New Orleans Catching up on back issues of the New Yorker from my time off-the-grid, I stumbled onto a great piece by Dr. Atul Gawande on “Big Med.” Believe it or not, he shrewdly argues that huge service industry operations, like the Cheesecake Factory of all places, might just be the model for a different way of delivering healthcare more systematically, more inexpensively, and with higher quality because of standardization, training, and basic management.
Ok, I’ve eaten there maybe once or twice, but have never thought I might thank the Cheesecake Factory for saving my life. My first time, and the only one I can remember, is that this is the location where we had our joint Local 100 and Local 880 dinner for our delegates to the 2004 SEIU Convention in San Francisco. Seems now that we were simply 20 or so of the staggering 80,000,000 people that the Cheesecake Factory serves every year, but Gawande makes the point brilliantly that the Factory is just that, a factory, and as such has “brought chain production to complicated sit-down meals” where “the casual-dining chains reengineer” high end offerings “for affordable delivery to millions.” He asks the obvious question: “Does health care need something like this?” Instinctively, one answers, YES, and Gawande’s article based on not only cheesecake but also tele-supervision and health care, high-tech, high-touch operations working almost like airport controller centers to look over the shoulders of their doctor-nurse pilots, is persuasive.
Tearing our hair out as we dealt with my mother’s broken hip, one can totally identify with Dr. Gawande’s own experience of trying to find – in his case successfully – a orthopedic surgeon to handle his mother’s knee replacements. He was fortunate to find a radical in the field, and here is what is crazy, this doc was a radical because he believed in following best practices and standardizing the operation with a set of protocols, which yield better results. Scary and amazing at the same time that this should be the case!
Reading about the resistance of many doctors and others to having a remote double-check on their procedures and whether or not everything had been checked off the list for the patients was equally sobering. Once again the problem of professionals forgetting that the patients, their customers, the members, are what it is all about, and not themselves was at the heart of the problem.
It worries me that too often in the “service” industry the scale involved makes the population served voiceless, like in healthcare and a long list of other pursuits.
Worth the read!
