Industrialized Medicine

I have made the case over and over again about the dangers of industrialized medicine.   It is the exact opposite of “authentic medicine” which is the reason why I became a doctor.   You may have heard about Dr. Atul Gawande’s call for our healthcare system to copy the Cheesecake Factory’s method of business.  It was in The New Yorker and reading it made me nauseous.  If you need something to curb your appetite then, by all means, go ahead and torture yourself.

In medicine, too, we are trying to deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality. Unlike the Cheesecake Factory, we haven’t figured out how. Our costs are soaring, the service is typically mediocre, and the quality is un

Hey, doc, our costs are soaring for many reasons but mostly due to the overabundance of administrators who produce nothing.  They sit around trying to make sure hospitals follow the cumbersome regulations that pile up each and ever day.  This bureaucratic drag has not improved service, your second point,  and quality is in the eye of the beholder (and undefinable) and unproven as a way to make healthcare better.  But I digress.  Anyway,  the WSJ attacked this piece which makes me feel good but put too much of a political spin on it.   That just creates more divisiveness.   Yes, politics is part of this and Gawande is in Obama’s pocket but that isn’t the point.  Medicine is not about herding cattle.   Sure, we try to use evidence-based medicine each time we see a patient but we also use our common sense and education to know when to deviate.  Industrialized medicine doesn’t allow for that.  If the administrators/government had its way then our doctors would be replaced by computers and LELTs.  It just won’t work.

Lastly, if evidence-based medicine is so important to gurus like Gawande (and I agree we need to at least use it as a reference) then why doesn’t he point out that there isn’t good enough evidence to prove that industrialized medicine (P4P, quality metrics, etc) has helped or worked?