, which generally helps the affluent. 

Imagine being on a transplant list, clinging to hope for a kidney that could literally save your life — only to find out you were skipped over because you’re poor, while someone with deeper pockets at a more “prestigious” hospital got the organ instead.

How many people at Parkland — people who waited, prayed, and trusted the process — were left to suffer or even die because someone decided the affluent deserved priority?  

 

This isn’t just a lawsuit. It’s a mirror held up to the ugly truth about healthcare inequality in America. Life saving Organs as VIP perks instead of lifesaving necessities is sick.

  • Rage+1 7
Posted

This is probably going to be one of those things where systemic bias comes into play.

All of those involved in the medical and administrative end are relatively upper class, the victims are relatively lower class.  There's probably not going to be anything expressly saying "don't give that kidney to that dirty brown poor when we got a perfectly good white boy here."  

But there's probably going to be a whole lot of decision points couched in medical or sociological terms that favor the more affluent patient/recipient.

  • Hook 'Em 2
Posted

So I guess just don't be poor is the lesson here right?

 

20 minutes ago, Im_smarter_then_you said:

Poor some need to work harder, be scrappier, grow their own kidneys 


... or get better at stealing rich peoples kidneys and leaving them in an iced down motel bathtub...

Posted (edited)

There can be much more to this story than rich vs poor. From a quick glance at the end of 2024, Parkland had 56 patients on their transplant waiting list, and UT Southwestern had 224. but even that doesn't mean that UT Southwestern should be prioritized over Parkland. Transplant centers are not all considered equal to each other: volume, ability to handle more difficult cases, response times, etc. are taken into account.

In 2024, Parkland performed 38 transplants and UT SW 205. I believe this can be taken into account because there is an assumption that UT SW has more capabilities than Parkland.

Finally, I gather that the patient wait list is not simply first come-first serve. Time on the list is a factor but if UT SW has higher acuity cases, some of their patients could be prioritized over Parkland's. 

To be clear, from a quick search, Parkland transplant center seems to be highly regarded. I'm not slamming them. (If any of this info is wrong, I hope someone corrects me. I'm only an google/chatgpt expert.)

EDIT: This story reminds me of the odd story out of Houston where the Memorial Hermann transplant doctor intentionally pushed some of his patients further down the transplant list, outside of the guidelines. I don't know if the why was ever fully understood by the public.

Edited by Nice Guy Eddie
Posted

It is a complicated, convuluted system - theoretically designed so that the sickest patients get bumped up to the front of the line.  Does that mean that's what is actually happening?  Who knows.

I have some indirect involvement at Vanderbilt University Medical Center, who did more heart transplants last year than anyone ever.  Does that mean they have a line out the door of the sickest of the sick?  No idea, but I can tell you that Vanderbilt inherits dumpster fire patients from most hospitals within about a 200 mile radius, so maybe.

Posted
22 hours ago, pacman said:

This isn’t just a lawsuit. It’s a mirror held up to the ugly truth about healthcare inequality in America. Life saving Organs as VIP perks instead of lifesaving necessities is sick.

mickey-mantle-in-his-final-press-confere

Posted

The system definitely has its inequalities, but a lot of times when a patient with better means jumps in line then it may often have to do with factors such as self advocacy, knowing how to navigate the convoluted healthcare system, and quite frankly, professional connections that don’t necessarily imply bias, but just get percolated up to the top of the healthcare chain. Those without education and those without means really do not have an advocate because the rest of the healthcare system is drowning in backlog and overburdened patient loads.

There’s not a bunch of rich white guys sitting in a boardroom, smoking cigars and drinking bourbon that are striking certain people off the list and adding their friends names to the top of the list. And I say that with much disgust at the C suite in healthcare, and certainly with private equity gutting the system for profit.

Posted
6 minutes ago, Newdoc said:

The system definitely has its inequalities, but a lot of times when a patient with better means jumps in line then it may often have to do with factors such as self advocacy, knowing how to navigate the convoluted healthcare system, and quite frankly, professional connections that don’t necessarily imply bias, but just get percolated up to the top of the healthcare chain. Those without education and those without means really do not have an advocate because the rest of the healthcare system is drowning in backlog and overburdened patient loads.

There’s not a bunch of rich white guys sitting in a boardroom, smoking cigars and drinking bourbon that are striking certain people off the list and adding their friends names to the top of the list. And I say that with much disgust at the C suite in healthcare, and certainly with private equity gutting the system for profit.

That, and there are probably things like lifestyle factors and access to follow up care that objectively favor the more affluent donee.  But that still remains a subjective criteria to an extent.

Like, the list at UTSW is almost four times as long as the list at Parkland likely because far fewer patients receive continuous care at Parkland (meaning regularly see a GP, then a nephrologist for diagnosis/treatment).

This is what I mean and is generally meant by "systemic bias."  No big cigar is sitting there saying "too brown" or "too poor" but the system decides that "unconsciously."

Posted

Not kidneys, but I have a kid who graduated from Texas in May and is now a CICU nurse at Children's in Dallas, which is adjacent to Parkland and UTSW (Children's at present doesn't do deliveries, so a lot of their patients come from one of those two places).  We haven't talked specifically about the concept of transplants, but she has obviously had patients who are/are not on a list for a new heart.  She might have a patient who could use a new heart, but they have way too many other issues to be a candidate.  Sometimes that could be a product of bad luck.  Other times, as has previously been pointed out, it could be a product of the ability of the family to care for the patient when they are home, etc, which then precipitated the other issues that no longer make a patient viable to be a transplant candidate.  She may have a patient where a series of procedures worked...until they didn't (like the teenager she had the other day, who had hypoplastic left heart syndrome, went through all the procedures from birth to 5, everything was fine for a decade, and now it isn't, so a decade of potentially being on a list was lost) 

I imagine at some point, when trying to address the problem of "what other issues does this candidate have that could make this heart transplant unsuccessful," that biases creep in. While there are certainly miles of objective criteria in medicine, the uncomfortable part for all of us is that there is a dose of subjectivity and intuition there as well...otherwise medical personnel would DO medicine, not PRACTICE medicine.  

And by the way, while this topic is about transplants, the same thing goes on when it comes to curative/palliative procedures.  

Not sure how we fix it.

  • Hook 'Em 1

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.



×
×
  • Create New...