Tuesday, 8 May 2012

Toyota for you doc

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?


Taste the sampler menu of clinical lean by attending the Clinical Quality Improvement Course
Find some of the high level the outlining principles HERE


Vikas Kumar said...

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?



HEMADRI said...

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.

MedicinMan said...

What about "Checklist" advocated by Dr. Atul Gawande?

M HEMADRI said...

Thanks MedicinMan
Checklist is one aspect of a whole new system that is needed.