The Catholic Church and Its Hospitals: A Marriage Made in Heaven?

Like the nuns who trained her, Dr. Gabow has never taken no for an answer. She always seeks the yes that will lead to better medical care for those in need. When other cities shut down their safety-net hospitals, Dr. Gabow built hers up. After decades of leading the way in developing sustainable systems for caring for the indigent ill, she delivers an urgent plea that all policymakers, administrators, and clinicians should heed. All should attend to her trenchant call for an equitable version of Catholic healthcare.

I couldn't put this book down. In her latest blockbuster, Dr. Gabow diligently traces the path that Catholic healthcare in America has followed, from its altruistic roots to its current role as a major player in the healthcare landscape. Her clarion call for transparency could not be more timely, as medical practice has achieved a level of sophistication that puts it more and more at theological and philosophical odds with basic tenets of Catholicism. It is an important conflict in need of resolution, and Dr. Gabow not only lays out the issues but proposes a path forward in this courageous work.

In one of the largest Catholic health systems where I served as vice president, we often said “no margin no mission” to justify our choices. As I connected with Dr. Patty Gabow, she mentioned writing this book. She may be the only person qualified to do so. She is a physician, a former CEO of the largest safety net healthcare systems in Colorado, a national leader in delivery system innovation and care for vulnerable populations, and a practicing Catholic. Dr. Gabow takes us on a journey from the very beginning of Catholic healthcare, through the many facets of care delivery today. She thoughtfully questions current practices and offers ideas for moving forward. May her work provide grounding for future discussions and actions that improve care for every American, especially the most vulnerable.

This is a passionate dissent against the financialization of Catholic healthcare institutions and the extension of church doctrine into realms where it does not belong. Gabow’s voice, grounded in church teachings, needs to be heard — in statehouses, in Congress, in the Vatican, in C-suites, and by everyone who cares about the future of American healthcare.

After describing the roots of the Catholic commitment to health in scripture and the early Church, she traces the dramatic evolution of Catholic hospitals in the United States, from the singular commitment of women religious in caring for the sick, to the struggle of Church authorities to maintain the Catholic character of their institutions, to the acute challenges posed by the onset of the massive healthcare systems that are currently reshaping Catholic hospitals.

With careful referencing and inclusion of scripture, Dr. Gabow delineates the history, mission, and foundational role Catholic healthcare institutions played in caring for poor, vulnerable, and marginalized Americans. As financial and secular forces changed Catholic healthcare, Gabow examines the ways it strayed from its noble past and offers a framework for getting back on track. Gabow doesn’t pull any punches. Students of US healthcare, especially those concerned with health equity, will find this a must read.

From its deep roots in the earliest Christian traditions, Patricia Gabow traces the rise of the American Catholic hospital and its transformation into one of the most powerful forces shaping healthcare and health policy today. Her book helps readers of all faiths more fully understand the healthcare and equity challenges we face today, especially when it comes to reproductive health. Dr. Gabow’s stature as one of the nation’s leading figures in healthcare, and her deep commitment to the Church’s original healing mission, give her recommendations for greater health equity even more power.

Dr. Gabow’s vocation for over 50 years, serving as a Catholic physician, researcher, and patient advocate, especially for the poor and most vulnerable patients, informs her insightful reflection on Catholic healthcare in the United States. Affirming its historical roots, grounded in Jesus’ compassion and healing ministry and incarnated through the unwavering commitment of nuns and religious orders, she provides critical insight into the current organizational and operational structures of Catholic healthcare. She proposes ways to move forward by returning to the original mandate of Catholic healthcare grounded in the Gospel and more fully committed to Catholic social teaching.

Dr. Patricia A. Gabow is asking all the right questions in this penetrating examination of how Catholic hospitals in the United States have transformed from humble facilities founded by orders of sisters with a mission to serve the poor into giant multi-state healthcare corporations with billions of dollars in assets that are governed by religious doctrine handed down by the US Conference of Catholic Bishops. Dr. Gabow is well-positioned to ask these questions, as a national leader in care of vulnerable populations during her 20 years as CEO of Denver Health, a safety-net hospital system, in her role as Chair of the Board of the Lown Institute and, perhaps most importantly, as a practicing Catholic who is dismayed that Catholic hospitals have "lost their way.

An inspiring critique of Catholic healthcare today, made even more powerful by the author’s obvious love and respect for her church, its belief systems, and its remarkable history in healthcare. When Dr. Gabow asks why Catholic social teachings about care for the poor have become mere recommendations, while its restrictions around sex and reproductive care have become iron-clad rules, the reader feels her visceral frustration. And lest you think this book is only for Catholics, the arguments she lays out apply in equal or greater measure to state laws that implement similar restrictions on medical care, using the power of the state to enforce religious edicts.

Dr. Gabow's book on the Catholic Church and its Hospitals is, as with all of her publications, extremely well written, easy to understand, logical and meticulously researched. I have served in healthcare administration for over 30 years, most of that time as a Chief Financial Officer, and I learned a lot of new information from this book. The growing issue of uninsured people living in the U.S. accompanied by the lower quality of health outcomes needs to be urgently addressed, an an important step is to understand the barriers to care for those living in poverty or under-insured as well as the responsibilities that our not-for-profit health systems, including the Catholic systems, have to care for these people as a priority over profit. Dr. Gabow makes a compelling argument that the Catholic systems have a moral obligation to do so, which may have been lessened in priority over dollars or other Directives, and that step 1 to accomplish change here is transparency. There is not an argument for quickly changing the Catholic Church, which we all know is a huge challenge, but rather for Catholic Health institutions to embrace and follow the obligations that are already in place. Highly recommended for reading and for action on Dr. Gabow's requirements for "walking the talk" found in the last chapter.

Throughout her long and distinguished career, Dr. Gabow has not held back. She has called out shortcomings in the American healthcare system, e.g., related to costs and insurance, and then worked and advocated for fixes. Now she has focused in on the growing Catholic healthcare system in the United States. Dr. Gabow, a life-long practicing Catholic, begins by describing the roots of Catholic healthcare’s humble start in this country — with Catholic nuns — and then shows how it grew into a rich and powerful corporate behemoth, similar in many ways to other large American healthcare systems. But unlike those other large institutions, Catholic hospitals (and the clinicians who work there) are governed by directives issued by the U.S. Congress of Catholic Bishops which, for example, prohibit abortion, birth control, and assisted suicide. These restrictions apply regardless of the wishes and views of the patients; worse, there often is little transparency about the directives. Dr. Gabow does not merely raise these important issues, she also channels her clear love of the Church into suggestions for dialogue and transformation.

Dr. Gabow is uniquely qualified to write about the history of the Catholic Church in healthcare. She is an academic clinician, and researcher, former CEO of a nationally respected safety net hospital, health policy leader, and a practicing Catholic. She is also a great writer. Thus, this book, which full of thoroughly researched information, gives us history of the influence of the Catholic Church from the earliest times when deeply religious nuns ran hospitals to the current multibillion dollar corporate healthcare organizations. It is a wonderfully readable history of the important role that the Catholic church has played in providing healthcare to the most vulnerable, but with prohibitions to some care because of directives issued by Catholic bishops.

This is an extraordinary book by an extraordinary author. Dr. Gabow is a physician and practicing Catholic who led Denver Health, a safety net health system serving primarily Medicaid and the uninsured, to some of the highest quality and efficiency markers of any hospital in the country. She is also the author of many previous excellent books including TIME's NOW for Women Healthcare Leaders: A Guide for the Journey. In this book she calls out the Catholic Healthcare System for the problems that are caused for patients who would like access to services that are not provided (abortion, IVF, birth control), the fact that this information is often hidden from patients, and for commercial practices which mimic non-Catholic systems in reduced commitments to serving the poor and the uninsured. This is a must read book if you want to understand how powerful the Catholic Healthcare System has become and how this is impacting the delivery of all healthcare in the US.

I learned so much from this thoroughly researched, absorbing account of the forces driving and constraining care in Catholic hospitals. Dr. Gabow takes us through the origins of Catholic health care, provides compelling vignettes and ends with a detailed call to action. This is a brave and important book.

Patty Gabow is an amazing leader, physician, and especially author. She is the former CEO of Denver Health, and also a very brave soul. In her latest book she has taken on the Catholic Church and Its hospitals – and it is an unflinching and penetrating portrait of a system in desperate need of reform. In this highly readable account Patty exposes the extensive set of rules, the “Ethical and Religious Directives,” which are set by the Church, but which then apply to all those who receive care in the Catholic hospital system, most of whom are not Catholic. Where is this system headed? This book is both a history, and a loud call for change.