Here’s a sentence I never thought I’d have to write:
the most interesting discussion in healthcare in the past week has been about
Neil Young versus Spotify.
For those of you who have not been following the controversy, Neil Young gave Spotify an ultimatum: it could have his music or Joe Rogan, but not both. “I am doing this because Spotify is spreading fake information about vaccines – potentially causing death to those who believe the disinformation being spread by them.” Spotify chose Rogan.
Mr. Young was not the first to express alarm at some of the Covid “information” promoted on Mr. Rogan’s podcast, The Joe Rogan Experience (JRE); in December, for example, several hundred scientists from around the world issued an open letter to Spotify specifically about JRE, warning:
By allowing the propagation of false and societally harmful assertions, Spotify is enabling its hosted media to damage public trust in scientific research and sow doubt in the credibility of data-driven guidance offered by medical professionals.
Nor is Mr. Young the only artist now boycotting Spotify
due to the content on JRE; Joni Mitchell and Nils Lofgren have followed
suit. Notably, though, more current artists
like Taylor
Swift or Adele have not yet, nor have celebrity podcasters like Meghan
Markel and Prince Harry or the Obamas, although the former royal couple have
expressed their concerns.
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To put things in context, Mr. Young is risking some
60% of his streaming income, estimated
at around $750,000 annually, whereas Mr. Rogan has a $100
million deal with Spotify for his 11 million faithful listeners. It evidently wasn’t a hard decision. Spotify lost as much as $4b
in market cap last week but seems to have fully recovered.
Mr. Rogan has
issued regrets, of sorts, not really apologizing but sorry if some people
were offended. He’s not anti-vaxx, he
claims, but just wants to get alternative information discussed and
debated. He admits he doesn’t do much
research prior to a guest coming on the podcast, claims he doesn’t try to be
controversial, but hopes to try to offer more balanced discussions.
Spotify also has
issued its own mea culpa, not planning to censor more content but, when it
comes to COVID-19 topics, at least directing people to its Covid-19 Hub
for “easy access to data-driven facts, up-to-date information as shared by
scientists, physicians, academics and public health authorities around the
world, as well as links to trusted sources.”
Show’s over, folks.
Nothing to see here. Move along.
I don’t have a Spotify account. The only podcast I pay attention to is THCB Gang (which, by
the way, you can listen to on Spotify). I
doubt that many people listen to JRE to be educated; more likely, they tune in
to be entertained, and, perhaps, to harden existing views that may be out of
the “mainstream.” To be honest, I’m not even
that big a Neil Young fan, and the last time I really watched Joe Rogan was on NewsRadio. But I do think what Mr. Young has done is
important.
The COVID-19 anti-vaxx movement threatens
everyone. We’d still be living with
polio and measles if such distrust had existed a few decades ago. As anyone could have predicted, controversy
over requiring vaccines for other diseases is
widening, with state legislators already working on bills that could weaken
existing requirements, such as for measles.
“Measles is like a jam jar full of wasps that
is raging to get out,” Professor Liam Smeeth of the London School of Hygiene
and Tropical Medicine warned
CNBC. “The minute vaccine coverage drops, measles will reappear. So
that is a worry, that that [Covid anti-vax sentiment] and that dent in
confidence is seeping across into other vaccines. That is a real worry.”
The scientists who signed the open letter to Spotify
opened themselves up to criticism, but Mr. Young put his income at risk. It’s not like his music isn’t available
elsewhere, but a loss of $750,000 annually would get most people’s
attention. He was already critical of
Spotify for what he perceived as issues
with sound quality, so perhaps there are other motives here, but I’ll
choose to believe that he’s willing to take the loss of income "in
solidarity with the frontline healthcare workers who risk their lives every day
to help others."
Bravo.
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In my opinion, though, this is even broader than COVID
misinformation, and we shouldn’t be relying on musicians for moral leadership
in healthcare. People working in
healthcare need to be willing to walk away from some of their income when they see
things that are wrong.
In the midst of incredible bravery and sacrifice by frontline
healthcare workers throughout the pandemic, there are some physicians who have spread
misinformation and promoted remedies that are at best useless and at worst
harmful. Where are the healthcare
workers who resign rather than be associated with them? Where are the medical boards who believe that
such practitioners are still deserving of their medical license?
And, let’s be clear, there are physicians who do such
things outside of COVID. They do
surgeries that aren’t necessary, they promote cures that aren’t, they treat
conditions they don’t really have qualifications for. Unless something particular egregious happens,
we allow it, because once physicians get a license, it’s awfully hard to take
it back. Doctors don’t like to criticize,
much less penalize, other doctors.
Similarly, there are hospitals who sue patients for
unpaid bills, even when those bills are based on charges that no one really
ever expects to have to be paid in full.
There are hospitals who contracted with, say, emergency room practices
or anesthesiology groups who, they knew, would be issuing “surprise” bills to
patients (at least, before the No
Surprise Act). The medical staffs can claim, oh, we didn’t know about these
practices, but, yeah, they probably did, or at least choose to look away.
There are people – physicians and others – working in
health insurances companies that deny treatments for critically ill patients,
or make them jump through needless loops that they don’t have time or energy
for. Who in those companies are fighting
for those patients, risking how much?
There are way too many situations when people in
healthcare should be pulling Neil Youngs and walking away -- noisily.
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It takes courage to speak up about injustices and dangerous practices. When someone puts their income at stake in doing so, all-the-more. Healthcare has a lot of things that need to be spoken up about and stood up against. If not now, when, and if not us, who?
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