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Big Med

What can hospitals learn from a national restaurant chain like Cheesecake Factory?

"'It is unbelievable to me that they would not manage this better,' Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. 'I don’t know anything about medicine,' he said. But when I pressed he thought for a moment, and said, 'This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.'

"This is not at all the normal way of doing things in medicine. ('You’re scaring me,' he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the 'best practices' are?"
PUBLISHED: Aug. 6, 2012
LENGTH: 39 minutes (9881 words)

Personal Best

Not long afterward, I watched Rafael Nadal play a tournament match on the Tennis Channel. The camera flashed to his coach, and the obvious struck me as interesting: even Rafael Nadal has a coach. Nearly every élite tennis player in the world does. Professional athletes use coaches to make sure they are as good as they can be. But doctors don’t. I’d paid to have a kid just out of college look at my serve. So why did I find it inconceivable to pay someone to come into my operating room and coach me on my surgical technique?
PUBLISHED: Oct. 3, 2011
LENGTH: 31 minutes (7913 words)

The Hot Spotters

Can we lower medical costs by giving the neediest patients better care? "The program, Fernandopulle told me, is still discovering new tricks. His team just recently figured out, for instance, that one reason some patients call 911 for problems the clinic would handle better is that they don’t have the clinic’s twenty-four-hour call number at hand when they need it. The health coaches told the patients to program it into their cell-phone speed dial, but many didn’t know how to do that. So the health coaches began doing it for them, and the number of 911 calls fell. High-cost habits are sticky; staff members are still learning the subtleties of unsticking them."
PUBLISHED: Jan. 24, 2011
LENGTH: 36 minutes (9005 words)

Letting Go

What should medicine do when it can’t save your life?
PUBLISHED: Aug. 2, 2010
LENGTH: 47 minutes (11989 words)

Testing, Testing

The health-care bill has no master plan for curbing costs. Is that a bad thing?
PUBLISHED: Dec. 14, 2009
LENGTH: 8 minutes (2058 words)

The Cost Conundrum

What a Texas town can teach us about health care.
PUBLISHED: June 1, 2009
LENGTH: 31 minutes (7755 words)