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?

“Big Med.” — Atul Gawande, The New Yorker

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