An interesting commentary (P Hartzband, J Groopman. NEJM 2016; 374: 106-8) explains the history of trying to achieve better efficiencies in medicine and some of the problems with this.
Frederick Taylor has been described as the “father of scientific management” and the original “efficiency expert.” He supported the notion that there is one best way to do every task. This was initially applied to car production but there have been attempts to adopt this idea into medicine. The authors make several key points:
- “The standardization integral to Taylorism and the Toyota manufacturing process cannot be applied to many vital aspects of medicine”
- “There is a certain hypocrisy among some of the most impassioned advocates for efficiency and standardization…they all want a different kind of health care for themselves and their families than they profess for everyone else. What they want is what every patient wants: unpressured time from their doctor or nurse and individualized care rather than generic protocols for testing and treating.”
- “Medical Taylorism began with good intentions — to improve patient safety and care. But it has gone too far…we must reject its blanket application…Good medical care takes time, and there is no one best way to treat many disorders.”
Zika NEJM Link (full text): Zika Virus in the Americas Anthony Fauci/David Morens
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