Jerry Groopman is such an admirable person and has so much good to say that when he is off track, it hurts to see it. In a recent Article in the New England Journal of Medicine, he and Pamela Hartzband conflate two issues. One the one hand, there are their legitimate complaints about the depersonalization and attacks on professional judgment that derive from so much that is wrong with the health care system today. On the other hand, there is a complete misrepresentation of the tenets and application of Lean (or Toyota Production System) in clinical settings.
I'll not go through all the details. Mark Graban does that in excellent fashion here.
No, what hurts more is the fact that our clinical staff at BIDMC, where the authors reside, were overwhelmingly engaged in the the philosophy and practice of Lean--at least during the time I was there. What's more, they enjoyed it and found that it made their lives better. Indeed, Mark Zeidel, our Chief of Medicine, regularly offered many positive thoughts on these matters in his missives to his staff, called Kaizen Corner.
The same is true in many other hospitals and physician practices. I've told many of these stories in my companion blog, "This is Not 'Not Running a Hospital." Gene Lindsey has done the same on his blog posts.
In his marvelous book, How Doctors Think, Jerry explains the occurrence of diagnostic anchoring among physicians, noting the power of confirmation bias--the tendency to see and believe evidence that supports your view and ignore facts that don't. I fear that this NEJM article is infected by this cognitive error.
I'll not go through all the details. Mark Graban does that in excellent fashion here.
No, what hurts more is the fact that our clinical staff at BIDMC, where the authors reside, were overwhelmingly engaged in the the philosophy and practice of Lean--at least during the time I was there. What's more, they enjoyed it and found that it made their lives better. Indeed, Mark Zeidel, our Chief of Medicine, regularly offered many positive thoughts on these matters in his missives to his staff, called Kaizen Corner.
The same is true in many other hospitals and physician practices. I've told many of these stories in my companion blog, "This is Not 'Not Running a Hospital." Gene Lindsey has done the same on his blog posts.
In his marvelous book, How Doctors Think, Jerry explains the occurrence of diagnostic anchoring among physicians, noting the power of confirmation bias--the tendency to see and believe evidence that supports your view and ignore facts that don't. I fear that this NEJM article is infected by this cognitive error.
