Have you ever felt that going to see your physician or going to the hospital is like stepping onto an assembly line?
Well, the metaphor of being a car (or a hamburger) is a pretty accurate one. Two articles I read this week discuss how health care leaders have been turning to the big manufacturers—Toyota, for example—to increase efficiency, production and profits.
Kaiser Health News (KHN) puts a positive spin on this trend:
As public hospitals…try to cut costs and make patients happier, administrators have turned to an unlikely ally: Toyota. They are adapting the car maker’s production system to healthcare, changing longstanding practices such as how to store equipment, schedule surgeries and discharge patients.
Changes inspired by the Toyota process had direct, positive results, such as reducing the time patients spent at the hospital and decreasing medication errors, according to the [California HealthCare] foundation. They also saved money. For example, reducing surgery cancellations at the San Mateo hospital saved nearly half million dollars, the foundation said.
I’m all for better organization to decrease waste. But will the Toyota effect stop at improving filing systems and patient scheduling?
DeAnn McEwen, a health and safety specialist with National Nurses United, said lean management reduces nursing to a series of standardized tasks, as if nurses were robots applying nuts and bolts to identical patients.
“The problem with that is patients, of course, are not widgets and nurses are not robots,” she said. “And nursing care is not a commodity but a service. It’s a process that requires critical thinking and the application of judgment.”
The Health Care Blog agrees with that nurse that our increasingly industrialized health care system delivers less-than-excellent care.
Our greatest resource, people, are being encouraged to forget their art and their passion to become a cog in the process of producing average care.
All in the promise of caring for more people, reducing the costs to the healthcare system, and improving outcomes for patients. Yet the price that we pay continues to grow.
As prices continue to rise, so does the mediocrity.
Healthcare isn’t producing Lamborghini’s or even Toyota’s. Our hospitals are producing Geo’s (yes, I specifically picked an old unreliable unprofitable production of cars that is now obsolete).
At one point in time the workers in Detroit took great pride in meeting and/or exceeding all of their production targets, quality metrics, and process improvement goals….before they were replaced with fewer people and eventually machines.
We are certainly getting less face-to-face time with our health care providers. We are encouraged to access our health information online and communicate with our health care teams via email. Many are turning to telemedicine as a cheaper, more accessible form of health care.
We are being offered screening tests and procedures and drugs based on large population studies. What’s good for the many must be good for the one, right?
No, I’m a person, not a crowd, not a “cog.”
Personally, I agree with the second author. The industrialization of health care is going too far, and while it might increase a hospital’s efficiency and profits, will it really improve health care and health outcomes for its patients?
Something to think about.