Atul Gawande’s recent New Yorker online article, Big Med: Restaurant chains have managed to combine quality control, cost control, and. In a new essay entitled “Big Med,” physician-author Atul Gawande muses in The New Yorker if The Cheesecake Factory and other successful. Re: Big Med: Restaurant Chains Have Managed to Combine Quality Control, this essay in The New Yorker, Harvard physician Atul Gawande outlines a model .

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I suggest the corporate model may not be the best model for health care. Gawande sees is simply a lack of communication, dissemination of information. Ernst trying to do the same in 4 ICUs with no systematic evidence of clinical gainthe Mario Negri achievement since is remarkable.

Gawande believes that standardization can and should be brought to areas of medicine, and that doctors can benefit from the same kind of training and coaching used in other industries. Have you looked into calorie count and portion size at Cheesecake Factory? The examples to feature of well-measured quality outcomes, clear protocols, well-coordinated teams, and incentives that reward better quality at lower cost are the remarkable achievements of Kaiser Permanente, Group Health of Puget Sound, the Veterans Health Administration, Marshfield, and Intermountain.

Network Fellow, Edmond J. Only then can they apply the best practices of leading innovators to ensure potentially transformative innovations are given every chance of success.

Big Med by Atul Gawande · Longform

If you are interested in our health care system, I recommend that you read the article. But the question we gawqnde to ask is what are we willing to give up in order to obtain the quality and experience we need at the prices we can pay? The problem is the American healthcare system is not a single corporation where a decision is made and, for better or for worse, the direction flows atyl the chain of command.


The rest is just there as infrastructure. To think that people get better quality of service from a blg like the cheesecake factory over a hospital is crazy. Few of bug have anything to do with the Cheesecake Factory and running a quality restaurant chain.

The reason is that even the most successful, well-regarded organizations tend to resist fundamental changes to their business model as the processes, systems, culture, rules, norms and metrics that have made them successful in the first place often aggressively support the status quo, even when the change in question seems highly compelling or inevitable.

How “Big Med” Trade-offs Can Transform Healthcare

The good news is that several major healthcare companies that Innosight has worked with have demonstrated that transformative innovations can be incubated and bog successfully despite the many pitfalls that exist. Our costs are soaring, the service is typically mediocre, and the quality is unreliable. As Gwande points out in his description of Dr.

Patients desperately need systems that are comprehensible, navigable and more importantly responsive to their needs. Take a fractured hip. Some types of elective surgery, such as hernia surgery, improve with standardization. But what else will fall through the cracks? Comments or opinions expressed on this blog are those of the individual contributors only, and do not necessarily represent the views of Gartner, Inc. They do not work on one station of the assembly line.

Gawande: Big Medicine Should Be More Like the Cheesecake Factory – Wes Rishel

The typical entrepreneur changes his game-plan four to five times before meeting with success. This requires diplomatically moderating the interface between the two.

In the future world of large and standardized healthcare juggernauts that Gawande describes, the patients and the physicians who are employed by them will be forced to make trade-offs by asking which dimensions of performance they are willing to give up to achieve the outcomes, experiences, and prices that everyone seems to want.

New menu items come along every six months, but the current batch has been in the pipeline for more than 18 months. In few other countries would are such relationships allowed to develop, for obvious reasons. Yawande Rishel is a vice president and distinguished analyst in Gartner’s healthcare provider research practice.


He makes several important observations about how standardization and oversight could improve health care.

Finding means to reduce unnecessary variability in procedure Finding means to reduce atuk variability in ingredients implants, medicines, etc. But, we need him, we need biig ideas and realistic assessment of what must come next in medicine in America. Practicality Exists Within Instability.

Now they are funded to teach ICUs in four other nations how to give better care to the sickest patients, but the United States is not among them. The truth is that very little is standard about health care. Or a bit further along the disruptive spectrum, how about forgoing clinic visits altogether if you can ibg with an expert via FaceTime whenever you wish and have every preventative test scheduled in your home or workplace at your convenience?

Indeed, Gawande posits that this nascent trend will inevitably take over large swaths of the system. Readers may copy and redistribute blog postings on other mrd, or otherwise for private, non-commercial or journalistic purposes, with attribution to Gartner. Time to talk to a diabetic patient about better diet? Large investment in training is the key to accelerated innovation.

What readers need to learn is how the organization of American medicine and incentives work against those good ideas. Eventually they will employ nearly all healthcare providers and will have enormous leverage on how medicine is practiced.