Hospitals Should Be More Like ... Cheesecake Factory
Atul Gawande argues for standardized health care
By Evann Gastaldo, Newser Staff
Posted Aug 6, 2012 1:30 PM CDT
Updated Aug 11, 2012 6:53 AM CDT
Atul Gawande thinks hospitals should be more like the Cheesecake Factory.   (Photo: Business Wire)

(Newser) – Medicine is plagued with inconsistency—different doctors have different preferred procedures; outcomes and costs are not predictable—and in an extensive New Yorker piece, Atul Gawande offers up a proposed solution: "Create Cheesecake Factories for health care." The doctor and author is serious—so serious that he spent time in a Cheesecake Factory kitchen to see how the chain restaurant serves up such diverse quality food so consistently. He asked a regional manager—who has had his own negative experiences dealing with health care for his mother—how he would implement Cheesecake Factory procedures in a medical setting. "This is pretty obvious. I’m sure you already do it," the manager said. "But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute." Nope, Gawande writes—hospitals, for the most part, don't already do that.

But that's starting to change, with an increase in large conglomerates comprising numerous hospitals and clinics, as well as the growing tendency of doctors to work for these conglomerates rather than remain self-employed. The idea of chain hospitals may scare some, but chains are successful for a reason, Gawande points out. "Size is the key," he writes. "It gives them buying power, lets them centralize common functions, and allows them to adopt and diffuse innovations faster than they could if they were a bunch of small, independent operations." Gawande takes a look at two people who are trying to increase consistency in health care: John Wright, who has cut both costs and recovery time by standardizing joint replacements, and Armin Ernst, who oversees ICU operations in 10 far-flung hospitals from an off-site control center. Such control centers could come to more hospitals—and though the idea of having a "kitchen manager" remotely overseeing your work is distasteful at first to many doctors, the end result will likely be better, cheaper, more efficient care. Click for Gawande's nearly 10,000-word article.

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Showing 3 of 22 comments
Aug 12, 2012 5:13 PM CDT
Wow ... it's interesting to see how much people dislike doctors. I work with a group of neurosurgoens who are the most kind, caring and compassionate individuals I have come across in a medical setting and I have a primary doctor who gives every patient as much time as they need. I know a general surgeon who gives her time for mission trips to other countries. I volunteer wtih doctors at free clinics who WANT people to be healthy and spend a lot of time counselling them on what to do differently so that can be accomplished. There are many, many Great doctors out there. But, there are also a lot of patients who are wanting to take the control out of the doctors hands because they "googled" and therefore know what's wrong wtih them. They think they know what surgery they need because this website said so, never mind that they don't have the correct symptoms for what their imaging shows. Or, people who come in who want a pill to take care of their problem when what they need to do is eat right, lose weight and stop smoking. sigh ... there are problems in more areas than just some doctors that give a bad name to the medical community. When a large corporation takes over a hospital and outpatient offices, it does dictate some of what goes on. But, it is the insurance industry that dictates if we can get another diagnostic image or if the patient gets an elective surgery that could take away some pain. It's the legal offices who go after indecently large sums of money that drive up medical malpractice insurance and thus, the rates people pay. There are some people who are on medicare and medicaid who think that they deserve to use this as a free for all instead of getting off their behinds and "working" at getting better. Yes ... there is more to reforming the medical problem than just slamming doctors. Let's start with tort reform, then welfare reform, insurance fraud reform, and, the biggest of all reforms, common sense reform ! Take charge of your health starting with your own habits and practices.
Aug 12, 2012 9:32 AM CDT
"It gives them buying power...". and thus savings... which they do not pass on to the patients.
Aug 11, 2012 4:32 PM CDT
Free refills?