Friday, April 06, 2007

Which came first, the free range chicken or the cage-free egg?

My daughter Sarah, who works in public relations in San Francisco, sent me the following note:


Have you considered transitioning to cage-free eggs in the hospital cafes?

I think that would be a nice thing to do. For the chickens, you know.

Burger King just went cage-free -- you HAVE to do better than that. The Humane Society of the US has a lot to say about it.

To which I thoughtfully responded:


Her riposte:

Hmm? Think of the chickens! Plus, it could be a nice tie-in to the OB dept. "We don't keep you behind bars during labor, and we require the same humane treatment for chickens."

Here's your chance, again, to advise the CEO. I actually do not know what kinds of eggs we use, but I will find out. What do you think of her suggestion? In your answer, please indicate whether you buy cage-free eggs for your personal use and/or whether they do so at your place of business.


Toni Brayer, MD said...

This is just great. Leave it to a daughter in SF to suggest such a wonderful idea. An environmentally conscious hospital that serves free range chicken eggs might just set a trend that JCAHO would appreciate. Who might become the new standard. Go for it. You are already on the cutting edge with this blog.

EverythingHealth - SF Doc

Anonymous said...

I'm going to have to go with a resounding "Who cares?" Hospitals should have priorities other than whether the eggs were laid by a chicken that lived free or in a cage. Really.

Go with the less expensive eggs, ceteris paribus.

I'd be MUCH more interested in whether or not the chickens your kitchens use are fed antibiotics to make them fatter.

Incidentally, your institution has really good food. Much better than Brigham and Women's...

Anonymous said...

Whichever produces better Egg-Beaters! Got to watch the cholesterol, after all. :-)

Anonymous said...

I sort of agree with RJS. I'd be way more interested in whether the eggs were organic or the hens had been fed antibiotics or other improper food.

Anonymous said...

Not only cage-free, non-antibio-fed, AND organic, but I say, I do, force Aramark or whoever does your food, to buy local. Another greening of the hospital. Go, Sarah-daughter--keep pushing your dad!

Anonymous said...

Are the beef cattle free range? What about the chickens who headed for food? I agree with Pesha -- buying local is the best for the environment. Hope your eggs are brown!

Anonymous said...

I think that the Medical Center should not dispense drugs that have been tested on animals. Think of the mice! An added benefit: you will probably reduce pharmacy stocking costs by 95%! Groovy.

Alexis said...

I think it might be a good idea to explore adding local and/or organic foods to your hospital cuisine, including things like eggs, etc.... It would certainly give your PR folks a new angle to promote. While it's good to use meats/eggs that're produced organically and humanely, it's also environmentally responsible to look for local and organic sources from an energy standpoint. I can definitely see the marketing campaign of a doctor standing on a local dairy farm with some sort of slogan like "Partnership in All We Do" or "Promoting the Health of Local People and Local Companies," and so on.

I think that while yes, it's an ethical option to pursue, it's also potentially good business. But I'd very much suggest going beyond eggs to look at local, organic, free-range, sustainable options. It's not possible to do this with every food item, certainly, but the more the better.

Sarah said...

We use cage-free at home.

I think it would be really cool if a hospital used all organic, non-hormone stuff. That would be a great, expensive, hospital.

Anonymous said...

Alexis and others, you neglect to mention your own practice at home, or in your place of work.

Anonymous said...

I am an incoming preliminary intern to BIDMC and am very glad that you blog! I vote for buying eggs from farmers who raise their hens in as healthy a manner as possible for the environment, animals, and us. Cage-free may not actually mean the hens are free-ranging. The University of Florida, Institute of Food and Agricultural Sciences wrote a good general introduction to the subject (

Everything an individual does--whether an individual person or an individual institution--affects the surrounding environment and the well-being of others. Hospitals use hundreds of eggs daily, and can use their buying power to improve animal welfare. BIDMC is trying to go green, as I understand, and buying cruelty-free eggs bolsters these efforts.

You're tracking readers from around the world visit who read your blog to learn about BID. That itself is an example of how an individual can possibly influence others in far-flung places.

Buying cruelty-free eggs is an action that has even more direct, positive impact on others and ourselves.

I choose to pay slightly more for certified organic eggs, because I vote with my dollar to support efforts that are good for ourselves and our environment.

Alexis said...

We use cage-free eggs at home, which I usually buy at one of the local farmer's markets (Madison has one all-year one, and several summer season ones). Local free-range duck eggs are particularly nice in the summer. We're even more particular about our meat and dairy - we try hard to get our dairy from local and free-range sources, and to seek out local organic meats. This is easy in Madison, but I imagine it's not too different in the Boston area.

As a med student, I have little say in the affairs of the hospital, but I suspect that the food is mostly mass-produced/factory-farmed and not necessarily local. I wish it were otherwise - I'd probably eat at the hospital cafeteria more often if so.

Anonymous said...

Cage free and organic! Is is not hospitals responsibilty to educate, promote and support healthier lifestyles? The food we provide our patients, staff and vistors should be of the highest quality. As they say "you are what you eat"!

Anonymous said...

Thanks, Jim, but do you, at home?

Anonymous said...

I'm glad to learn that you have eliminated medication errors in the hospital so you can concentrate on more important matters like organic eggs.

Anonymous said...

Only on the weekends . . .

Anonymous said...

yes, paul, we try to eat organic and non gmo foods at home. and yes, i try to be an example for patients, staff, friends, etc on leading a healthy lifestyle. i am proud to state our hospital is providing "healthier" choices for patients, staff, etc, but we still have a long way to go.

as for medication errors, they may never be eliminated, but we take them seriously and strive hard to reduce them (even on weekends)! to be a well balanced and dynamic person, heathcare professional for that matter, they should have interest outside their profession...just ask paul.

Jon said...

Another incoming intern who is glad that you blog:
I almost always buy some variant of organic/free range eggs, though it can be hard to tell which are truly environmentally friendly and which are just marketing gimmicks. I buy organic meat about half of the time; as a student i just can't afford to all of the time. However I do try to responsibly buy seafood (ie No Chilean SeaBass). I tend to purchase organic versions of big brand name foods when they come out, if for nothing else than to send the message that I appreciate the effort of making such things. I also try to buy locally raised as much as possible. I certainly don't do a wonderful job of this, but I think even a little bit helps, both with my health and with the environment.

I would love it if the hospital offered morally/ethically/environmentally/healthily responsible food choices. I've spent too much time in hospitals where my breakfast choices are powdered eggs, Wendys, or vending machines. It would be great if I could eat a well-rounded, nutritious and partially organic/locally raised meal at work without having to bring it in a cooler.

Anonymous said...

My wife gets organic, free range from a friend at work. The kids eat them, love them - really love them - much more than stop and shop eggs.

Generally as young kids they seem much more in tune with what is healthy and what is not. Twizzlers - out. Easter bunny chocolates - in.

I think if you serve nutricious, healthy food your staff will be happier and more focussed.

And more focussed will mean less medication errors.

Elliott said...

We use cage free eggs at home at $1.99/dozen they are more than twice as expensive as regular old eggs $1.89/36. We make that choice beause we can afford it (and my wife argues that factory-farmed eggs are non-kosher).

OTOH, I do not believe that you should buy more expensive eggs for the cafeteria unless it increases the cafeteria's profits. Despite our intuition, there is no evidence that organic or cage-free eggs are healthier (or even more environmentally friendly). The food in most hospital cafeterias is lousy. The prices are too high for the quality received and the main culprit is that they are selling to a captive audience. I do not believe it is fair to impose higher prices on people who have no choice. You might argue that you would just absorb the cost, but I can't believe that.

I think that those who are arguing for the organic/environmentally friendly option are those who are more likely able to afford better choices. Many of your customers are not so fortunate is my guess.

Finally, even though I don't think you should make this change I think this blog is great. I love that you are willing to indulge your daughter by entertaining the suggestion here.

Anonymous said...

The following conference takes place in your own backyard - check it out!

Anonymous said...

I say that a hospital that does not recognize the importance of good, nourishing food in the healing process is not one that I trust. Going organic and ensuring that the chickens (and all other meat products you serve) aren't pumped full of antibiotics, hormones, and other harmful substances should be a concern.

Anonymous said...

Thanks, Rick.

Rick and Rachel,

How come you and others insist on not telling us about your personal habits in this regard, or where you work? It's not fair to suggest things to me for BIDMC without telling us if you do the same at home and where you work.

krylonultraflat said...

Several points come to mind:

Personally, I don't take anything the government says about my food very seriously. So if something is labelled "organic" or "cage free," I tend not to assume it's better. Isn't the definition of cage-free a little wonky when it comes to eggs, as opposed to chickens being raised for food?

Whenever a new label is created for food ("organic," "macrobiotic," "non-GMO") producers create another race to see who can specifically tailor their product to meet those restrictions while being as cheap to produce as possible. The end result is a definition that doesn't always mean a whole hell of a lot.

That said, you have two concerns:
1. Feeding a lot of people
2. Public image

On balance, I'd argue that convincing patients that hospital food is GOOD for them outweighs the additional funding.

Do I personally think it's better for them? No, but I think given all the recent press given to organic living, anything to convince people that being in a hospital isn't making them sicker is a good thing.

Anonymous said...


Not sure I suggested anything to you or BIDMC other than the sustainable food conference for healthcare was worth checking out but - we do use cage free eggs ( at home and love em.

Anonymous said...

nice one sf doc.

i wish i could be as socially/nutritionally conscious as some of the other interns. i'm looking at my future salary and plotting how high i can push the % savings on my next shaw's receipt.

i go with cheap eggs - brown, white, super-tiny, xl - whatever's on sale. from the hospital perspective, i think i'd sacrifice the chicken if the extra dollars/resources/time went to keeping the nurses happy. happy nurses = happy patient = happy intern.

sorry ginger.

Unknown said...

We use cage-free and organic for all items at home, whenever possible. I would strongly support BIDMC's use of more organic and cage-free ingredients. One of the real downsides of our last hospital stay (for a birth, not at BIDMC) was the lack of good (vegetarian) food similar to what we eat at home. If BIDMC distinguished itself in this respect, we would certainly be more likely to consider that hospital, especially if it involved an extended stay.

eeka said...

Cage-free if you must have them at all.

I think the hospital should make purchases (food and otherwise) that do the best to conserve energy. Plant-based foods are much more energy-efficient. As a member of the global warming committee at my agency says, "we can't provide quality healthcare services if Boston is under water."

Anonymous said...

I would argue that you should choose based on one criteria: patient health. That has several aspects. If you believe cage-free, or vegetarian-fed, or antibiotic-free eggs will contribute to better patient health, by all means switch to them. Otherwise, choose whichever costs the least, and direct money instead towards something that *will* improve patient health. Any penny spent on one thing doesn't get spent on another.

Unknown said...

We buy Chip-In Farms eggs ( from Russo's in Watertown ( where they don't cost much more than the factory eggs at Shaw's.

Russo's is also a great place to buy local produce. Maybe they should be your supplier.

Betsy B. said...

Geeze, I just started shopping at Whole Foods! Haven't even gotten to cage free! I believe that money spent in good food is well spent, but it is true that many of our patients don't have that choice.

I'd say make the switch if it doesn't come down to higher prices for the people who are frequenting the cafeteria.

At home I go with organic eggs from Whole Foods, not sure if they are cage free or not. I tend to be more concerned about artificial than cage free.