Hospital wrestles with fast food option
With thousands of hungry employees, patients and visitors passing through its doors, lunchtime is busy at Truman Medical Centers in Kansas City, Mo.
Option one: the cafeteria down the hallway from the hospital’s entrance on Charlotte Street.
Option two: McDonalds, the first place you hit when you enter the hospital.
The pairing doesn’t sit well – at least, anymore – with hospital CEO John W. Bluford, the safety net hospital’s chief executive officer.
“When you come in, you could be on your way to a diabetic clinic appointment, or your hypertensive clinic appointment, or going to see the bariatric surgeon for your weight problem. And you're passing a McDonald's on your way — that’s an inconsistent message,” he said.
But the relationship between hospitals and fast food restaurants goes back several decades. Today, there are 27 McDonald's in hospitals throughout the U.S., according to the McDonald's Corp.
As chair last year of the American Hospital Association, Bluford issued a call to action, mapping out how hospitals can serve as better leaders in creating a culture of wellness. And he said changes in the health system, which have been set in motion by the federal health law, are also motivating hospitals to assume a greater role in prevention and community health.
“We need to find ways to keep people out of the hospital, even though we don’t get paid for that right now,” Bluford said. “But it won’t be too long before it’s reversed.”
This wellness push has brought about several changes at Truman. For example, fitness and nutrition tips are now posted on elevators, in hallways and in staff emails. Baked chips have replaced regular ones in vending machines. The hospital launched a seasonal farmer’s market, opened a specialized cafe on the surgical wing, formed an employee gym and is working to establish a full-service grocery store a few blocks away, where affordable, fresh produce is hard to come by.
Another visible change has taken place in the cafeteria. It was remodeled about a year half ago. The salad bar has expanded. That case full of cakes and pies? Gone. You can still get burgers, cookies and fries, but the hospital’s food vendor, Morrison, said it is using less sugar, sodium and fat in the foods it prepares.
In the last few months, Bluford has become increasingly vocal about junk food and about what it means to have a fast-food restaurant inside Truman.
Hospital vs. Fast Food
“From an optical point of view, it doesn’t play too well now, does it?,” Bluford said as he sat down for a meal in the employee section of the cafeteria.
Behind him, a TV screen displayed various nutrition facts. One slide cautioned about how much bigger a portion of fries is today compared to 20 years ago. Another message then popped up in McDonald's signature red and yellow colors: ‘TMC cafeteria is for patrons only. If you purchase food from an outside vendor, please eat your meal in their restaurant.” The ‘M’ in “meal” looked a lot like the McDonald’s ‘M.’
Bluford said the sign is more about the cafeteria needing space for customers. But he also said there’s a place for fast food, and that having it in the hospital goes against the very core of his wellness campaign.
Twenty years ago, when Truman signed a lease with McDonald's, putting fast food establishments in hospitals was a popular trend, he said. It made sense from a business standpoint.
“One, because there wasn’t the kind of emphasis on healthy eating and portion size management,” Bluford said. “And those franchises used to pay a nice penny to lease the space. The hospitals needed the revenue, and that’s no different than what happened to Truman in 1992.”
Under the terms of the contract signed at that time, which is public record, McDonald's pays Truman $57,750 in yearly rent, plus 8 percent of its annual gross sales of over $1 million. Truman also agreed to not bring in any other fast food establishments to the hospital.
The lease is for up to 25 years, with McDonald's making the decision every five years whether to renew it. That means McDonald's could exercise its final, five-year renewal soon. Bluford didn’t want to discuss details of the contract situation, but he said in the last year, he’s been looking into a “palatable solution for all people involved.” He said for Truman, the financial benefit of having a McDonald's in the hospital is waning.
“Our mission doesn’t dictate that we generate revenue from our leases,” Bluford said. “Our mission states that we should improve the health of the community.”
For its part, McDonald’s can be a convenience and a comfort. It may appeal to some patients’ lack of appetite when undergoing certain treatments.
Both the McDonald's Corp. and the local franchise owner declined requests for interviews. But in a statement, McDonald’s said it’s proud of its menu, and the evolving choices offered at the restaurant. It’s not about where you eat, the company said, but what and how much you choose to consume.
As for Ralph King, the owner of the McDonald's at Truman, he owns five other McDonalds in the region. He has been involved in several local organizations, including the Heartland Black McDonald's Operators Association, which has been championed by the Black Health Care Coalition for its support of several health initiatives and for its reinvestment in the community.
A remaining choice
Standing at the bus stop on Charlotte Street, right in front of both the McDonald's and the hospital cafeteria, Keena Owsley waited for a ride after her prenatal visit. She said she enjoys eating at both places and that it’s nice to have a choice between a burger from McDonalds or a salad or pizza from the cafeteria.
“Most people want a variety, so I don’t see anything wrong with that,” Owsley said.
Charles Henderson, a 38-year-old with two broken ankles, sat in a wheelchair nearby. He wasn’t sure whether there should be a McDonald’s inside Truman. He said he heals faster when he doesn’t eat so much fast food, but he said McDonald’s tastes better and is quick and economical.
“I like that it’s greasy and hot, and it’s 99 cents,” Henderson said. "I like the deals they've got."
The hospital hopes its wellness efforts will make it easier for employees, patients and the community to make healthy choices. But within its doors, at least for now, food options will still include a quarter-pounder, fries and a coke.