|Source: The New Yorker|
Physician practice has traditionally allowed for near complete autonomy. The result? Significant variation in practice and little standardization of care. This can result in costly care with a high risk of error and adverse events.When clinical pathways, safety checklists or other standardized practices are suggested, there is frequent push back from practitioners.
Medicine is nuanced and all patients are not the same, yet, there is a role for standardization of care. By using clinical pathways, safety checklists and comprehensive unit safety programs (CUSP), medical care can be made more appropriate, better coordinated, efficient, less costly and safer. Even with greater standardization, medicine will undoubtedly remain an art, as providers will still need to recognize and respond to nuances in patient condition and deviate, accordingly, from routine care.
Here is an article by Atul Gawande, published in the New Yorker, exploring the Cheesecake Factory model of medical care.
The argument is persuasive and the model proposed may represent the future of medical practice.