Nephrology nurse's comments about dialysis patients stirs controversy

A Nov. 20 article written by ProPublica journalist Alec MacGillis attempts to explain why economically depressed regions of the United States that rely on Democrat supported safety-net programs are voting increasingly for Republicans who are opposed to the programs. The article was featured in the New York Times.

The Kidney Patient Advisory Council rebuttal: Nurse’s characterization doesn’t represent most dialysis patients

As part of the story, MacGillis interviews nephrology nurse Pamela Dougherty, who was attending a Rick Santorum speech in Kentucky before the 2012 Iowa caucuses.

"In a lengthy conversation, Dougherty talked candidly about how she had benefited from government support. After having her first child as a teenager, marrying young and divorcing, Dougherty had faced bleak prospects. But she had gotten safety-net support — most crucially, taxpayer-funded tuition breaks to attend community college, where she’d earned her nursing degree.

"She landed a steady job at a nearby dialysis center and remarried. But this didn’t make her a lasting supporter of safety-net programs like those that helped her. Instead, Dougherty had become a staunch opponent of them. She was reacting, she said, against the sense of entitlement she saw on display at the dialysis center. The federal government has for years covered kidney dialysis treatment in outpatient centers through Medicare, regardless of patients’ age, partly on the logic that treatment allows people with kidney disease to remain productive. But, Dougherty said, only a small fraction of the 54 people getting dialysis at her center had regular jobs.

"'People waltz in when they want to,' she said, explaining that, in her opinion, there was too little asked of patients. There was nothing that said 'You’re getting a great benefit here, why not put in a little bit yourself.' At least when she got her tuition help, she said, she had to keep up her grades. 'When you’re getting assistance, there should be hoops to jump through so that you’re paying a price for your behavior,” she said. 'What’s wrong with that?'"

The interview with the nephrology nurse was criticized on social media and got a response from a dialysis patient advocacy group. "Dialysis nurse Pamela Dougherty’s complaint in Who Turned my Blue State Red? that too many of her patients have a 'sense of entitlement' and do not want to work, hit a very raw nerve in the dialysis patient community," wrote Denise Eilers, BSN, RN, president of Home Dialyzors United and former home dialysis care partner. "Home Dialyzors United believes that far more patients would choose to work if they had access to better treatments, work friendly scheduling, and comprehensive rehabilitation. Ideal treatments include home peritoneal dialysis, home hemodialysis, and nocturnal dialysis. Studies show outcomes on these modalities are equal to and even better than that of a transplant,” wrote Eilers.

“However, Medicare payment policy and federal regulations favor in-center treatment. As a result, 90% of the nearly half million people in the United States who need dialysis are treated in-center, which benefits their clinic, not the dialyzor. Until barriers to home dialysis are removed the great majority of dialysis patients will NEED to be 'entitled' to be disabled, not by choice, but by being limited in their treatment options."

Do you think Dougherty's assessment of dialysis patients is accurate? Do you think more patients would work if they had access to better care, and more flexible treatment schedules? Tell us what you think in the comment section. -by Rebecca Zumoff