Ghost hunting is based on anecdotal evidence and mumbo jumbo, not science or empirical evidence...
Marshall Allen reponds,
Patrick - You possess ignorance in abundance and seem proud to put it on display. I would dismiss your wild allegations, but you're questioning my integrity.
You accuse me of jumping to conclusions, but do so yourself. Let me assure you that I am the one who has been driving this project, based entirely on more than 170 interviews with health care experts and insiders and years of in-depth reporting about health care in Nevada. The health care sources have been directing this work, not my higher-ups. I do not get any type of mandates from above.
I write about health care from a patient-centered perspective, and that's been the foundation of this entire series. Hospital care in Las Vegas has become a joke -- "Where do you go for good health care in Las Vegas?" "The airport." -- and that's not acceptable to anyone with a conscience. So I've been exploring the reasons for this.
The story does not say that nonprofit medicine is better than for-profit medicine. But the quest for profits does relate to short-staffing of nurses and non-academic medicine, which has a direct effect on patient care. The story also points out that Las Vegas is missing an academic medical center, there is not effective oversight, and that hospitals often do not learn from their own mistakes. Those issues combine to help explain our substandard hospital care here.
If you really care to understand these issues, including how the Sun operates, then please call me at 259-2330. I enjoy being informed by by people with all types of points of view. I would be interested in hearing what you've been doing to improve the quality of health care here.
I responded back, this time asking how they reached their conclusion (I'll post Marshall's response when/if it comes).
Marshall Allen,
Anecdotal evidence about preventable problems are not sufficient to conclude that profits are being put in front of patients. No amount of interviews will be sufficient to prove that -- you need solid empirical evidence; which you don't have.
Lets look at one of your unsupported statements,
"The corporate push for profits sometimes trumps patient care and can create an environment where best practices give way to risky shortcuts. Nevada and Clark County have the highest concentration of for-profit hospitals of any state or urban county in the nation."
How did you justify making this claim?
Lets take a look at the data from Health and Human Services.
1) There is not a statistically significant difference in mortality or readmission rates for the problems tracked by HHS between southern Nevada's hospitals and the national average.
2) There is no evidence to suggest that for-profits are statistically different than the non profit and government hospitals in southern Nevada
3) Patient satisfaction surveys conduced by HHS at southern Nevada hospitals suggest people are actually happier with the for-profit Hospital service than UMC.
Furthermore, your most damning evidence was against UMC (southern Nevada's government run hospital), not the for-profits. I'm seriously confused as to how or why you'd even suggest profits are the problem.
Now, I'm not questioning your integrity (but suggesting someone is ignorant after they provide evidence that you are wrong does say something about you) I do question the intentions of the Las Vegas Sun's management.
So why is anecdotal evidence so bad if it is human interest stories that puts a real face to real problems? Anecdotal evidence is worthless to the scientific community because it doesn't paint a broad picture of reality itself. One issue may turn out minor or even rarely occur, but to the people who experience those problems it can be a big deal - it is natural to think this.
But in order for Allen to prove that for-profit hospitals put profits before people he has to show a systematic failure of for-profit hospitals in Nevada. And not just systematic failure of for-profits, the failure has to be statistically different than the outcomes at other hospitals in Nevada AND the rest of the nation. This is why you need good quantitative data - its not sexy but it does get you closer to the truth.
Think about this another way - Marshall Allen thinks 170 interviews with insiders is sufficient to prove the point (though provides no evidence beyond "I did 170 interviews.") With who, what did they say? What was their proof? Most of the interviews turn out to be more anecdotal evidence and do not further us in our quest to prove that profit seeking hospitals provide lower quality care.
This is about as good as interviewing 170 people about ghosts or aliens to determine whether or not ghosts and aliens exist. We know ghosts don't exist because the alleged ghost hunters use fallacious scientific methods and misuse scientific tools in ways that aren't proven to do anything. This isn't intended to diminish the suffering of patients in Nevada's hospitals who are, in fact, experiencing problems that could have been avoided, but it is intended to help demonstrate why one person's experience, as traumatic as it might be, may not explain what is going on in the world at large.
I see anecdotes
Besides, I found patient surveys at HHS that contradicted Allen's claims - every single for-profit hospital in southern Nevada was more responsive to patient needs than the government run UMC. Additionally, patients at for-profits were also more likely to recommend the hospital to others than patients at UMC. The HHS patient survey, I bet, is far less likely to be subjected to selection bias as Mr. Allen's interviews (investigative journalism's biggest bounty comes from disgruntled employees and in this case, patients, wanting to tell their stories in public. This means you are likely to get a concentration of personal but negative stories that may, or may not, accurately represent the typical experience. This may be effective at highlighting specific problems but in no way, shape, or form, should be used to draw broad conclusions like assuming hospitals are putting profits before patients).
Allen wants us to believe the anecdotal evidence is good enough, but if it is good enough for you, then you might as well believe
the world ends in 2012, that aliens travel thousands of light years to make crop circles and probe an anus or two, or that
Jupiter will spontaneously combust and turn into a star when a human space probe crashes into it sometime in 2014 (which won't matter because you died in 2012).
2012 - based on hysteria, mumbo jumbo, revisionist history and yes, anecdotal evidence.
Real hard science and real numbers can prove those anecdotal pieces of misinformation wrong just as the empirical evidence I found proved that at least one of Marshall's theories (profits are a problem) was wrong.
Finally, Mr. Allen seems more concerned with the idea that I've besmirched his integrity because I suggested that political bias was used to fill in the blank - that is, create a narrative that was intuitive to his political or ideological understanding of how the world works - than the fact that he has little to no evidence to support his claims. Without calling him names, suggesting he was unprofessional, or poorly trained, this was actually the nicest thing I could have said.
These aliens had to call an emergency meeting because too much anecdotal evidence was "proving" alien abductions are real.
It is easy, and natural, for us to backfill stories with our own personal biases. Its not that Mr. Allen is a scientifically untrained and unethical moron, its that he has a certain understanding of the private sector and profits that influences his way of thinking. The real problem isn't that he theorized that for-profit hospitals put profits before people, the problem is that he substituted his personal bias and theories for actual hard evidence. It is easy enough to do and it doesn't mean he's not intelligent or lacks ethics. But it may mean he didn't think too hard about the problem at hand, or was too easily swayed by the anecdotal stories of pain or loss that could have been prevented.
After reviewing the article and weighing the available empirical evidence available online at the Health and Human Services website, it appears Mr. Allen's reliance on anecdotes gets him in the usual sort of trouble. That is, he's guilty of the usual logical fallacies such as
confirmation bias,
non causa pro causa, and
post hoc ergo propter hoc.
Again, this doesn't necessarily mean he's stupid or unethical (I doubt he is either) but it does mean he has made an error in reasoning. But that said, the ethical thing to do would be to run a correction in the next issue of the
Las Vegas Sun or at least point out all the available evidence that suggest profit seeking behavior is not likely reducing the quality of healthcare in Nevada.