What do “Avengers: Endgame” and the U.S. healthcare system have in common? Surprisingly, a lot.
Having reached $2.5 billion at the global box office in just its first three weeks in theaters, analysts project that the film could surpass a whopping $3 billion — a figure that has never been achieved before. Sadly, in a very similar way, healthcare costs in the U.S. are also projected to balloon, but in exponentially larger proportions and that prospect is not that happy. CMS estimates that U.S. healthcare spending will grow by an average of 5.5 percent annually from 2017 to 2026, reaching about $5.7 trillion by 2026.
While drawing parallels to a comic book-based story line is no silver bullet (or Thor’s Hammer if you will) for solving our healthcare problems, perhaps some of the metaphors we see in these stories could be applied to healthcare and serve as a reflection of the function — and dysfunction — of our imperfect system.
Here is one physician’s (needless to say, I am avid Avengers fan) take on who a few of the major characters from Avengers: Endgame might represent in our healthcare system and what our industry could glean from their story arcs. Don’t worry – I promise there are no spoilers.
Tony Stark makes me think of medical technology and health IT. Technology companies, and the stakeholders that support tech innovation, in healthcare mirror Stark’s desire to innovate…and all of his wins and failures that go into such efforts. Sometimes it works, sometimes it doesn’t. Occasionally, technology companies can lose sight of the actual mission and get carried away, missing the mark altogether. Take for example, electronic health records (EHRs) and patient portals. These are examples of technologies that are very well-intentioned and could serve an amazing purpose in healthcare and medicine today. But physicians have cited a range of issues with EHRs – attributing the cumbersome, time-consuming data entry system to a barrier that greatly hinders their work and significantly contributes to physician burnout. Greater care needs to be taken in these pursuits.
In Captain America, I see clinicians. We are the paragon of ethics and take an oath and a vow to first, do no harm in everything that we do, for everyone that we treat. But sometimes, providers can find ourselves feeling manipulated by the government or feel like there are constant obstacles that prevent us from doing our jobs. Like the regular conflicts between Tony Stark and Captain America, there are also many areas of friction between physicians and medical technology. Ultimately, both are meant to serve the same mission: improve patient care. Unfortunately, the plans, ideas and routes they take to accomplish that mission can sometimes be at odds.
The Incredible Hulk can mirror what I often see in our healthcare legislation. With the Hulk, you might see a lot of nothing for a while, and then there is an explosion of dramatic overreaction that can destroy entire cities. Hulk is very often hard to contain. Legislation may be well-intended and thought out like Dr. Banner, but then it can be thrown off the rails if/when the wrong things are said and done, or the wrong people poke around too much. Like the Hulk, healthcare legislation can be very hard to manage and often leads to untoward damage. Take for example the HITECH Act – well-intentioned and epic in nature with dramatic peaks and valleys in its execution. There are myriad such examples.
Black Widow is an ex- Russian spy. I’m therefore not going to touch this one…
In Black Panther, I see our constant hope and desire for what could be if we could better emulate the positive aspects of the health systems of other countries. The Black Panther and the people of Wakanda seem to have it all figured out. Their country borders on magical in its technological advances and they can do all the things we dream of while living in peace. But this utopia requires being smaller, hidden, and having a protective force field surrounding it. American healthcare can’t necessarily mirror Canada or European systems that are regularly lauded for their high-quality and low-cost care, but we can, and should, certainly still learn from them and begin to apply the right principles to our complex system.
Our superhero team wouldn’t be complete without the huge player that seems to be missing here, one that is also, oddly, almost always playing second fiddle in the Avengers series. What about the innocent people? In all of the movies where entire cities are destroyed, very little attention is actually given to the innocent civilians on whose behalf all of the fighting is presumably taking place. Sure, we all take it as a given that the Avengers’ mission is to save the people, but there were undoubtedly hundreds and thousands of lives harmed and casualties along the way throughout the epic journeys and battles the Avengers have gone through over the last decade or so. I often feel that debates and fights about our healthcare system similarly de-emphasize the folks who should actually be kept front and center – the people (i.e. our patients).
Each Avenger “hero” in our healthcare system must keep this in mind. Otherwise, we all lose and, god forbid, our version of “Thanos” just might win.
Photo: Gabe Ginsberg/WireImage, Getty Images