The children’s hospital where I work recently announced it will be getting rid of its onsite McDonald’s. The restaurant will be out by the end of the year. It joins a long line of hospitals that have ejected their golden arches, including Parkland Hospital in Dallas, Vanderbilt Hospital in Nashville, Lurie Children’s Hospital in Chicago, and the Children’s Hospital of Philadelphia. The Cleveland Clinic once tried to do so, but couldn’t get out of its contract. Why would a hospital seek to evict McDonald’s from its premises? In a nation confronting epidemics of obesity, diabetes, and heart disease, healthcare facilities do not want to encourage fast-food eating patterns. No hospital wants to “send the wrong message.” A 2006 study showed that people who see a McDonald’s in a hospital tend to rate its food as healthier. Perhaps its mere presence smacks of endorsement. McDonald’s child-centric marketing focus is also a source of scrutiny: Happy Meals with toys that are often tied to children’s movies, Ronald the clown, playgrounds, etcetera. This might encourage unwise eating behaviors at an early age. Yet McDonald’s must be doing something well. They are the world’s leading food service retailer, serving 69 million people each day in more than 34,000 restaurants in 118 countries. Why do people eat there? Their food is consistent. It’s available at all times of the day—an especially important service in a hospital, where schedules are frequently disrupted. Plus the service is generally fast and efficient and the prices are relatively low. McDonald’s is also a major economic force, with over 1.8 million employees worldwide. Especially at a children’s hospital, it is hard to overlook Ronald McDonald House Charities, which operate over 320 facilities in 52 countries. They have been McDonald’s “charity of choice” since the first one opened in 1974. The Ronald McDonald House at my hospital opened its doors in 1982, and since then it has served over 35,000 families as a home-away-from-home while their children were hospitalized. It costs the Ronald McDonald House about $75 per night to provide lodging to each family, but it requests just $15, and no family is ever turned away because they cannot pay. Moreover, Ronald McDonald Houses serve as frequent focuses of local charity and volunteerism, providing businesses, churches, civic groups, and individual community members well-structured opportunities to give. The health arguments have two sides; the battle lines having been sketched out a decade ago in two films. In Super Size Me, filmmaker Morgan Spurlock ate only McDonald’s food for a month and gained 25 pounds. In Me and Mickey D’s, Soso Whaley lost 30 pounds in 3 months eating only McDonald’s. The difference? Spurlock consumed 5,000 calories per day and didn’t exercise, while Whaley exercised and stuck to a reduced-calorie diet. Often where we eat is less important than how much. Then there is the human side. For every physician, nutrition scientist, and health policy advocate who bemoans the very existence of McDonald’s as an assault on the nation’s health, there must be 50 parents who are thankful just to be able to get hot food at 2 a.m. For a sick child, sometimes nothing is more reassuring than a familiar burger and fries. For my own part, I tend to find demonizing McDonald’s difficult. In our children’s hospital, we care for lots of skinny kids who aren’t eating enough because their illnesses have sapped their appetites. When I see one of those kids munching happily on a French fry or sipping even a high-calorie chocolate shake, I don’t wince. It’s good just to see them eat.
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