that while the business of medicine does sometimes make money, medicine cannot be run like a traditional business?
I can't possibly say it better than Dr. Whitecoat at WhiteCoat Rants. On his blog, he posts a link to an editorial by Kevin, MD, a response to Kevin's article, and Dr. WhiteCoat's own response to that response. Please go read all three. My blood is boiling.
Listen, all you MBAs and businesspeople who think that you've got a handle on how the "business of medicine" is going wrong: People are not egg timers. Diseases are not just broken cogs and gears to be fixed and then everything is good as new. You sometimes can't predict results of things--you may not be able to manage time or money in any predictable way when you're dealing with actual human beings on both sides (producer and consumer) of the equation.
Most things in business don't apply to medicine. Let's look at an example near and dear to my heart: Guitars.
I buy a guitar for $500. Is that the end of the story? No. I have to buy strings and picks if I intend to actually PLAY the thing, as opposed to just looking at it. I also have to get it "set up," or adjusted for optimum playing enjoyment.
If I take my guitar to any competent luthier (or "guitar fixer-upper"), I will undoubtedly see a sign that informs me that it costs $50 or whatever to just hand over my guitar so the luthier can tell me what's wrong with it. Even if I don't choose to have the guy DO ANYTHING, I still have to pay the $50. It's called a bench fee. If I don't pay the fee, I can't get my guitar back.
Apply that to medicine. If I have a medical problem, I can go to a doctor in the emergency room (or "people fixer-upper"). I don't have to pay anything to see that doctor, and if he fixes me up? I don't really have to pay him! Even if I don't have insurance! He's supposed to take care of me ANYWAY, because the law says so!
Yeah. That's really the same thing.
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4 comments:
our ER recently increased staffing, and guess what our Press Ganey scoreswent through the roof in a good way. Hmmm wonder why that happened LOL
About 12 years or so ago, there was a Total Quality Management craze sweeping through EMS and hospital medicine in general. I couldn't see it working for a couple of reasons.
As you say, people are not egg timers or tires. There are just too many variables to control. Plus the federal government has so many regulations that require actions that are contrary to good business practices that it would be impossible to follow those practices if you could figure out what they were.
Last, doctors are all for things like TQM as long as they don't have to follow them their selves. Nurse, Xray techs, and other peons (in the doctor's opinions) may have time for that foolishness, but doctors are way too important to follow silly rules.
Gary
Okay, point taken.
:-)
$500 guitar?? $50 Set-Up??? Not even $50 for a bench check these days. Are you talking 1972?
My doc checked me. I couldn't pay. He didn't give me back.
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