Toyota for you doc, what will it be for your patients?
In
a recent Medscape survey it was found that doctors’ choice of cars were as
follows: Toyota (16.73%), Honda (14.8%), Lexus (8.3%), BMW (7.5%), and
Mercedes-Benz (5.32%). Ford came in a very close sixth at 5.24%, and Chevrolet
came in eighth at 4.13%.
It
is apparent that 25% of doctors chose Toyota directly (since Lexus is
manufactured by Toyota) and 31.53% come from the the lean methodology
(since Honda also follows similar methods) constituting the top two car choices of American doctors. If other Japanese manufacturers were included it would be much more. It is a 2012 survey
that means the doctors were probably aware of Toyota’s problems from
2010.
Why
would doctor’s chose cars manufactured with lean methodology despite Toyota's recent
problems? It is possible that the doctors feel those cars are still highly
reliable despite the odd headline problems. The doctors are perhaps really
impressed with the degree of honesty with which Toyota has recalled to rectify
problems and the degree of humility shown in offering a public world wide
apology. It may be the case that Toyota, Honda and those who share their lean
philosophy still offer great value for money – doctors also do look for value for
money.
What
is fascinating is that the majority of doctors, the same doctors who like Toyota
lean methodology despite its problems, do not follow the healthcare adaptations
of lean methodology despite undeniably proven examples within America. Virginia
Mason is a small scale system and Intermountain is a large scale system that has
excellent versions of clinical lean (there are others too). There is huge
resistance to even begin to look at the methodology.
Human
beings and healthcare, are not cars and car manufacturing, so I do understand if
we did not want industry people directly applying their methods to healthcare.
Clinical lean and healthcare delivery lean is specific and different (as
practised at a few places in the world), the translation and adaptation has
already been done and fine tuned for nearly a quarter of a century. Clinicians
need to show the relevant leadership to make it work in their patch where ever
they are in the world.
It
is not too much to ask is it, to deliver value to your patient; the same or more
value that you expect from your car? I know patients are not cars and healthcare is godzillion times more complex that the automotive industry. That is why I talk about value creation and the application of healthcare specific lean (not other industry lean) from proven systems. Clinicians only have to learn and apply
clinical lean in healthcare – if you can learn and practice medicine with all
its complexity, applying clinical lean where possible, with its eventual elegant simplicity is a piece of cake. Or
is it?
©M HEMADRI
Taste
the sampler menu of clinical lean by attending the Clinical Quality Improvement Course
Find some of the high level
the outlining principles HERE
4 comments:
Dear Mr Hamadri
I really enjoy reading your thought provoking blog, which is so directly related to our business.
Whenever I read about any comparison of health profession with any other profession, one thing come in my mind can we apply the system directly from other profession or with some modification??? Don’t know….
Like in car business there is role of manufacturer but at the end consumer decide which car to buy and goes with pro and cones of that car.
I am not able to understand, when we compare health profession how to minimize the variability, which affect the out come of health system.
I understand this world is buying online system but I think in health care still we need to go to till and speak to sales man.
Need to give responsibility to consumer (patient) as well as along with choice.
I do not know I am able to understand and convey my thought or not?
Thanks
Vikas
Thank you Vikas Kumar for your kind words about the blog and your comments.
You are not alone. Most clinicians will find this new paradigm uncomfortable. There are high performing systems in other industries. Adapting them for healthcare is not easy. But it has been done, it can be taught and with some persistence it can be applied anywhere to reduce variability.
The patient of course has a choice and choose a poor performing system. As professionals we should of course always aim to be in the high performance zone.
What about "Checklist" advocated by Dr. Atul Gawande?
Thanks MedicinMan
Checklist is one aspect of a whole new system that is needed.
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