I’m a big fan of Dr. Atul Gawande. No, I haven’t signed up for his Facebook page (I doubt he has one), but I really like his perspective on healthcare. He’s a surgeon at Brigham and Women’s Hospital in Boston, but Wikipedia describes him as an expert on reducing error, improving safety, and increasing efficiency in surgery.
He’s an excellent writer. His book “The Checklist Manifesto” was the inspiration for my post “The Customer Experience Checklist Manifesto.” If you’re working on patient experience or healthcare reform, then you should get to know his work.
I just read a fantastic article that he wrote in The New Yorker “Big Med: Restaurant chains have managed to combine quality control, cost control, and innovation. Can health care?” Gawande uses a recent experience at Cheesecake Factory, a restaurant chain that consistently delivers a wide variety of freshly prepared menu items to eighty million people per year, to draw a comparison with the current U.S. healthcare system. Here’s an excerpt:
“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 unreliable. Every clinician has his or her own way of doing things, and the rates of failure and complication (not to mention the costs) for a given service routinely vary by a factor of two or three, even within the same hospital.”
My take: Our U.S. healthcare system is broken. Without a clear focus on operational efficiency, repeatability, or accountability for results, the only thing that is guaranteed is escalating costs. But it doesn’t have to be this way. Look at how Aravind Eye Care revolutionized eye surgery in India. Gawande’s article also includes innovative practices such as Brigham and Women’s Hospital’s work to standardize the entire protocol for knee replacements and Steward Health Care System’s remote “command center” for its intensive care unit.
What does all of this have to do with patient experience? Everything. There’s no worse patient experience than an unsuccessful medical procedure, a procedure that you can’t afford, conflicting medical advice, or going though an unnecessary procedure. Unfortunately, our current healthcare system is set up to breed these types of experiences.
I recently republished my manifesto: Great Customer Experience Is Free. It seems to me that I could have also said that Great Patient Experience Is Free. Gawande shows that there’s enormous opportunity for both better outcomes and lower costs.
The bottom line: It’s time for a truly patient-centric healthcare system